How can infertility be treated?

Infertility is a condition affecting the reproductive system of either males or females, characterized by the inability to conceive after 12 months or more of regular, unprotected sexual intercourse.

This condition can arise due to factors associated with either partner or remain unexplained. Notably, some causes of infertility are preventable.

Fortunately, modern medicine offers various treatments, including in-vitro fertilization (IVF) and other medically assisted reproduction techniques, to help those affected.

Causes of infertility in women

Infertility in the female reproductive system can stem from various causes:

Tubal Disorders: Blocked fallopian tubes, often resulting from untreated sexually transmitted infections (STIs), complications from unsafe abortions, postpartum sepsis, or abdominal/pelvic surgeries.

Uterine Disorders: These may include inflammatory conditions like endometriosis, congenital anomalies such as a septate uterus, or benign growths like fibroids.

Ovarian Disorders: Issues such as polycystic ovarian syndrome (PCOS) and other follicular disorders can impact fertility.

Endocrine System Disorders: Hormonal imbalances affect the reproductive hormones due to problems in the endocrine system, which includes the hypothalamus and pituitary glands. Examples include pituitary cancers and hypopituitarism.

Cancers: Particularly those involving the reproductive organs, can significantly impact female fertility. Treatments like radiation and chemotherapy also have the potential to affect fertility.

Fallopian tube blockage: Damage or blockage of the fallopian tubes is often caused by a condition known as salpingitis, which is the swelling of the fallopian tube. This swelling typically results from an infection of the female reproductive organs, referred to as pelvic inflammatory disease.

Causes of infertility in men

Medical Conditions: Several medical conditions can impact sperm production and quality. These include undescended testicles, genetic abnormalities, hormonal imbalances, and various health issues such as diabetes.

Infections: Infections like chlamydia, gonorrhoea, mumps, and HIV can also influence sperm health.

Varicocele: Varicocele, an enlargement of veins within the scrotum, can degrade sperm quality.

Reproductive Tract Issues: Issues with sperm reaching the female reproductive system can stem from sexual problems like premature ejaculation, genetic disorders like cystic fibrosis, physical obstructions in the testicles, or injuries to the reproductive organs.

Environmental Factors: Exposure to pesticides, chemicals, or radiation can harm fertility. Medications for bacterial infections, high blood pressure, and depression may also have adverse effects. Frequent exposure of the testicles to heat, such as in saunas or hot tubs, can impair sperm production.

Cancer and Treatments: Cancer and its treatments, including chemotherapy and radiation, can damage sperm production capabilities.

The primary indication of infertility is the inability to conceive. Irregularities in the menstrual cycle, such as cycles longer than 35 days, shorter than 21 days, irregular cycles, or absence of menstruation, can suggest a lack of ovulation.

Other than difficulties with conception, symptoms can differ widely among individuals. Depending on the underlying cause of infertility, women might experience pelvic discomfort, heavy menstrual bleeding, missed periods, or unexpected vaginal bleeding. It’s crucial to talk to a doctor about any unusual symptoms.

Symptoms of infertility in men

Testicular Pain or Swelling: Various conditions can cause pain or swelling in the testicles, many of which can impact fertility.

Changes in Sexual Desire: Male fertility is closely connected to hormonal health. Alterations in libido, often regulated by hormones, may signal fertility problems.

Difficulty Maintaining an Erection: The ability to maintain an erection is frequently tied to hormone levels. Lowered hormone levels might lead to challenges with conception.

Ejaculation Issues: Problems with ejaculation can be a sign that medical advice is needed.

Small, Firm Testicles: Since the testes produce sperm, their health is crucial for male fertility. Small or unusually firm testicles could indicate potential issues that require medical evaluation.

How can infertility be diagnosed?

For men tests that are commonly used to diagnose male infertility include a semen analysis, which is a lab test that looks at the volume and quality of sperm in a semen sample.

In addition to this test, healthcare providers may also order imaging tests such as ultrasounds or MRIs, blood tests to measure hormone levels or look for genetic abnormalities, urinalysis to check for STIs or diabetes, and testicular biopsies to evaluate sperm production in the testicles.

Female fertility relies on the ovaries releasing healthy eggs and the reproductive tract allowing the egg to travel through the fallopian tubes, where it can meet sperm and then reach the uterus to implant. Infertility tests assess various stages of this process:

Ovulation Testing: Measures hormone levels to determine if ovulation is occurring.

Thyroid Function Test: Checks thyroid hormone levels to see if thyroid issues are affecting fertility.

Hysterosalpingography: Uses a special dye and X-ray to check the condition and possible blockages in the uterus and fallopian tubes.

Ovarian Reserve Testing: Evaluates the number of eggs available for ovulation through hormone testing.

Other Hormone Tests: Assesses hormone levels related to ovulation and pituitary function.

Imaging Tests: Includes pelvic ultrasound to detect issues with the uterus or ovaries and saline infusion sonogram (sonohysterogram) for detailed images of the uterine lining.

How can infertility be managed in men and women?

Adopting healthier habits can increase the chances of better treatment.

Avoid using sexual lubricants during intercourse.

Stay connected with loved ones. Communicate with your partner, family, or friends, as they often provide the best support.

To manage stress effectively, consider integrating mindfulness techniques, yoga, journaling, or engaging in relaxing hobbies into your routine. Studies suggest that reducing stress during infertility treatments may improve outcomes.

Additionally, maintaining a healthy lifestyle through regular exercise, a balanced diet including fruits and vegetables .

Sufficient sleep can also enhance your overall well-being and focus.

How can male infertility be treated?

For the man hormone therapy may be prescribed to balance hormone levels affecting sperm quality. Alternatives may be needed for medications like:

• Tricyclic antidepressants.
• Calcium channel blockers.
• Anti-androgens. Surgical Interventions

Surgery can address specific issues, including:

Vasectomy reversal: Reconnecting the vas deferens to allow sperm to enter the semen again.

Vasoepididymostomy: Removing blockages in the epididymis to enable sperm to enter the semen.

Sperm retrieval: Extracting sperm directly from the testicles or epididymis through a biopsy.

Varicocelectomy: Removing varicose veins in the scrotum to improve sperm quality and increase pregnancy chances.

For the female treating infertility involves addressing the underlying cause with various methods:

• Surgery : Used to correct structural problems, blockages, or scarring that may be affecting fertility.

• Fertility Medications : Help to correct hormonal imbalances or stimulate ovulation. Medications can encourage the release of eggs.

• Antibiotics : Prescribed to treat infections affecting the reproductive organs.

• Fertility Awareness : Involves monitoring ovulation through methods such as tracking cervical mucus, basal body temperature, and using ovulation predictor kits or menstrual cycle tracking apps.

For some, advanced treatments like intrauterine insemination (IUI) or assisted reproductive technologies (ART), including in vitro fertilization (IVF), might be necessary. Adoption and gestational surrogacy are alternative options for those facing infertility who wish to have a family.

Potential Complications of infertility treatment in women

Multiple Pregnancies : Treatments, especially those involving ovulation stimulation, can increase the likelihood of conceiving more than one baby.

Ovarian Hyperstimulation Syndrome (OHSS): A condition where ovaries become swollen and painful due to fertility medications.