Most experts define infertility as not being able to get pregnant after at least one year of trying. Women who are able to get pregnant but then have repeat miscarriages are also said to be infertile.

Pregnancy is the result of a complex chain of events. In order to get pregnant:
1. A woman must release an egg from one of her ovaries (ovulation).
2. The egg must go through a fallopian tube toward the uterus (womb).
3. A man's sperm must join with (fertilize) the egg along the way.
4. The fertilized egg must attach to the inside of the uterus (implantation).

Infertility can result from problems that interfere with any of these steps.

Is infertility a common problem?
About 20 percent of women aged 20-35 have difficulty getting pregnant or carrying a baby to term.

Is infertility just a woman's problem?
No, infertility is not always a woman's problem. In only about one-half of cases is infertility due to the woman (female factors). In another one fourth of cases, infertility is due to the man (male factors). The remaining cases are caused by a mixture of male and female factors or by unknown factors.

What causes infertility in men?
Infertility in men is most often caused by:
1. problems making sperm -- producing too few sperm or none at all
2. problems with the sperm's ability to reach the egg and fertilize it -- abnormal sperm shape or structure prevent it from moving correctly

Sometimes a man is born with the problems that affect his sperm. Other times problems start later in life due to illness or injury. For example, cystic fibrosis often causes infertility in men.

What increases a man's risk of infertility?
The number and quality of a man's sperm can be affected by his overall health and lifestyle. Some things that may reduce sperm number and/or quality include:

1. Alcohol
2. Drugs
3. Environmental toxins, including pesticides and lead
4. Smoking cigarettes
5. Health problems
6. Medicines
7. Radiation treatment and chemotherapy for cancer
8. Age

What causes infertility in women?
Problems with ovulation account for most cases of infertility in women. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.

Less common causes of fertility problems in women include:

  • Blocked fallopian tubes due to pelvic inflammatory disease, endometriosis, or surgery for an ectopic pregnancy.
  • Physical problems with the uterus.
  • Uterine fibroids.

What things increase a woman's risk of infertility?
Many things can affect a woman's ability to have a baby. These include:

1. Age
2. Stress
3. Poor diet
4. Athletic training
5. Being overweight or underweight
6. Tobacco smoking
7. Alcohol
8. Sexually transmitted diseases (STDS)
9. Health problems that cause hormonal changes

How does age affect a woman's ability to have children?
More and more women are waiting until their 30s and 40s to have children. Actually, about 20 percent of women in the United States now have their first child after age 35. So age is an increasingly common cause of fertility problems. About one third of couples in which the woman is over 35 have fertility problems.

Aging decreases a woman's chances of having a baby in the following ways:
  • The ability of a woman's ovaries to release eggs ready for fertilization declines with age.
  • The health of a woman's eggs declines with age.
  • As a woman ages she is more likely to have health problems that can interfere with fertility.
  • As a women ages, her risk of having a miscarriage increases.

How long should women try to get pregnant before calling their doctors?
Most healthy women under the age of 30 shouldn't worry about infertility unless they've been trying to get pregnant for at least a year. At this point, women should talk to their doctors about a fertility evaluation. Men should also talk to their doctors if this much time has passed.

In some cases, women should talk to their doctors sooner. Women in their 30s who've been trying to get pregnant for six months should speak to their doctors as soon as possible. A woman's chances of having a baby decrease rapidly every year after the age of 30. So getting a complete and timely fertility evaluation is especially important.

Some health issues also increase the risk of fertility problems. So women with the following issues should speak to their doctors as soon as possible:
  • Irregular periods or no menstrual periods
  • Very painful periods
  • Endometriosis
  • Pelvic inflammatory disease
  • More than one miscarriage

No matter how old you are, it's always a good idea to talk to a doctor before you start trying to get pregnant. Doctors can help you prepare your body for a healthy baby. They can also answer questions on fertility and give tips on conceiving.

