Infertility is a condition wherein a woman does not get pregnant in spite of having unprotected intercourse over a period of a year or even more. An abnormal menstrual cycle that is either too short or too long, irregular or even scanty can be an indication of a lack of ovulation, which in turn, is another factor behind female infertility.

Causes

Ovulation disorders are characterized by either a lack of ovulation or irregular and infrequent ovulation. These are a major cause of infertility. This may be due to defects in the regulation of the reproductive hormones by the pituitary gland or the hypothalamus (brain center responsible for producing some of the most essential hormones required by the body). Malfunctioning of the ovary is another cause in itself. Polycystic Ovarian Syndrome, premature failure of the ovaries (a condition wherein a woman s ovaries fail to function properly even before she is 40 years old), hypothalamic dysfunction (a dysfunction of the hypothalamus) and excessive production of prolactin (a hormone that stimulates milk production among women after childbirth) by the pituitary gland are some of the factors responsible for the occurrence of such a disorder.

Damaged fallopian tubes do not allow the sperms to fuse properly with the egg. They might also prevent the fertilized egg from entering into the uterus. This condition may be caused due to pelvic inflammatory diseases (a group of infections of the reproductive organs in women), an infection in the fallopian tubes or the uterus caused due to various Sexually Transmitted Diseases, any abdominal surgery or surgery of the pelvic region and pelvic tuberculosis.

Endometriosis, wherein the tissue that usually grows in the uterus, starts growing outside it, is another factor responsible for infertility.

Several cervical or uterine disorders, such as tumors, inflammation within the uterus, uterine abnormalities, a cervical narrowing or the inability of the cervix to produce mucous for the sperm to travel to the uterus, are likely to impact fertility by obstructing implantation or enhancing the chances of miscarriage.

Treatments

Fertility drugs can be used to regulate and induce ovulation. But they carry with them certain risks and therefore you should consult your physician prior to consumption. Few examples of these drugs are Clomiphene Citrate, Gonadotropins, Metformin, Letrozole and Bromocriptine.

Surgical procedures can be recommended to correct reproductive abnormalities and restore fertility. A laparoscopic surgery or a tubal ligation reversal surgery (a surgery that unites one s fallopian tubes again in order to enable the woman to have a baby) can be advised by the doctor.

Reproductive assistance by Intrauterine insemination (a process that involves putting sperms inside a woman s uterus in order to help her conceive) and Assisted reproductive technology (consisting of IVF and surrogacy).

Infertility - 4 Causes Behind It

While some couples conceive with ease, conceiving a child can be extremely difficult for others. In cases where a woman is not able to get pregnant despite having regular intercourse in tune with her biological cycle, infertility tests may be suggested to investigate the reason behind this. In most cases, these tests are suggested if a year has gone by without intercourse resulting in a pregnancy. Women may also be said to be infertile, if they cannot carry a foetus to full term. 

Infertility can affect both men and women and can be triggered by a number of different reasons. In some cases, it is treatable while in others, alternative ways of having a family may need to be discussed. Hence, it is very important to understand the different types and triggers for infertility and to undergo complete infertility investigations. Some of the common types of infertility investigations are as given below.

Blood tests: A blood test of both partners is used to assess the general health of the couple and to identify any health factors that may be impeding fertility.
Tests for women: 
Hysterosalpingogram: This is an X ray that can identify if a blockage or any other issue in the fallopian tubes are the cause for infertility.
Pelvic ultrasound: This is used to have a look at the anatomy of the female reproductive system and to check for fibroids.
Laparoscopy / hysteroscopy: This is used to get a clearer picture of the ovaries, uterus and other parts of the reproductive system.
Tracking cycle: Ovulation and the thickness of the uterus lining may also affect infertility, This can be diagnosed by tracking and assessing the menstrual cycle.
Tests for men
Semen analysis:This test is used to get an idea of sperm concentration, motility and the appearance of sperm in a man s semen. In some cases, the semen may not include any sperm cells. In such cases, a follow up investigation may be required to assess if sperm cells are being created in the testicles. This is known as testicular sperm aspiration or a testicular biopsy.
Sperm DNA: The DNA in sperm also plays an important role in fertility. This test is used to assess the sperm DNA integrity and to see how it may affect embryo development and chances of an on-going pregnancy.
Infertility treatment depends on the cause identified by the above tests and hence it is important for both partners to undergo complete testing.

Complete Infertility Investigation - Why is It Important?

There are some commonest misconceptions about infertility and these misconceptions should be eliminated as soon as possible so that the actual facts can be known. There are many online sites where you can find detailed information on the scientific explanations regarding infertility and you can follow them.

