Infertility
Causes
There can be many reasons why you don't easily become pregnant. Only a third of those trying fall pregnant each month, although some of these will miscarry before they even know they're pregnant. The most common reasons include hormonal problems and blocked fallopian tubes in women, and a low sperm count in men.
What will your GP do?
Your doctor will want to know about your development as a teenager and your periods. He or she will ask when they started, how regular they are, whether you've ever been pregnant before or whether you've ever had a pelvic infection or sexually transmitted infection.
It's also important to mention any other illnesses you've had and any medication you may be taking. Your doctor will examine you, including internally, and send you for blood tests to check your blood count and hormone levels.
Your doctor may ask your partner about his development too, examine him and give him instructions to collect a semen sample for testing.
What can specialists do?
Once referred to a fertility specialist (called a reproductive medicine specialist), the cause of your infertility will be investigated. The treatment will depend on the cause and can range from hormone treatments to assisted conception techniques such as in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSE).
IVF and ICSE
IVF involves removing eggs from the woman's ovaries and mixing them with her partner's or donated sperm in a laboratory. A number of eggs are then placed back in the womb. This is a demanding treatment for the woman and there's a success rate of just 15 per cent. Many cycles may be required.
Access to IVF is limited on the NHS. However, from April 2005 couples should be entitled to one round of treatment. To qualify, women must be between 23 and 39 and have a specific fertility problem (eg, blocked fallopian tubes) or have failed to conceive for three years despite regular intercourse. A cycle of IVF at a private clinic costs around £2,000.
ICSE is sometimes recommended to those couples who have had no success with IVF. It involves injecting a single sperm into the egg. If a healthy embryo develops, it's then placed back in the womb as in IVF.
Topics:
"Then one day, the stork came flying by and dropped off a baby at our doorstep...."
For some couples, the wish of having a baby is not easily fulfilled. In fact, as much as 15% of the world's population endure the difficulties of trying to make a baby.
The magic formula is not as simple as man-meets-woman. However, help is at hand with the advancement of modern science and technology.
Assisted Reproductive Technology (ART)
For many couples, infertility is a crisis, often accompanied by feelings of guilt or inadequacy. But a diagnosis of infertility is not a verdict of sterility. While about 15 percent of all couples are infertile (that is, they are Unable, to conceive after a year of trying), only 1 or 2 per-cent are sterile (meaning that conception is physically ruled out). Of couples who seek help, about half can eventually bear a child, either on their own or with medical assistance.
I am 33 years old and want to have a second child. My first child is now 10 years old, and I had no problem getting pregnant with him. About two weeks ago I had a laparoscopy with tubal lavuge and laser surgery, and the outcome was this: I have severe endometriosis and blocked tubes. I am also in a lot of pain. My doctors told me the only way I could get pregnant is through in-vitro fertilization. My husband and I cannot afford this procedure, so they are saying the only other solution is hysterectomy. (?!) Help! Is this really my only solution?
In the United States there are approximately 800,000 reproductive-aged men and women who have cancer, many of whom have concerns about their fertility. Life- saving cancer treatments may reduce fertility by destroy- ing eggs and sperm. The likelihood of reproductive dam- age depends on the age and sex of the patient and the type and duration of treatment. The most severe damage comes from radiation to the ovaries or testicles and cancer drugs in the “alkylating agent” category such as cyclophos- phamide, mechlorethamine, chlorambucil, and melphalan.
SEEING A SPECIALIST
Q: I am wondering if it is possible to conceive with PCOS, thyroid disease, and Factor 5 blood disorder in a fairly reasonable time. We have been trying for a year and have now been referred to a specialist. I have two other children but have never had to see a specialist. I don't think I can handle the ups and downs of infertility much longer - what can a specialist do that my regular doctor can't?
Ovulation induction is a term that refers to the administration of medication to stimulate ovulation. These medications range from clomiphene to gonadotropins to combinations of the two. Gonadotropins are injectable ovulation stimulating hormones that are identical to the hormones secreted by the body. With the administration of these injectable medications, the circulating levels of these hormones are increased, resulting in the stimulation and growth of multiple eggs.
Human conception is an elegantly simple and marvelously complex series of events. Before we can begin to discuss the reasons certain couples have difficulty conceiving, it is important to have a full understanding of the way things are supposed to work. A good working knowledge of normal events will make the steps that can be taken to evaluate a couple's fertility make more sense. Understanding "nature's way" will also provide a framework for understanding the rationale behind some of the therapeutic measures that will be discussed later.
THE MALE
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