Preconception & Fertility
In general, infertility is defined as the inability to conceive (get pregnant) after one year (or longer) of unprotected sex. Because women’s fertility is known to decline steadily with age, some medical professionals assess and treat women 35 years of age or older after six months of unprotected sex. Infertile women should think about scheduling a consultation with a reproductive endocrinologist, a medical professional who focuses on treating infertility. Women who have experienced two or more spontaneous miscarriages may also benefit from the assistance of reproductive endocrinologists.
To Conceive
- An egg must be released by a woman’s body from one of her ovaries.
- Along the way, a man’s sperm must connect with the egg (fertilize).
- To reach the uterus, the fertilized egg must travel through a fallopian tube (womb).
- The embryo must adhere to the uterus’s interior (implantation).
Infertility may be caused by an issue with one, all, or more of these steps.
Women who have difficulty getting pregnant or carrying a pregnancy to term are said to have impaired reproductive success, which is a condition associated with infertility.
Symptoms
The inability to become pregnant is the most common symptom of infertility. If your menstrual cycle is too long (35 days or more), too short (less than 21 days), irregular, or absent, you may not be ovulating. There may be no other indications or symptoms.
Male Infertility Causes
Infertility in men typically results from problems with the following:
- Effective sperm production
- Sperm count, also known as the quantity of sperm, shape of the sperm, and movement of the sperm, refers to both the sperm’s wriggling and the movement of the sperm through the male reproductive system’s tubes.
- Numerous risk factors, illnesses, and medications can also have an impact on fertility.
Female Infertility Causes
Numerous factors that have an impact on or interfere with the following biological processes can lead to female infertility in women:
Ovulation disorders account for approximately 25% of female infertility cases. The monthly release of an egg is known as ovulation. The eggs may never be released, or they may be released only in certain cycles.
Ovulation disorders can occur as a result of:
- Hyperprolactinemia: If a woman’s prolactin levels are high and she is not pregnant or breastfeeding, it can interfere with ovulation and fertility.
- Thyroid issues: A thyroid gland that is overactive or underactive can cause a hormonal imbalance that interferes with ovulation.
- Polycystic ovary syndrome (PCOS) is a hormonal condition that causes irregular or prolonged menstruation and interferes with ovulation.
- Obstacles in the uterus or fallopian tubes can also prevent the egg from moving from the ovary to the uterus, or womb. It may be more difficult to conceive naturally if the egg does not travel.
Other factors include:
- Chronic conditions: AIDS and cancer
- Primary ovarian insufficiency (POI) occurs when the ovaries cease to function normally before the age of 40.
- Poor egg quality: Egg quality can interfere with conception. The number and quality of eggs produced by a female decrease as she ages. Damaged eggs or eggs with genetic abnormalities may also be unable to sustain a pregnancy. The risk increases with age in a female.
- Pelvic surgery can result in scarring or damage to the fallopian tubes. Cervical surgery can sometimes result in scarring or cervix shortening. The cervix is the uterine neck.
- Sub mucosal fibroids are benign or noncancerous tumors that develop in the uterine muscular wall. They can disrupt implantation or block the fallopian tube, preventing sperm from fertilizing the egg.
- Endometriosis is a condition in which cells that normally grow in the uterine lining begin to grow elsewhere in the body.
Tubal ligation: Females who have chosen to have their fallopian tubes blocked can have the procedure reversed, but the chances of becoming pregnant again are slim.
Risk Factors
Certain factors may increase your chances of infertility, including:
- With age, a woman’s egg quality and quantity begin to decline. The rate of follicle loss accelerates in the mid-30s, resulting in fewer and lower-quality eggs. This complicates conception and increases the risk of miscarriage.
- Smoking, in addition to damaging your cervix and fallopian tubes, increases your risk of miscarriage and ectopic pregnancy. It is also thought to prematurely age your ovaries and deplete your eggs. Before beginning fertility treatment, you should quit smoking.
- Obesity or being significantly underweight may interfere with ovulation. Increasing your BMI to a healthy level may increase the frequency of ovulation and the likelihood of pregnancy.
- Sexual background. Sexually transmitted infections like chlamydia and gonorrhea can cause fallopian tube damage. Having unprotected sex with multiple partners raises your risk of a sexually transmitted infection, which can lead to fertility issues later in life.
- Excessive alcohol consumption can harm fertility.
Treatment
Men’s fertility treatments may include:
- A change in one’s lifestyle, such as quitting smoking, exercising regularly, or increasing the frequency of sex.
- Taking the right medications to improve testicular function, which will improve sperm quality and quantity.
- Surgery to remove the sperm blockage and restore fertility
- When there is no sperm in the ejaculate, the sperm retrieval technique is used.
On female patients, any of the following treatments could be used:
- Fertility medications that regulate or induce ovulation.
- Hysteroscopic surgery can treat endometrial polyps, uterine septum, and other uterine issues that may interfere with pregnancy.
- Intrauterine Insemination (IUI) is a fertility treatment that involves inserting fertile sperm into the uterus at the precise moment the ovary releases the eggs that must be fertilized. It is done to increase the number of sperms expected to enter the fallopian tubes, potentially increasing the likelihood of conception.
- In vitro fertilization (IVF): Using in vitro fertilization, several mature eggs are stimulated, collected from the female partner, and fertilized with a man’s sperm in a lab (IVF). The embryos are then implanted in the woman’s uterus three to five days after conception. Other IVF procedures include assisted hatching, in which the embryo is implanted.