Every couple dreams of playing with their newborn someday. You try for many years to have a baby only to be told by your gynaecologist that the reason for not being able to get pregnant is infertility. One word is all it takes to bring your world down crashing. Many couples who have babies often complain about parenthood being the hardest thing yet. For those on the opposite side, dealing with infertility is a lot harder.
What is infertility?
When a couple is not able to conceive despite regular unprotected sex after a year, they are defined as being infertile.The numbers of infertile couples continue to rise each year. The truth is, it is much more difficult to get pregnant these days, no matter what statistics may suggest.
It is commonly assumed that infertility is a woman’s problem, though in reality, infertility affects both men and women. 30% of the issues are due to women, 30% due to men and the rest 40% are due to several unexplained factors that doctors don’t know yet. However, the women mostly bear the brunt of social stigma attached with infertility. The tendency to have children in an advanced childbearing age is the single biggest risk factor for infertility today.
What are the causes of infertility?
Every woman has 1-2 million eggs at birth. By the time she hits puberty, the number dwindles to only 600,000! Every cycle, 500 eggs are destroyed before one matures to become an ovum which has the chance to get fertilized. This cycle continues until they reach menopause. With men, it is not the case. Sperms are formed every 90 days and they can produce them even in their old age.
Experts have found that a woman’s age is the biggest factor for infertility today. With every increase in age, the risk of infertility also rises. With passing age, the number of eggs drop dramatically as do their genetic normality.
Irregular menses, illnesses like PCOD, infrequent periods, spotting, anovulatory cycles can affect a woman’s chances of conceiving. Other factors like smoking and drinking also increase the risk of infertility.
Causes of infertility in men range from lack of sperm to abnormal sperm morphology and hormonal issues. Factors like injury to testicles, chemotherapy, and radiation also affect the chances of sperm production. Endocrine illnesses like diabetes and thyroid may lead to erectile dysfunction and sperm production. Infectious diseases like mumps, sexually transmitted diseases can alter sperm production as well. Even though the sperm count is normal, factors like morphology, motility can also be a factor leading to infertility.
Identifying the cause for infertility is the first step towards treatment.
Which factors of infertility are easier to treat?
Women who have issues with ovulation are easier to treat, as they require only medical intervention and hormonal pills. With issues that need surgical interventions like endometriosis, repair of fallopian tubes, the success rates in achieving a pregnancy are lesser.
Men dealing with erectile dysfunction, diabetes, thyroid issues can improve their sperm count with medicines. Damage to testicles, chemotherapy, radiation, issues with sperm morphology and motility have limited success rates.
Tests for infertility
Your gynaecologist might order tests for both you and your partner to find out the reasons why you cannot conceive. These tests help to find out whether infertility is due to issues in the male, female or both. The doctor usually asks both partners for their medical and sexual history, birth control methods, STDs, menstrual cycle patterns and addiction history. A complete physical examination is performed on both partners. For men, usually a testicular exam is performed. For women, a pap smear and a pelvic exam too are needed to get a clear diagnosis.
Specific tests for men include a semen analysis to check for sperm count, morphology and motility, hormonal tests like testosterone and other male hormones. Abstinence from intercourse and masturbation is necessary for 3 days prior to semen sample collection. The sample should be collected in a sterile, wide mouthed bottle and delivered to lab within an hour of collection. Sometimes genetic testing and testicular biopsy may be conducted in some cases to check for further abnormalities that could lead to infertility.
For women, various hormonal blood tests like Follicle Stimulating Hormone (FSH), Prolactin, Luteinizing Hormone (LH) will help to identify issues with ovulation and the menstrual cycle. Sometimes a thyroid profile (T3, T4, TSH) may be done to look for problems with anovulatory cycles. Some of these tests require fasting prior to sample collection and are collected via a simple needle prick in the arm. Further tests like HysteroSalpingoGraphy (HSG) evaluate the condition of the uterus and the Fallopian tubes for any blockages that could prevent a pregnancy. A pelvic ultrasound is advised before Hysterosalpingography to check for normal structure of uterus ,Fallopian tubes and ovaries.
Dealing with infertility
Infertility brings about a lot of emotional upheaval. Infertility is still a social taboo, and it is not uncommon for couples to avoid talking about it. The social pressure is such that couples are not able to open up about their issues to talk about it, often ending up dealing it alone. Emotional distress, anxiety, depression are common issues couples face while they struggle to coping with infertility.
It is important that you take counselling sessions with an expert psychologist to help dealing with it in a more positive approach. This will help in strengthening their relationship as partners can address each other's emotional difficulties better. With infertility, it is common for a woman to doubt her worth and disappointed in herself and her body that she is not able to conceive. A therapist can provide positive reinforcement techniques to improve her self worth and offer solutions that help her solve her emotional issues. Another helpful method is to join groups to share your problems. Finding someone who has the same problem as yours will make you realize that you are not alone.
Increased stress comes with increased rates of infertility.Doctors encourage one to adopt healthy lifestyle measures like walking, jogging, yoga apart from eating a healthy diet. There are studies that show those couples who practiced healthy living had increased their chances of conceiving ending with a successful pregnancy.
Coping with infertility can help bring back the love and emotional support one needs for each other. Reach out for professional help without being ashamed and anxious, as dealing with low self esteem and depression require more than just coping techniques.