I have seen many cases in my career as an IVF Expert where over 10% of reproductive-age couples are unable to conceive even after a year of trying. There are many possible reasons for this, including issues with the male’s sperm, the woman’s ovulation, hormonal issues; from being very underweight or very overweight, or from thyroid, cervical or uterine problems, or blocked fallopian tubes.
What to do if unsuccessful.?
The first step to identify possible issues contributing to a couple’s inability to conceive. Both man and her woman should undergo a physical exam depending on the risks identified, further testing is done to specifically identify the limiting conditions. This may include testing to examine the male’s sperm (amount, motility, etc.), evaluation of the female’s anatomy (for example a hysterosalpingogram, ultrasound, and/or other tests) and evaluation of the women’s ability to ovulate (possibly including hormonal testing and/or other tests).
In fact out of 100% nearly 30% of all infertility cases, the cause is attributed to a problem in the male, 30% of cases, the cause is attributed in female and 30% to both male and female factors and rest 10% is unknown.
The main cause of infertility is the
- abnormalities in sperm of males which includes low sperm production or immobile sperm.
- tubal issues in the woman account for another third, ovulation issues for about 15 percent, and
- other issues or no explanation identified in the rest.
What treatment to go for when the cause is identified?
Once a cause is identified, a specific care plan can be developed. This may include treatment for the male partner (or even consideration of using sperm donation), medical treatment of the woman to help increase ovulation (including weight
change if that is a contributing factor, as well as medications to stimulate ovulation), surgery to address anatomical issues, use of intra-uterine insemination (where sperm is injected into the woman’s uterus), and possibly use of assisted reproductive technology (ART, which is taking eggs from the women, typically by a minimally invasive surgical procedure, and combining them with sperm in the laboratory).
In India nowadays the most common approach to ART is in vitro fertilization or IVF, where a sperm is directly injected into the egg with subsequent transfer of the embryo (after the fertilized egg has been incubated in a special culture medium for several days to increase the chance that is will be viable). The first IVF was done in 1976, and since then it has led to over 5 million successful pregnancies worldwide.
Couples having difficulty conceiving should see a fertility specialist so they can have the workup appropriate for them and then discuss their best options.