How will doctors find out if a woman and her partner have fertility problems?
Sometimes doctors can find the cause of a couple's infertility by doing a complete fertility evaluation. This process usually begins with physical exams and health and sexual histories. If there are no obvious problems, like poorly timed intercourse or absence of ovulation, tests will be needed.

Finding the cause of infertility is often a long, complex and emotional process. It can take months for you and your doctor to complete all the needed exams and tests. So don't be alarmed if the problem is not found right away.

For a man, doctors usually begin by testing his semen. They look at the number, shape, and movement of the sperm. Sometimes doctors also suggest testing the level of a man's hormones.

For a woman, the first step in testing is to find out if she is ovulating each month. There are several ways to do this. A woman can track her ovulation at home by:

1. Recording changes in her morning body temperature (basal body temperature) for several months
2. Recording the texture of her cervical mucus for several months
3. Using a home ovulation test kit (available at drug or grocery stores)

Doctors nowadays check if a woman is ovulating by doing blood tests and an ultrasound of the ovaries. If the woman is ovulating normally, more tests are needed.

Some common tests of fertility in women include:
Hysterosalpingography : In this test, doctors use x-rays to check for physical problems of the uterus and fallopian tubes. They start by injecting a special dye through the vagina into the uterus. This dye shows up on the x-ray. This allows the doctor to see if the dye moves normally through the uterus into the fallopian tubes. With these x-rays doctors can find blockages that may be causing infertility. Blockages can prevent the egg from moving from the fallopian tube to the uterus. Blockages can also keep the sperm from reaching the egg.

Laparoscopy : During this surgery doctors use a tool called a laparoscope to see inside the abdomen. The doctor makes a small cut in the lower abdomen and inserts the laparoscope. Using the laparoscope, doctors check the ovaries, fallopian tubes, and uterus for disease and physical problems. Doctors can usually find scarring and endometriosis by laparoscopy.

Hysteroscopy : With this the inside of the uterus and the openings of the fallopian tubes are checked for any potential problems. Usually hysteroscopy, laparoscopy and tube testing are combined and done at the same sitting.

How do doctors treat infertility?
Infertility can be treated with medicine, surgery, artificial insemination or assisted reproductive technology. Many times these treatments are combined. About two-thirds of couples who are treated for infertility are able to have a baby. In most cases infertility is treated with drugs or surgery.

Doctors recommend specific treatments for infertility based on:

1. Test results
2. How long the couple has been trying to get pregnant
3. The age of both the man and woman
4. The overall health of the partners
5. Preference of the partners

Doctors often treat infertility in men in the following ways:
1. Sexual problems: If the man is impotent or has problems with premature ejaculation, doctors can help him address these issues. Behavioral therapy and/or medicines can be used in these cases.
2. Too few sperm: If the man produces too few sperm, sometimes surgery can correct this problem. In other cases, doctors can surgically remove sperm from the male reproductive tract. Antibiotics can also be used to clear up infections affecting sperm count.

Various fertility medicines are often used to treat women with ovulation problems. It is important to talk with your doctor about the pros and cons of these medicines. You should understand the risks, benefits, and side effects.

Doctors also use surgery to treat some causes of infertility. Problems with a woman's ovaries, fallopian tubes, or uterus can sometimes be corrected with surgery.

Intrauterine insemination (IUI) is another type of treatment for infertility. IUI is known by most people as artificial insemination. In this procedure, the woman is injected with specially prepared sperm. Sometimes the woman is also treated with medicines that stimulate ovulation before IUI.

IUI is often used to treat:

1. Mild male factor infertility
2. Women who have problems with their cervical mucus
3. Couples with unexplained infertility

What medicines are used to treat infertility in women?
Some common medicines used to treat infertility in women include:
1. Clomiphene citrate (Clomid): This medicine causes ovulation by acting on the pituitary gland. It is often used in women who have Polycystic Ovarian Syndrome (PCOS) or other problems with ovulation. This medicine is taken by mouth.

2. Human menopausal gonadotropin or hMG (Repronex, Pergonal): This medicine is often used for women who don't ovulate due to problems with their pituitary gland. hMG acts directly on the ovaries to stimulate ovulation. It is an injected medicine.

