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In today’s era, many couples are having difficulty becoming pregnant because they are struggling with infertility. For the majority of couples, infertility is defined as the inability to conceive while engaging in regular, unprotected intercourse for at least a year.
A problem with either men or women or a combination of circumstances that hinder pregnancy, maybe the cause of infertility. The infertility issue affects men and women in equal amounts. In reality, both men and women are just as susceptible to experience fertility issues. Fortunately, there are numerous treatments that are risk-free and efficient and dramatically increase the chances of getting pregnant.
How Common is Infertility?
Female infertility accounts for around one-third of infertility cases, while issues with men account for another third of infertility cases. According to studies, 12 to 15 per cent of couples who engage in unprotected sex for a year are unable to conceive, and 10 per cent of couples still don't have a live birth after two years. 40% to 60% of young, usually healthy couples can conceive during the first three months of trying.
Both men and women experience a loss in fertility as they age, but women are more affected than males. Women are approximately half as fertile in their 30s as they are in their early and late 20s, and their chances of becoming pregnant dramatically reduces after age 35. Age-related decreases in male fertility also occur, though more subtly.
Types of Infertility
There are mainly two types of infertility:
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Primary
A female who has never given birth and who, after a year of not using birth control, is unable to get pregnant.
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Secondary
A woman experiences secondary infertility when she is not able to conceive after at least one successful pregnancy.
Causes of Infertility
For ovulation and fertilisation to take place as intended, every step must be completed successfully. When a couple is experiencing infertility, there are several factors that can be at play, some of which may even be present at birth. Both partners may be impacted by the causes of infertility. Sometimes there is no cause whatsoever.
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Cause of male infertility
It includes the following conditions:
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Abnormality in sperm function or production
It occurs as a result of undescended testicles, genetic flaws, health issues like diabetes, or infections like chlamydia, gonorrhoea, the measles, or HIV. Varicocele, or enlarged testicular veins, can also lower sperm quality.
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Difficulties with sperm delivery
It usually occurs due to sexual issues like early ejaculation, genetic conditions like cystic fibrosis, structural issues like a blocked testicle, or damage or injury to the reproductive organs.
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Overexposure to some environmental factors
It includes certain environmental factors like pesticides, other chemicals, and radiation. Fertility can also be affected by cigarette smoking, alcohol consumption, marijuana use, anabolic steroids, and prescription drugs for depression, high blood pressure, and bacterial infections. Regular heat exposure, like that experienced in saunas or hot tubs, can elevate body temperature and have an impact on sperm production.
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Cancer-related treatment damage
Radiation and chemotherapy are the leading causes of male infertility, as these treatments can severely impair sperm production in some cases.
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Cause of female infertility
It includes the following conditions:
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Problems related to ovulation
It involves issues related to the release of eggs from the ovaries. One of these is polycystic ovary syndrome, a hormonal condition. The hormone that increases the production of breast milk, prolactin, which causes hyperprolactinemia, can also prevent ovulation. Menstrual cycle disruption or infertility can result from either an excess or a deficiency of thyroid hormone (hyperthyroidism or hypothyroidism). Excessive exercise, food disorders, or cancer are all possible underlying causes.
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Abnormalities in the uterus and cervix
Abnormalities of the uterus or cervix, such as polyps in the uterus or uterine abnormalities, may occur in terms of shape. Uterine fibroids are non-cancerous (benign) masses that can either prevent a fertilised egg from implanting or block the fallopian tubes.
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Blockage of the fallopian tube or its damage
Damage or blockage in the fallopian tube is often caused by inflammation, and the condition is known as salpingitis. It is the result of pelvic inflammatory disease, mostly caused by sexually transmitted infection, endometriosis, or adhesions.
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Endometriosis
The ovaries, uterus, & fallopian tubes may all be impacted by endometriosis, which develops when endometrial tissue spreads outside of the uterus.
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Early menopause
It occurs before the age of 40 when the ovaries stop producing menstrual blood. Early menopause has some risk factors, including immune system disorders, genetic problems like Turner syndrome or carriers of Fragile X syndrome, radiation or chemotherapy treatment, and other ailments, even if the cause is frequently unclear.
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Pelvic adhesions
After pelvic surgery, endometriosis, appendicitis or other abdominal or pelvic conditions, bands of scar tissue that connect the organs may develop.
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Cancer and its treatment
Several malignancies, particularly those of the reproductive system, impact female fertility. Fertility may be affected by radiation and chemotherapy.
Visit a top hospital for male and female infertility treatment in Mangalore.
Possible Risk Factors for Infertility
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Age
Women's fertility generally falls with age, especially in their mid-30s, and it reduces quickly after age 37. Older women's infertility is probably caused by their eggs being of reduced quality and quantity, although it is also possible that their health issues, which can impair fertility, are to be blamed. Older males may not be as fertile as younger ones.