List of myths and facts regarding infertility

1. Myth: The menstrual cycle of a woman is for 28 days.
Fact: Normal cycle ranges between 21 to 36 days.

2. Myth: A woman can have pregnancy on the day one of menstrual cycle.
Fact: The released eggs remain viable for almost 12-14 hours and a woman can get pregnant after an intercourse done two days after ovulation and five days before ovulation.

3. Myth: Infertility occurs due to stress.
Fact: Ovulation can surely get delayed due to hormone suppression, but infertility does not occur due to stress.

4. Myth: Sperms stay active for few hours.
Fact: Sperms stay alive at least for five days.

5. Myth: Men with a higher sexual drive will have a normal sperm count.
Fact: There is no relation in between fertility and virility. Sometimes, it has been found that men having a higher sex drive do not produce sperms.

6. Myth: Women have to wait for three months to conceive after stopping the usage of contraceptive pills.
Fact: As soon as a woman stops pill usage, hormonal levels go back to normal condition, as a result of which ovulation begins immediately.

7. Myth: Only females have infertility troubles.
Fact: Both women and men suffer from infertility troubles as per the current scientific studies.

8. Myth: Ovulation occurs in a woman on the 14th day of menstrual cycle.
Fact: Ovulation can be calculated by counting 14 days backwards from the past menstrual cycle's last day.

9. Myth: Daily sex can increase conceiving chances.
Fact: During ovulation, having sex each day, especially in between 12 to 16th day of the cycle can be the best timing.

10. Myth: Fertility troubles occur at 35.
Fact: Peak fertility timing in a woman's life is 20 and this might continue until late 30s. Fertility troubles might even arrive at a younger age. With age, conception chances get declined, especially after 35.

Myths & Facts About Infertility

Common causes of infertility in Women

Fertility in women can be affected because of various external or internal reasons. It is good to understand the problems since this fast becoming a very common problem. 

The causing factors usually include - 

1. Ovulation problems - One reason for female infertility is when eggs don't mature in the ovaries. This is known as ovulation problems. Possible symptoms of this are absent or irregular periods and the possible solution is keeping a check on body weight, taking fertility drugs and/or having IVF.

2. Uterus problem - There are tissues, known as endometrial tissues which form the lining of the uterus. When they grow outside the uterus, it is called endometriosis and can be a reason for infertility. While some women have no symptoms of this, some have painful periods. Fertility drugs, ivf and surgery to remove the tissue are its possible solutions.

3. Pcos - Pcos or Polycystic Ovarian Syndrome is of late one of the most common reasons of female infertility. It is characterised by unpredictable ovarian patterns and hormonal imbalances. Possible symptoms are acne, obesity, irregular periods, and excessive hair growth. Weight loss, changes in lifestyle, injected fertility drugs, ivf and ovarian drilling are its possible solutions.

4. Damaged fallopian tubes - Some women have blocked or damaged fallopian tubes which prevent the sperm from getting to the egg. This situation leads to stds and pelvic inflammatory diseases. There are no symptoms as such and the methods of solution are surgery to open the tubes and if that is not possible, to remove the tubes and try ivf.

5. Unidentified reasons - There are many unexplained fertility problems where none of the above mentioned problems exist. In such situations, fertility drugs - with or without artificial insemination or ivf are advised.

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5 Major Causes Of Infertility In Women

Female infertility is considered as the inability of conceiving. As per WHO it is described as the inability to be pregnant, maintain and carry forward a pregnancy to its full term. It is often of two types:

    Primary Infertility: This is the inability to give birth to a baby either due to the inability to become pregnant or maintain a pregnancy, which includes stillborn and miscarriage.
    Secondary Infertility: This refers to the inability to give birth when there is already a live birth or the woman was pregnant.

The causes of infertility can vary from being acquired or genetic. However, following factors are largely responsible for infertility:

    Genetic: Some genes can lead to mutation leading to infertility like, in case of BMP15 gene there is a hypergonadotrophic ovarian failure which causes infertility.
    Acquired: This is caused by factors like age, smoking, sexually transmitted diseases, obesity, body weight, eating disorders, diseases like diabetes, thrombophilia and also radiation and chemotherapy.

The treatment for infertility usually depends on the cause, age, duration of time for which a person has been infertile and preference of the patient. Infertility is believed to be a complex disorder and the treatment involves a huge amount of physical, financial and psychological commitments. All this also requires a lot of time. Some women might need just a minimum of two therapies to attain fertility while others might require different treatment before they can conceive.

