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Infertility

Infertility is the inability to conceive after having regular unprotected sex for one year. Conditions such as endometriosis and polycystic ovarian disease may cause infertility in women whereas low sperm count and decreased sperm motility causes infertility in men.

Signs and symptoms

Symptoms of infertility vary in men and women.

Symptoms in Men

Infertility is usually noticed in men only when they try to conceive. Some symptoms that may indicate infertility are-

  • Changes in hair growth
  • Changes in sexual desire
  • Pain, lump or swelling in testicles
  • Problems in erection or ejaculation
  • Small firm testicles

Symptoms in Women

Infertility in women may be related to changes in menstrual cycle or hormonal imbalances. Symptoms suggestive of infertility in women are:

  1. Abnormal periods: Increase or decrease in bleeding, irregularities in periods or painful periods may be related to infertility.
  2. Dark hair growth in lips and chin, loss of hair
  3. Changes in sex drive
  4. Weight gain

Diagnosis of Infertility in Men

The doctor will initially collect information regarding the medical history, ongoing medications and sexual habits.  A physical examination will be done to check for lumps and deformities on the testicles. Shape and structure of penis are also examined to check for abnormalities. In order to find out the cause of infertility, your doctor may ask you to take a few tests.

  • Semen analysis: A sample of your semen would be analysed to find out the count, motility and shape of the sperms. This is the primary test for infertility in men.
  • Blood tests: This helps in estimating the level of hormones such as testosterone, luteinizing hormone and prolactin.
  • Ultrasound: Ultrasound helps in the detection of ejaculatory duct obstructions or any other structural abnormalities that may cause infertility.
  • Chlamydia test: Chlamydia is a sexually transmitted infection which may affect fertility. This test helps to find the presence of chlamydia infection

Diagnosis of Infertility in Women

The doctor will assess the women’s medical history, medicines, menstrual cycle, and sexual habits. Following this, a gynecological examination is done. While assessing for infertility, it is important to determine whether the woman is ovulating or not.

  • Ovulation test: Levels of luteinizing hormone is elevated 1-2 days before ovulation and this increase can be assessed by analyzing an early morning urine sample.
  • Ovarian reserve testing. This test helps to find out the quality and quantity of the eggs produced for ovulation.
  • Blood tests: Abnormal blood levels of hormones such as anti- Mullerian hormone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), estradiol, progesterone and Estrogen can cause infertility
  • Hysterosalpingography: Hysterosalpingography is a procedure in which clear X-ray images of the uterus and fallopian tube are obtained. This test is usually done to rule out any obstruction of the uterus or the fallopian tubes which may cause infertility.
  • Hysteroscopy: Hysteroscope is an instrument which is inserted through the cervix. This helps in viewing the inside of the uterus and the fallopian tubes. This test is done to assess the structural defects in the reproductory system that may cause infertility.
  • Laparoscopy: A laparoscope is a thin, flexible tube with a camera at the end. It is inserted in the abdomen and pelvis to assess the fallopian tubes, uterus and the ovaries. It helps in diagnosing conditions such as endometriosis, scarring, blockade, and abnormalities in uterus or fallopian tubules.
  • Pelvic Ultrasound: Ultrasound is useful to assess for blockages of fallopian tubes and the uterus.
  • Genetic Testing: Genetic testing may be needed to rule out any genetic disorder that may cause infertility.

Management of Infertility

The treatment of infertility is dependent on various factors such as the cause of infertility and the age of the patient

Treatment for men:

  • Lifestyle changes: Measures such as regular exercise, improved timing and frequency of intercourse, discontinuing the drugs which may cause infertility can increase the likelihood of having a successful pregnancy.
  • Medications: Medications can help in normalizing the hormone levels and improve testicular function such as sperm and sperm quality.
  • Surgery: Surgery is useful for removing sperm blockage. Surgery can also be prescribed for repairing a varicocele.

 Treatment for women

  • Fertility drugs: These drugs help in inducing ovulation.
  • Surgery: Laparoscopic surgeries are recommended to open blocked tubes, or remove ovarian cysts, or to treat endometriosis. Hysteroscopy may be prescribed to remove polyps and fibroid tumors.
  • Intrauterine Insemination: In this procedure, male sperm is directly placed in the uterus when the female is ovulating. This procedure is usually done in combination with fertility drugs which induce ovulation.

 

In vitro fertilization(IVF): This is one of the most commonly used process and an alternate way of fertilization. In IVF, female eggs and male sperms are combined outside the body in a laboratory. Once the embryo is formed, it is placed in the female uterus. IVF is prescribed only in those cases where methods such as fertility drugs, surgery, and artificial insemination have not helped in conception.

Prevention of infertility:

Following are the preventive measures for infertility:

  1. Avoid alcohol and smoking: Alcohol increases the risk of ovulation disorders and endometriosis. Smoking increases the risk of miscarriage, early menopause and causes infertility.
  2. Try to conceive at a younger age: Fertility decreases after the age of 35 and declines with increase in age.
  3. Maintain a healthy weight: Avoid excess eating. Overweight or underweight can cause problems in ovulation. Maintain a healthy weight to conceive easily.
  4. Practice safe sex: Sexually transmitted diseases can lead to pelvic inflammatory disease, which leads to infertility.

Why choose Apollo Diagnostics?

We have the expertise of 34 + years in healthcare. Our labs are equipped with EQUAS (External Quality Assurance System) and loaded with full automated machines to ensure error free reports, with a quick turnaround time, and at an affordable price. For your convenience, we offer free home collection of samples.

For appointments, please call 4444 2424.

References

  1. https://medlineplus.gov/ency/article/001191.htm. Accessed on 3-10-2017.
  2. Infertility; causes, diagnosis, risk and treatment. https://www.medicalnewstoday.com/articles/165748.php. Accessed on 3-10-2017
  3. 4 keys to preventing infertility. http://attainfertility.com/article/preventing-infertility. Accessed on 4-10-2017
  4. 5 most causes of infertility, http://health.howstuffworks.com/pregnancy-and-parenting/pregnancy/fertility/5-most-common-causes-of-infertility3.htm. Accessed on 4-10-2017
  5. Infertility symptoms in men and women. https://www.webmd.com/infertility-and-reproduction/guide/understanding-infertility-symptoms#1. Accessed on 04-10-2017


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