Infertility : When to see a doctor ?

Infertility : When to see a doctor ?

What should I Know before meeting a Fertility Specialist?

  • WOMEN – A woman’s fertility gradually declines with age, especially in her mid-30s, and it drops rapidly after age 37. Infertility in older women may be due to the number and quality of eggs, or to health problems that affect fertility.

When to see a doctor if you are a female patient?


You probably don’t need to see a doctor about infertility unless you have been trying regularly to conceive for at least one year. Talk with your doctor earlier, however, if you’re a woman and:

  • You’re age 35 to 40 and have been trying to conceive for six months or longer
  • You’re over age 40
  • You menstruate irregularly or not at all
  • Your periods are very painful
  • You’ve been diagnosed with endometriosis or pelvic inflammatory disease
  • You’ve had multiple miscarriages
  • You’ve undergone treatment for cancer

When to see a doctor if you are a male patient?


  • You have a low sperm count or other problems with sperm
  • You have a history of testicular, prostate or sexual problems
  • You’ve undergone treatment for cancer
  • You have testicles that are small in size or swelling in the scrotum known as a varicocele
  • You have others in your family with infertility problems

What are General factors responsible for infertility?


  • Diabetes mellitus,
  • thyroid disorders,
  • undiagnosed and untreated coeliac disease,
  • adrenal disease

What are environmental factors responsible for infertility?


Environmental factors

  • Glues,
  • Volatile organic solvents
  • Pesticides.
  • Tobacco smokers are 60% more likely to be infertile than non-smokers.

 What is the effect of age on fertility? 


  • Age.
    • WOMEN – A woman’s fertility gradually declines with age, especially in her mid-30s, and it drops rapidly after age 37. Infertility in older women may be due to the number and quality of eggs, or to health problems that affect fertility.
    • MEN -Men over age 40 may be less fertile than younger men .
  •  What is the effect of tobacco on fertility? 


    Smoking tobacco –

    • reduces the chances of pregnancy.
    • reduces the possible benefit of fertility treatment.
    • Miscarriages are more frequent in women who smoke.
    • Smoking can increase the risk of erectile dysfunction
    • low sperm count in men is common in tobacco use.

 What is the effect of tobacco on fertility? 


  • WOMEN -Avoid alcohol if you’re planning to become pregnant. Alcohol use increases the risk of birth defects, and may contribute to infertility.
  • MEN – Heavy alcohol use can decrease sperm count and motility.

 What is the effect of Weight on fertility? 


  • Overweight- Inactive lifestyle and being overweight may increase the risk of infertility.
    • WOMEN -Ovulation Disorders .
    • MEN – A man’s sperm count may also be affected if he is overweight so a normal weight is always healthy for fertility.
  • Underweight. Women at risk of fertility who follow a very low calorie or restrictive diet.So eat healthy foods and develop healthy habits .

What is the effect of Exercise on fertility? 


  • Exercise- Insufficient exercise contributes to obesity, which increases the risk of infertility.
  • Heavy Exercise – Ovulation problems are associated with frequent strenuous  and  intense exercise in women who are not overweight.Hence , it is important to avoid heavy exercise when you want to be pregnant.

What are infections associated with infertility?


  • Sexually transmitted infections 
  • chlamydia,
  • gonorrhea
  • Adeno-associated virus might have a role in male infertility so it is important to have a screening for these infections.


  • WOMEN – A woman’s fertility gradually declines with age, especially in her mid-30s, and it drops rapidly after age 37. 
  • MEN -Men over age 40 may be less fertile than younger men .


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Successful IUI programme

Successful IUI programme

Intrauterine insemination (IUI) is  a  simple and cost effective fertility treatment.In this procedure healthy sperm is placed into a woman’s uterus when she is ovulating. This procedure is used for couples with unexplained infertility, minimal male factor infertility, and women with cervical mucus problems. IUI success is improved when it is done in conjunction with ovulation-stimulating drugs. It can be performed using the husband’s sperm or donor sperm. Before the procedure, the woman should be evaluated for any hormonal imbalance, infection or any structural problems.

Factors for a successful IUI programme :

  • Healthy sperm (Sperm count, motility and morphology should be good)
  • Timing of IUI – for a healthy pregnancy the sperm and egg should meet within 24 hrs. of ovulation. An aged or degenerated egg cannot yield a healthy pregnancy.
  • Fallopian tubes should not have any blockage or obstruction.
  • Similarly, the quality of egg should be good, an egg with thick covering(zona) does not allow sperm to enter inside the egg.
  • The uterus should be prepared well to receive the embryo otherwise implantation does not happen.

When is IUI used?

The most common conditions where IUI is recommended :

  • Low sperm count or decreased sperm mobility.
  • Unexplained infertility
  • A hostile cervical condition, including cervical mucus problems
  • Cervical scar tissue from past procedures which may hinder the sperms’ ability to enter the uterus
  • Ejaculation dysfunction

Success rate in  IUI :

The success of IUI depends on several factors. If a couple has the IUI procedure performed each month, success rates may reach as high as 20% per cycle depending on variables such as female age, the reason for infertility, and whether fertility drugs were used, among other variables.

Pregnancy rate :

Approximate pregnancy rate as a function of total sperm count (may be twice as large as total motile sperm count). Values are for intrauterine insemination. (Old data, rates are likely higher today)

The pregnancy or success rates for artificial insemination are 10 to 15% per menstrual cycle using ICI, and 15–20% per cycle for IUI. In IUI, about 60 to 70% have achieved pregnancy after 6 cycles.

However, these pregnancy rates may be very misleading, since many factors, including the age and health of the recipient, have to be included to give a meaningful answer, e.g. definition of success and calculation of the total population.For couples with unexplained infertility, unstimulated IUI is no more effective than natural means of conception

 

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