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Tobacco consumption
It may be less likely to become pregnant if one or both partners smoke tobacco or marijuana. The effectiveness of reproductive treatments may also be lowered by smoking. Women who smoke experience higher miscarriages overall. Erectile dysfunction and a low sperm count in males are also risks that smoking might increase.
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Alcohol consumption
There is no accepted level of alcohol consumption for women during pregnancy or conception specified. Alcohol usage may be a factor in infertility. Excessive drinking can reduce sperm count and motility in men.
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Obesity/overweight
The likelihood of infertility may rise with an unhealthy lifestyle and excess weight. Being overweight may also have an impact on sperm count in men.
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Being underweight
Women who have eating disorders, such as anorexia or bulimia, or who have low caloric intake or adhere to a rigid diet are at increased risk of having fertility issues.
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Exercise issues
Obesity increases the risk of infertility and is a result of inactivity. Less frequently, ovulation issues in women who are not overweight may be attributed to frequent, intense, and rigorous activity.
Diagnosis of Female & Male Infertility
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Female diagnostic approach for infertility
The doctor might ask you to keep track of ovulation-related indicators like cervical mucus and basal body temperature. A home ovulation kit is an additional option. The following are some tests that help in diagnosing any fertility issues in females:
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Pelvic examination
The doctor will conduct a pelvic exam, which will include a Pap test, to look for structural issues or disease symptoms.
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Thyroid hormone levels
These can be determined using a blood test.
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Transvaginal ultrasound
A vaginal ultrasound probe is inserted by the doctor to check for reproductive system issues.
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Hysteroscopy
To check the uterus, the doctor inserts a tiny, illuminated tube called a hysteroscope into the vagina.
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Saline sonohysterogram (SIS)
A transvaginal ultrasound is performed while saline (sterile salt water) is injected into the uterus. It is easier to look into a uterus that is full.
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Hysterosalpingogram (HSG)
An injected dye is seen by X-rays as it passes through the fallopian tubes. This examination searches for obstructions.
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Laparoscopy
The doctor makes a tiny abdominal incision and inserts a laparoscope—a narrow tube with a camera. Endometriosis, uterine fibroids, and scar tissue can all be found via a female pelvic laparoscopy.
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Diagnosis of male infertility
The following are some tests that help in diagnosing male infertility issues:
- Semen analysis
This test looks for sperm issues such as a low sperm count and clumsiness. To collect sperm from the testicles and test it, some men require a needle biopsy. The majority of men will only require this test for the investigation of infertility.
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Blood test
Testosterone, thyroid, and other hormone levels can be determined with a blood test. Chromosome abnormalities are looked for during genetic blood tests.
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Scrotal ultrasound
Varicoceles and other testicular issues are discovered with an ultrasound of the scrotum.
Management and Treatment of Infertility
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Male infertility can be treated by
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Surgery
If the reason is a varicocele (widening of the scrotum's veins) or a blockage in the vas deferens, the only treatment is surgery.
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Antibiotics
They are effective in treating infections of the reproductive tracts.
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Medications and counselling
They assist men in dealing with erection and ejaculation issues.
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Hormone treatments
If hormone levels are the issue, hormonal therapy may be used.
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Women's infertility can be treated by
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Infertility hormones and medications to help the woman ovulate or replenish hormone levels.
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Surgery to unblock blocked fallopian tubes or remove tissue that prevents reproduction, such as endometriosis.
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Assisted reproductive technology
Assisted reproductive technology, or ART, can also be used to treat infertility in both men and women. There are several types of ART:
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Intrauterine insemination (IUI)
When a woman is ovulating, sperm is harvested and deposited just within her uterus.
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In vitro fertilization (IVF)
After the stimulation is finished, the eggs are collected, and the sperm and eggs are combined in a lab dish. The eggs are fertilised by sperm. One of the fertilised eggs is placed into the woman's uterus by a carer.
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Intracytoplasmic sperm injection (ICSI)
It is similar to IVF. A single sperm is directly injected into each of the retrieved eggs by an embryologist, who subsequently transfers the embryo into the uterus.
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Third-party ART
Couples may use donor eggs, sperm, or embryos. Some couples need the services of a gestational carrier or surrogate. This individual agrees to carry & deliver your child.
Consult the best gynaecologist in Mangalore for diagnosis and treatment of male and female infertility.
Prevention of Infertility
Men and women can protect their fertility by doing the following:
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Maintain a healthy BMI by following a well-balanced diet.
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Quit smoking, drinking, and using drugs.
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Acquire treatment for STDs.
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Limiting toxin exposure
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Perform physical activities, but limit over-exercising.
Department of Obstetrics and Gynaecology
KMC Hospital, Mangalore