3. Follicle-stimulating hormone or FSH (Gonal-F, Follistim): FSH works much like hMG. It causes the ovaries to begin the process of ovulation. These medicines are usually injected.

4. Gonadotropin-releasing hormone (Gn-RH) analog: These medicines are often used for women who don't ovulate regularly each month. Women who ovulate before the egg is ready can also use these medicines. Gn-RH analogs act on the pituitary gland to change when the body ovulates. These medicines are usually injected or given with a nasal spray.

5. Metformin (Glucophage): Doctors use this medicine for women who have insulin resistance and/or Polycystic Ovarian Syndrome (PCOS). This drug helps lower the high levels of male hormones in women with these conditions. This helps the body to ovulate. Sometimes clomiphene citrate or FSH is combined with metformin. This medicine is usually taken by mouth.

6. Bromocriptine (Parlodel): This medicine is used for women with ovulation problems due to high levels of prolactin. Prolactin is a hormone that

Many fertility drugs increase a woman's chance of having twins, triplets or other multiples. Women who are pregnant with multiple fetuses have more problems during pregnancy. Multiple fetuses have a high risk of being born too early (prematurely). Premature babies are at a higher risk of health and developmental problems.

What is assisted reproductive technology (ART)?
Assisted reproductive technology (ART) is a term that describes several different methods used to help infertile couples. ART involves removing eggs from a woman's body, mixing them with sperm in the laboratory and putting the embryos back into a woman's body.

Success rates vary and depend on many factors. Some things that affect the success rate of ART include:
1. Age of the partners
2. Reason for infertility
3. Clinic
4. Type of art
5. If the egg is fresh or frozen
6. If the embryo is fresh or frozen

The U.S. Centers for Disease Prevention (CDC) collects success rates on ART for some fertility clinics. According to the 2003 CDC report on ART, the average percentage of ART cycles that led to a healthy baby were as follows:
  • 37.3% in women under the age of 35
  • 30.2% in women ag
  • 20.2% in women aged 37-40
  • 11.0% in women aged 41-42

ART can be expensive and time-consuming. But it has allowed many couples to have children that otherwise would not have been conceived. The most common complication of ART is multiple fetuses. But this is a problem that can be prevented or minimized in several different ways.

What are the different types of assisted reproductive technology (ART)?

Common methods of ART include:
* In vitro fertilization (IVF) means fertilization outside of the body. IVF is the most effective ART. It is often used when a woman's fallopian tubes are blocked or when a man produces too few sperm. Doctors treat the woman with a drug that causes the ovaries to produce multiple eggs. Once mature, the eggs are removed from the woman. They are put in a dish in the lab along with the man's sperm for fertilization. After 3 to 5 days, healthy embryos are implanted in the woman's uterus.
* Zygote intrafallopian transfer (ZIFT) or Tubal Embryo Transfer is similar to IVF. Fertilization occurs in the laboratory. Then the very young embryo is transferred to the fallopian tube instead of the uterus.
* Gamete intrafallopian transfer (GIFT) involves transferring eggs and sperm into the woman's fallopian tube. So fertilization occurs in the woman's body. Few practices offer GIFT as an option.
* Intracytoplasmic sperm injection (ICSI) is often used for couples in which there are serious problems with the sperm. Sometimes it is also used for older couples or for those with failed IVF attempts. In ICSI, a single sperm is injected into a mature egg. Then the embryo is transferred to the uterus or fallopian tube.

In Vitro Fertilization (IVF)

In Vitro Fertilization (IVF) is a medical procedure used to help individuals or couples with fertility issues conceive a child. Here's a brief explanation of IVF, including its causes, prevention, and treatment options:

1. Causes: IVF is often recommended when natural conception is difficult or impossible due to various factors, such as:
• Blocked or damaged fallopian tubes.
• Low sperm count or poor sperm quality.
• Ovulation disorders.
• Endometriosis.
• Genetic disorders.
• Unexplained infertility.

