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?

Both women and men suffer from infertility troubles. There are a host of causes that may lead to infertility in men such as lifestyle choices and obesity. Male infertility is characterized by irregular sperm function or reduced sperm count. Infertility has emerged as a common problem as a result of the modern day lifestyle. Extremely hectic schedules, stress, burnout, depression, unhealthy diets; all of these can contribute to fertility issues.

The various reasons for infertility in men are:
1. If you are overweight, then it is time to lose those extra kilos. Obesity leads to a number of health problems, one of them being erectile dysfunction.
2. Various hormonal problems such as complications of the hypothalamus, pituitary and adrenal glands may lead to low testosterone levels in the body.
3. Various infections such as inflammation of the testicles and epididymis that causes blockage of the tubes carrying the sperm can be a cause.
4. Various medications such as using anabolic steroids, antifungal medications and chemotherapy may hamper production of the sperm and thus hit fertility.
5. Both alcohol and cigarettes may cause problems in sperm production, and cause erectile dysfunction. Excessive drinking may lead to complications in the liver resulting in infertility.

The reasons of infertility may range from medical causes to lifestyle choices; some of the causes may be related to the environment. A common cause of infertility is due to problems with transportation of the sperm. These are mainly due to blockages in the tubes that carry the sperm.

Symptoms of infertility in men are:
1. You may experience low libido
2. Your sperm count may be low
3. You may experience lumps or swellings in the testicles
4. Chromosomal complications such as reduced body hair
5. You may have chronic respiratory problems.

What Causes Infertility in Men?

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

Infertility is a very common problem among both men and women and it refers to the inability to conceive even after regular unprotected sex. The causes of this can be varied and some of the most prominent ones are:

Causes in Women:

1. Polycystic ovarian syndrome

PCOS is a medical condition in women in which they do not ovulate. It is a major cause of infertility in most women. It can often result in irregular menstruation and an increase in the release of male hormones in the female body. This causes male symptoms like the growth of a beard, hoarse voice etc. in females. The probable causes of this condition comprise being over or under weight, thyroid imbalance etc. It is possible to treat this condition with medical aid and weight management can also prove to be helpful.

2. Lack of sufficient healthy eggs

As you grow in age, the number and health of your eggs decline significantly. This could be a possible reason for your infertility. In this condition, optimizing egg health by maintaining a healthy weight and quitting alcohol and cigarettes can help you get rid of your infertility.

3. Blockage of the fallopian tubes

Blockage of or damage to the fallopian tubes causes the tubal factor that is responsible for infertility in women. The tubal factor can also be a result of endometriosis or any sexually transmitted disease like Chlamydia etc.

Causes in Men:

1. Ejaculatory disorders

Retrograde ejaculation, premature ejaculation, and other issues associated with ejaculation may cause infertility in men. In retrograde ejaculation, the semen enters the bladder instead of emerging out of the penis during orgasm. In premature ejaculation, the ejaculation occurs before the vagina is prepared to receive the semen.

2. Chromosome defects

Disorders like Klinefelter's syndrome can cause abnormal growth of the male reproductive organs resulting in infertility. Other such syndromes include Kallmann's syndrome, Karatagener's syndrome, cystic fibrosis etc. These conditions are mostly genetic.

3. Hormonal imbalance

Male infertility can also be a result of hormonal imbalances like hypogonadism (low testosterone levels), disorders of the testicles, abnormal functioning of the pituitary, thyroid, adrenal and the other glands as well.

6 Common Causes of Infertility That are also Curable

One of the most important decisions a couple takes is to start a family. It fills them with hope and joy of new future, but if the attempts have been unsuccessful for more than six months, it can take a toll on the relationship and the mental health of the couple. This is the time to seek fertility specialist who will be appropriate to analyze the situation and provide proper guidance. Read on to find out the exact indications to see a fertility specialist:

1. If a woman who is under the age of 35 is unable to get pregnant even after a year of having regular unprotected sex
2. A woman who has had more than three miscarriages
3. Someone who has suffered from blocked fallopian tubes and is in need of surgery
4. One who experiences irregular ovulation
5. A couple who has suffered from genital infections
6. A pregnant woman who has consumed an estrogen derivative
7. A man who has been diagnosed with low semen count, also known as poor motility
8. A couple who has not been diagnosed with any irregularity but is infertile

Which specialist should you visit?

If you or your partner or both have shown signs of infertility, then visiting the following specialists can be helpful:

Specialists for men

Urologists and Andrologists are specialists who treat men for infertility. Urologists conduct an analysis of semen quality, semen count, hormone levels, reproductive organs and abnormalities in bladder and kidneys. Andrologists are medical professionals who specialize in hormonal conditions and physiology of male infertility.

Specialists for women

Hormonal imbalance is one of the potent obstacles to pregnancy. If a general obstetrician/gynecologist has not been able to successfully treat a woman then she can visit a reproductive endocrinologist who specializes in hormonal disorders. Depending upon the nature of the problem, she can also visit a reproductive surgeon who deals with uterine abnormalities, endometriosis, and reproductive organ surgery.

When Should a Couple See a Fertility Specialist?

It's normal to be concerned with your fertility after early miscarriage. Many couples want to try to conceive again right away, while others need time to heal. Ultimately, though, fertility following a miscarriage is an issue of concern for most couples.

Once you are ready to start trying for a child again, there are a number of things you can do to increase your chances of having a successful pregnancy.

Rest and Recuperate- Many women want to hurry and start trying to get pregnant again right away after their miscarriage. This is a perfectly normal response, but may not be the best way to guarantee a healthy pregnancy. Give your body a chance to rest so your menstrual cycle can get back to normal. You also want to give yourself plenty of time for your mental balance to return so you are ready to take on the trials of trying to become pregnant. Be gentle and give yourself time to rest and focus on taking care of your physical and emotional needs until you are ready to try again.
Change Lifestyle- Eliminating unhealthy habits can help increase your chances of conceiving later. Eliminate drug or alcohol use and quit smoking before you start trying for pregnancy. Cutting down or eliminating caffeine can also help you conceive a healthy pregnancy.
Eliminate Stress- Eliminating stress can also make conceiving easier. Stress can reduce fertility levels, making it harder to get pregnant. Practicing meditation, yoga or taking time to relax after dealing with tough issues in your life can make it much easier to conceive.
Eat Healthy- Eating a healthy diet is also essential to having a healthy pregnancy. This can also help women manage the depression caused by their miscarriage. Getting a variety of vitamins and minerals and cutting down on saturated fats and processed foods can help you get pregnant and maintain a healthy pregnancy.
Take Fertility Drugs or Therapies- There are various fertility drugs and therapies on the market today. Your doctor will prescribe different medications based on your overall health and age.
Use an Ovulation Predictor- An ovulation predictor can help you map out your cycle. This will allow you to determine which days in your cycle will be the most likely for you to conceive. 
Support the Uterus and Liver- Performing a fertility cleanse after your period has stopped can help support the uterus and liver, promoting overall fertility health. Sometimes stagnant blood can get left behind after your period which can cause discomfort or health issues. Following a fertility diet to help rid your body of the excess blood and hormones in your system can help your conceive more easily.
Massage the Uterus- When you have stopped bleeding after your miscarriage, performing a uterus massage can help your body relax. This massage will help bring fresh blood to the area and soothe the body so you can relax. 
If you have been having trouble conceiving it may be time to talk to a fertility expert. Your doctor can perform fertility tests on you and your partner to determine if there are any underlying issues present. Then you can work together to determine if any additional medical treatment is necessary to help you get pregnant.

Ways to Increase Fertility after Miscarriage

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