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Infertility is the incapability of a couple to conceive after indulging in unprotected sex multiple times over a long period. It can also be referred to as the biological inability of a man to cause conception or a woman to conceive as well as being unable to carry the pregnancy for the whole duration. Research has shown that female problems contribute to over half of all the infertility cases.
Causes of infertility in include:
Ovulation Disorders – This is regarded as the most common cause of infertility in women. The disorders can be caused due to conditions like PCOS (polycystic ovary syndrome), Premature ovarian failure, poor quality of eggs, overactive or underactive thyroid gland and chronic conditions like cancer or AIDS.
Problems in fallopian tubes or uterus – Abnormalities in the uterus or fallopian tubes render the woman incapable of conceiving naturally. This might be due to conditions like Endometriosis, previous sterilization treatments or surgeries to correct past problems.
Medications or Treatments – There is a possibility of some treatments affecting infertility. Examples include NSAIDs (non-steroidal anti-inflammatory drugs), Chemotherapy and Radiotherapy.
Usually, the initial steps for diagnosing infertility involve a review of the complete medical history of the patients as well as a physical exam. Post this check-up, some diagnostic tests are conducted for infertility. This might include-
Blood and Urine tests: For checking hormone levels.
Pap smear:For checking the health of your cervix.
X-ray: For outlining the internal shape of the uterus so that blockages in fallopian tubes can be identified.
Age – Increasing age tends to lower the quality as well as the quantity of a woman's eggs
Smoking – Besides damaging your cervix and fallopian tubes, smoking increases your risk of miscarriage. It is also believed to deplete your eggs at a premature stage, thereby reducing your chances of pregnancy.
Weight – Normal ovulation is hindered by being overweight or even significantly underweight. This is because lower levels of BMI (body mass index) reduces the frequency of ovulation, reducing the chances of pregnancy.
Sexual history – Sexually transmitted diseases like gonorrhea and Chlamydia can cause damage to the fallopian tubes, resulting in infertility.
Even though it is possible to restore fertility in women using only one or two therapies, a number of treatments might be required before conception is possible. Some of these treatments include:
Intrauterine insemination (IUI): deliberately introducing sperm into the uterus of a woman for achieving pregnancy.
Stimulating ovulation with fertility drugs.
Surgery to restore fertility.
In situations where pregnancy does not happen spontaneously, Assisted Reproductive Technology (ART) can be used by couples to achieve a pregnancy. It is any form of fertility treatment which involves the handling of sperm and egg. The entire ART team consists of psychologists, physicians, embryologists, nurses and lab technicians.
One common ART technique is In vitro fertilization (IVF). It is a process where an egg and sperm are manually combined in a laboratory dish, followed by transfer of embryo to the uterus.
As much as as physical intimacy is pleasureable at the same time it also affects the health of the woman's reproductive organs in a number of different ways during intercourse. A few of the effects and factors responsible for these effects are listed as below:
- Vaginal secretion: When you are aroused during sex, the blood vessels supplying the vagina expand immediately. The blood flow increases to lubricate the vaginal walls (rugae). The rugae unfold and the space increases. These secretions are important because, women who are sexually inactive for a long time at a stretch, experience dryness that leads to urinating difficulties and rashes.
- Unusual discharge: Apart from natural lubricants, vagina secretes some fluids, the process being termed as 'female ejaculation'. A tiny amount of white fluid made of prostate plasma cells, is produced just before you climax and discharged with some quantity of urine. Sometimes, prostatic specific antigen (PSA) and prostatic acid phosphatase (usually found in semen) are also found in the secretion.
- Changing size of the vagina: The vagina is designed to be elastic and adjustable. So, no permanent change in size is possible but it does undergo temporary changes in sizes as effects of sex. The inner walls of the vagina enlarge during sexual intercourse and during childbirth. Tissues in the clitoris puff out and harden, this also causes an expansion in size. It takes a while to get back to its normal size.
- Vaginal pain: A lot of women report the experience of pain and discomfort inside or around the vagina during and immediately after sex. The pain can result from repeated sex within a short period of time or reduced secretion of natural lubricants. If the pain is too severe, you should see a doctor because yeast infections or chronic vulvodynia can also be responsible for the pain sensation.
- Infections in the urinary tract: The friction caused by sexual intercourse may cause small cuts which enable bacteria to pass from the vagina to the urinary bladder through the urethra. This causes infection in the bladder, the urinary tract and the vagina. These can be avoided by using a condom or by urinating before and after having sex.