2. Prevention:Preventing the need for IVF depends on the underlying causes of infertility. Some general measures to improve fertility include: • Maintaining a healthy lifestyle, including a balanced diet and regular exercise.
• Avoiding smoking, excessive alcohol consumption, and recreational drug use.
• Managing stress levels effectively.
• Protecting against sexually transmitted infections.
• Consulting a doctor if any signs of fertility problems arise.

3. Treatment: IVF involves several steps and may vary depending on individual circumstances. The general process includes: • Ovarian stimulation: The woman receives medications to stimulate the development of multiple eggs in her ovaries.
• Egg retrieval: Mature eggs are collected from the woman's ovaries using a minor surgical procedure.
• Sperm collection: The man provides a semen sample, which is prepared in the lab to isolate healthy sperm.
• Fertilization: The eggs and sperm are combined in a laboratory dish, allowing fertilization to occur.
• Embryo culture: The fertilized eggs (embryos) are monitored and cultured in a laboratory for a few days.
• Embryo transfer: One or more embryos are transferred into the woman's uterus using a thin catheter.
• Pregnancy test: After a specified period, a pregnancy test is conducted to determine if the procedure was successful.

It's important to note that the success rate of IVF varies depending on factors such as age, overall health, and the cause of infertility. Additionally, other assisted reproductive technologies, such as intracytoplasmic sperm injection (ICSI) or preimplantation genetic testing (PGT), may be used in conjunction with IVF to increase the chances of a successful pregnancy. Consulting with a fertility specialist can provide personalized guidance and information regarding available treatment options

Personalized/Frozen Embryo Transfer (FET)
Personalized/Frozen Embryo Transfer (FET) is a technique used in assisted reproductive technology (ART) to improve the chances of successful pregnancy during in vitro fertilization (IVF). Here's a brief explanation of FET, its causes, prevention, and available treatments

1. Personalized/Frozen Embryo Transfer (FET): FET involves the freezing and storage of embryos after IVF. These frozen embryos are later thawed and transferred into the woman's uterus during a subsequent menstrual cycle when the endometrium is most receptive . FET offers several advantages, such as allowing for better synchronization of the embryo with the woman's uterine lining and the opportunity for genetic testing of the embryos prior to transfer.

2. Causes: FET is often recommended in cases where the woman's uterine lining may not be adequately prepared for embryo implantation during the same IVF cycle. It can also be used to improve pregnancy outcomes in certain medical conditions or when additional genetic testing of the embryos is desired.

3. Prevention: The need for FET can sometimes be prevented or reduced through careful monitoring and optimization of the woman's hormonal levels and uterine lining during the IVF cycle. This includes appropriate administration of medications and timely evaluation of the woman's uterine environment.

4. Treatment: The treatment for FET involves a multi-step process:

a. Ovarian stimulation and egg retrieval: The woman undergoes hormonal stimulation to produce multiple mature eggs, which are then retrieved from the ovaries.

b. Fertilization: The retrieved eggs are fertilized with sperm in the laboratory to create embryos.

c. Embryo cryopreservation: The resulting embryos are frozen and stored in a specialized solution for later use.

d. Thawing and transfer: In a subsequent menstrual cycle, the selected frozen embryos are thawed and transferred into the woman's uterus using a catheter.

e. Supportive medication: The woman may be prescribed medications to support the uterine lining and improve the chances of successful embryo implantation. f. Pregnancy test: A pregnancy test is conducted around two weeks after the embryo transfer to determine if pregnancy has occurred. It is important to note that personalized/FET is a complex medical procedure, and the specifics of the treatment can vary depending on individual circumstances and the recommendations of fertility specialists. Consulting with a fertility expert is crucial to understand the personalized options, risks, and success rates associated with FET in each particular case.

Egg Freezing
Egg freezing, also known as oocyte cryopreservation, is a medical procedure that involves collecting and freezing a woman's eggs for future use. Here's a brief explanation of the causes, prevention, and treatment options related to egg freezing:Causes:

1. Age: Women may choose to freeze their eggs due to concerns about age-related decline in fertility.

2. Medical Conditions: Certain medical treatments, such as chemotherapy or radiation therapy, can affect a woman's fertility. Egg freezing can be an option for women undergoing these treatments.