Treatment is largely aimed to restore the fertility either by means of medication and surgery or help in reproduction with the help of some procedures.

Fertility Restoration through medication

This is the main treatment for women who are infertile because of ovulation disorders. These drugs include:

    Gonadotropins: These are injected to stimulate the ovaries. Drugs like Menopur, Repronex, Follistim AQ, Gonal-F, Bravelle restore the production of eggs, while Ovidrel and Pregnyl are used for maturing the eggs and for their release.
    Clomiphene citrate: This is taken orally and stimulates ovulation by releasing more Follicle Stimulating Hormone and Luteinizing Hormone from the pituitary gland.
    Metformin: This is used in females who have PCOS and also when insulin resistance plays a major role in infertility.
    Bromocriptine: Used when the infertility is caused due to excess prolactin production.
    Letrozole: This also induces ovulation

Fertility Restoration through surgery

Surgical procedures can amend the problem of infertility. However, these treatments are very rare these days owing to the success of other fertility treatments. These include:

    Tubal ligation reversal surgery: In case a tubal ligation has been performed it can be reversed by reconnecting the tubes again through surgery.
    Hysteroscopic surgery: This corrects or removes the abnormalities that cause infertility. This surgery can correct the shape of the uterus, remove endometrial polyps and improve chance of getting pregnant.
    Tubal surgeries: In case of blocked fallopian tubes laproscopic surgery can be performed to dilate the tubes, removed blockages or create a new opening.

Assistance in Reproduction through techniques

The most common used techniques for reproduction assistance are:

    Intrauterine insemination or IUI: In this about million healthy sperms are put in the uterus at the time of ovulation.
    Assisted reproductive technology: In this mature eggs are retrieved from a woman and this is then fertilized with sperms in a dish in the lab. Once the fertilization is done the embryo is placed in the uterus for further development. IVF is the most common and effective assisted reproductive technology. This procedure takes place over weeks with several blood tests and hormone injections.

Dealing with infertility is not easy and can be emotionally and physically draining. To cope with the various tests and treatments of infertility one should be fully prepared, eat a healthy diet, exercise reach out for help and support of family and friends and look for other options like a donor egg, adoption or no children.

Treatments of Infertility

Disregarding genital tract infections and issues including the symptoms of the same can lead to problems when it comes to fertility. It may also cause problems in your sexual life. Genital problems can also lead to infertility. These days, infertility is a noteworthy and very important occurrence that plagues many couples.

Common Infections: A large portion of these genital tract diseases occurs because of infections. Salpingitis happens in close to 15% of ladies in their reproductive age and 2.5% of all ladies get to be infertile as an aftereffect of salpingitis by age 35. Many times, symptoms of conditions and STDs like Chlamydia trachomatis are usually nonexistent. The real rate of ladies with upper genital tract infections is presumably underestimated.

Infection and Infertility: Infectious agents can hinder different vital human functions, including reproduction. Bacteria, fungi, infections and viruses can meddle with the reproductive capacity in both genders. Diseases of male genito-urinary tract represent around 15% of the instance of male infertility. Diseases can influence distinctive areas of the male regenerative tract, for example, the testis, epididymis and male sex organs and glands. Urogenital diseases at various levels of their advancement, development and transport can affect the sperms themselves in this manner. Among the most widely recognized microorganisms required for sexually transmitted diseases, meddling with male fertility are Chlamydia trachomatis and Neisseria gonorrhea.

Symptoms: If the following symptoms of a genital tract infection are ignored, it can definitely lead to the person being infertile in some stage of life or immediately. These are as follows:

The signs and symptoms in males are

Changes in the way you discharge
Bleeding while urinating or discharge
Thick white, yellow or green release from the tip of the penis along with pain in urethra or pain while urinating
A hard but painless sore on the penis along with swelling of the lymph hubs in the crotch
Pain or uneasiness while urinating or discharge from the urethra
Difficult or irritated red spots and small blisters on the penis
Chestnut bits on the hair around the penis
Gentle delicacy around one of the testicles
Delicate swelling in the scrotum on one or both sides
Extreme pain after injury to your penis
The signs and symptoms in women are as follows:

Irregular vaginal discharge with a pungent smell
Burning sensation while urinating
Tingling or itching in the outer area of vagina
Uneasiness and pain during sex
Sore vagina
Foamy greenish-yellow discharge with a foul smell
Light bleeding after intercourse
Warts in the vagina
Regular check-ups and visits to the gynecologist are very essential. One should always keep the partner updated about their sexual health problems to practice a healthy and honest relationship and to avoid further contagious infections from occurring.

Can Genital Tract Infections Lead to Infertility?

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