Infertility is defined as the inability to achieve pregnancy after one year of regular, unprotected intercourse. Evaluation may be initiated sooner in patients who have risk factors for infertility or if the female partner is older than 35 years. Causes of infertility include male factors, ovulatory dysfunction, uterine abnormalities, tubal obstruction, peritoneal factors, or cervical factors. A history and physical examination can help direct the evaluation. Men should undergo evaluation with a semen analysis. Abnormalities of sperm may be treated with gonadotropin therapy, intrauterine insemination, or in vitro fertilization. Ovulation should be documented by serum progesterone level measurement at cycle day 21. Evaluation of the uterus and fallopian tubes can be performed by hysterosalpingography in women with no risk of obstruction. For patients with a history of endometriosis, pelvic infections, or ectopic pregnancy, evaluation with hysteroscopy or laparoscopy is recommended. Women with anovulation may be treated in the primary care setting with clomiphene to induce ovulation. Treatment of tubal obstruction generally requires referral for subspecialty care. Unexplained infertility in women or men may be managed with another year of unprotected intercourse, or may proceed to assisted reproductive technologies, such as intrauterine insemination or in vitro fertilization.
Infertility is defined as the inability to become pregnant after 12 months of regular, unprotected intercourse. In a survey from 2006 to 2010, more than 1.5 million U.S. women, or 6% of the married population 15 to 44 years of age, reported infertility, and 6.7 million women reported impaired ability to get pregnant or carry a baby to term.1 Among couples 15 to 44 years of age, nearly 7 million have used infertility services at some point.2 This encompasses couples with infertility and impaired ability to get pregnant, but it does not capture those who are not married, so actual numbers may be underestimated. These numbers are comparable to those of other industrialized nations.3,4 Infertility may arise from male factors, female factors, or a combination of these
A: Yes, lifestyle factors like diet and exercise significantly impact fertility. Maintaining a balanced diet, managing weight, and engaging in regular physical activity can improve reproductive health by regulating hormones and promoting overall well-being. These factors can enhance the chances of conception for both men and women.
A: Infertility can lead to emotional distress, including feelings of sadness, frustration, and guilt. It may strain relationships and self-esteem. Psychological aspects can include anxiety and depression. Coping strategies, support, and counseling are crucial in addressing these emotional and psychological challenges.
A: Male infertility is diagnosed through a comprehensive evaluation, including a medical history, physical examination, semen analysis to assess sperm count and quality, hormone tests, and imaging studies like ultrasound. Additional tests may be done to identify underlying causes, such as genetic testing or specialized sperm function tests.
A: Yes, egg or sperm donation is a viable option for couples facing fertility issues. It allows them to use donor eggs or sperm to conceive a child when they cannot do so with their own reproductive cells. This is a common and effective solution for many couples struggling with infertility.
A: Yes, fertility treatments can increase the chances of multiple pregnancies. Medications like Clomid and assisted reproductive technologies such as in vitro fertilization (IVF) can lead to the release of multiple eggs, raising the likelihood of twins, triplets, or more.
A: Yes, there are surgical options to treat infertility in both men and women. In men, procedures like varicocelectomy can improve sperm quality, while women may benefit from surgeries to correct issues like blocked fallopian tubes, surgeries for the uterus, or endometriosis. However, the suitability of surgery depends on the underlying cause of infertility.
A: To improve fertility, maintain a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. Stay hydrated, limit caffeine and alcohol, and manage stress. Adequate folate, zinc, and omega-3 fatty acids may also support reproductive health. Consult a healthcare professional like Dr. Rekha Rajendrakumar for personalized guidance.
A: Yes, specific tests for identifying male infertility include semen analysis to assess sperm count, motility, and morphology, as well as blood tests to evaluate hormone levels (e.g., FSH, testosterone). Additionally, genetic tests and physical exams may be conducted to identify potential causes of infertility.
A: Intrauterine insemination (IUI) is a fertility treatment that involves placing processed sperm directly into the uterus to facilitate fertilization. Compared to in vitro fertilization (IVF), it is less expensive and less intrusive. Success rates for IUI vary but are generally lower than IVF, making IVF a more effective option for some couples with infertility issues.
A: Yes, stress and anxiety can impact fertility by disrupting hormonal balance and menstrual cycles. Relaxation techniques like deep breathing, meditation, and yoga can reduce stress, potentially improving fertility. Consult a healthcare professional like Dr. Rekha Rajendrakumar for personalized guidance.