3. Career or Personal Reasons: Some women may choose to freeze their eggs for personal or professional reasons, allowing them to delay childbearing until a more suitable time.

Prevention: There are no definitive ways to prevent the need for egg freezing. However, maintaining a healthy lifestyle, including a balanced diet, regular exercise, and avoiding smoking or excessive alcohol consumption, can help support overall reproductive health.Treatment Options:
1. Egg Retrieval: The first step in egg freezing involves a woman undergoing a process called ovarian stimulation, where fertility medications are used to stimulate the ovaries to produce multiple eggs. The eggs are then retrieved through a minor surgical procedure known as transvaginal ultrasound aspiration.

2. Cryopreservation: The retrieved eggs are rapidly cooled and frozen using a process called vitrification, which helps prevent ice crystal formation and potential damage to the eggs.

3. Storage: The frozen eggs are stored in specialized facilities known as cryobanks until the woman decides to use them.

4. In vitro fertilization (IVF): When a woman is ready to use her frozen eggs, they are thawed and fertilized with sperm in a laboratory. The resulting embryos are then transferred to the woman's uterus through an IVF procedure.It's important to note that while egg freezing can offer women the possibility of preserving their fertility, it does not guarantee a successful pregnancy in the future. The success of pregnancy depends on various factors, including the quality of the eggs, the age of the woman at the time of freezing, and other individual circumstances. Consulting with a fertility specialist is crucial to discuss individual options and considerations related to egg freezing.

Male infertility Faq What is male infertility?

Male infertility refers to the inability of a man to impregnate a female partner due to factors related to his reproductive system, such as low sperm count, poor sperm motility, abnormal sperm morphology, or blockages in the male reproductive tract.

What are the common causes of male infertility?

Common causes of male infertility include hormonal imbalances, varicocele (enlarged veins in the testicles), testicular injury or infection, genetic disorders, certain medications, chronic illnesses, lifestyle factors (smoking, excessive alcohol consumption, drug use), and age-related decline in sperm quality.
How is male infertility diagnosed? Male infertility is diagnosed through a series of tests, including a thorough medical history review, physical examination, semen analysis to assess sperm quantity and quality, hormonal tests, genetic testing, and imaging studies (such as ultrasound or MRI) to evaluate the reproductive organs.

What are the treatment options available for male infertility?

Treatment options for male infertility depend on the underlying cause and may include lifestyle changes, medications to address hormonal imbalances or infections, surgical interventions to correct anatomical issues or blockages, assisted reproductive techniques (such as intrauterine insemination or in vitro fertilization) with donor sperm, or intracytoplasmic sperm injection (ICSI) for severe cases.

Can lifestyle changes improve male fertility?

Yes, adopting a healthy lifestyle can positively impact male fertility. Measures such as maintaining a balanced diet, exercising regularly, avoiding tobacco and drug use, limiting alcohol consumption, managing stress, and practicing safe sex can improve sperm health and overall fertility

Is male infertility a permanent condition?

Male infertility is not always a permanent condition. Depending on the underlying cause, appropriate treatments can improve fertility outcomes. However, it is essential to consult a urologist or fertility specialist for a thorough evaluation and personalized treatment plan.

Are there any natural remedies or alternative therapies that can help with male infertility?

While some alternative therapies may claim to improve male fertility, their efficacy is not scientifically proven. It is advisable to consult a medical professional for evidence-based treatments and guidance.

When should I consult a urologist or fertility specialist for male infertility?

It is recommended to consult a urologist or fertility specialist if you have been actively trying to conceive for one year (if under 35 years old) or six months (if over 35 years old) without success. If you have known risk factors or symptoms related to male infertility, seeking professional help earlier is advisable. They will conduct appropriate tests, determine the underlying cause, and provide suitable treatment options based on your specific situation.

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