There are two types of abortion, namely medical and surgical. In case of medical abortion, pills are taken to terminate the pregnancy; whereas, surgical abortion is done if the pregnancy has reached an advanced stage when pills are ineffective. While generally there are no health risks or negative effects of abortion on fertility, there are rare cases of complications, which can give rise to severe symptoms post abortion. Following is the information you need to know about abortion and its effects on fertility:
When to seek medical assistance:
It is advisable to seek medical help if you have the following symptoms post abortion:
- Persistent pain in the lower abdomen, which lingers even after taking medication
- Excessive bleeding
- A high temperature
Possible effects of surgical abortion on fertility:
- Infection after abortion: Infections post abortion like Pelvic Inflammatory Disease (PID), if left untreated for long can spread and harm your reproductive organs, thereby impacting your fertility. It can cause complications like infertility or ectopic pregnancy.
- Damage to the cervix during abortion: Damage to the cervix during an abortion can cause cervical incompetence and consequently increase the risk of miscarriage.
- Damage to the womb during abortion: There are chances of damage of the womb (uterus) during abortion, resulting in scarring, which can cause fertility issues if not corrected. This is more likely in case you had multiple abortions.
Apart from the above mentioned complications there are a number of other complications, which can happen due to abortion, preterm birth, vaginal bleeding during pregnancy and low birth rate, etc. Further, infertility can also be a possible side effect of abortion pills, which happens due to scarring of the uterus during the procedure of forcible elimination of the fetus. In all such cases it is advisable to schedule regular check up with your gynaecologist.
Intracytoplasmic Sperm Injection i.e. ICSI is different from conventional IVF i.e. In Vitro Fertilization because a single sperm is selected by the embryologist to be injected by a needle into the egg rather than a dish with many sperms placed near the egg so that the fastest swimming sperm enters it. Once the sperm is injected directly into the egg, it fertilizes, after which the embryo is transferred into the womb or uterus.
Your doctor might recommend ICSI treatment for you if you have an extremely low sperm count resulting in infertility or other medical sperm conditions such as poor motility or poor morphology. It may also be suggested if prior attempts at IVF procedures have failed in fertilizing the egg or the fertilization rate is extremely low. You must also consider ICSI treatment if you resort to embryo testing or if the sperm needs to be collected from the epididymis or testicles surgically.
However, you must keep in mind that if your partner has a genetic problem resulting in low sperm count, it could be passed on to your child, if you decide to use your husband's sperm for this process.
Success Rates of ICSI:
The success rate of ICSI treatment depends on your age and your fertility problem. Your eggs are healthier when you are young and as you age, chances are that they will become less healthy.
- 35 per cent if you are under 35 years of age
- 29 per cent if you are between 35 to 37 years of age
- 21 per cent if you are between 38 to 39 years of age
- 14 per cent if you are between 40 to 42 years of age
- 6 per cent if you are between 43 to 44 years of age
- 5 per cent if you are above 44 years of age
Advantages of ICSI Treatment:
Intracytoplasmic Sperm Injection gives you a chance to conceive a child genetically when most other options are exhausted. Males may be unable to ejaculate on the day the eggs are collected due to anxiety. ICSI proves to be advantageous because sperm may also be surgically extracted for this process. It is extremely helpful for those couples who suffer from unexplained infertility. However, one of the most important factors is that ICSI treatment does not affect your child's physical or mental health.
All you need to know about infections of the uterus, vagina and cervix
The uterus, vagina and cervix are major components of the female reproductive system. Their functioning impacts the overall growth and health of the female body as well as sexuality.
There are a number of infections and diseases that affect the female reproductive organs. Most cases require clinical care and treatment in consultation with a gynaecologist.
Following are the symptoms of infection in the uterus, cervix or vagina:
- pain or numbness in the pelvic region
- unusual discharge from the vagina
- bleeding during or after intercourse
- pain or burning sensation during urination
- skipped periods
- excessively painful menstrual cramps
- nausea and vomiting
- urinary incontinence
There are three main types of infections that affect the organs of the female reproductive system. They are as follows:
This is an infection that affects the vagina. It occurs when the walls of the vagina get inflamed and irritated. It is caused by bacteria, viruses, yeast, chemicals and even clothing. It often occurs due to sexually transmitted diseases (STDs). The different types of infections that occur as vaginitis are yeast infection, viral vaginitis, bacterial vaginitis, trichomoniasis vaginitis, etc.
This infection affects the cervix. Cervicitis can either be acute or chronic in nature, depending upon what causes the cervix to get inflamed. It occurs most commonly due to sexually transmitted infections such as gonorrhoea, chlamydia and herpes. This condition is often confused with vaginitis as the two have similar causes and symptoms.
3. Pelvic inflammatory disease
Pelvic inflammatory disease (pid) is a serious infection that affects the uterus, ovaries and fallopian tubes. It is caused by sexually transmitted infections like chlamydia and gonorrhoea and can lead to severe complications. It often causes scar tissue to grow between the internal organs and may even lead to ectopic pregnancy. If not properly diagnosed, it can cause infertility and other chronic problems.
Treating the various infections that affect the female reproductive system depends on a number of factors such as nature of the problem, age and medical history of the patient, and the root causes. Early detection and diagnosis ensure effective treatment which makes it important to see a gynaecologist at the onset of symptoms.