Infertility: Causes, diagnosis, risks, drugs, and treatments

Infertility is defined as the inability to conceive after 12 months of unprotected sexual intercourse. Infertility may be attributed to the man, the woman, or both partners. Infertility does not mean that a couple is sterile and will never have a child.

Approximately half of all couples who seek help for infertility will eventually conceive a child. There are several treatments available that may help to improve the chances of a conception and a successful pregnancy.

In Africa, More than 100 thousand cases per year (Nigeria). Ages affected 14-60. And usually self-diagnosable and treated by a medical professional. 

Causes of Infertility

Not all causes of infertility are known, however, infertility may be affected by genetic disorders, previous radiation and chemotherapy treatments for cancer and medical conditions such as thyroid problems or diabetes. Other factors may also play a role in the cause of infertility and may include:

In Women:

• Advanced age
• Endometriosis
• Ovulation disorders
• Abnormalities with the uterus or cervix
• Damage or blockage in the fallopian tubes
• Eating disorders.

Medications, treatments, and drugs that can affect fertility in a woman

Some drugs can affect fertility in a woman. This include:

• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Chemotherapy
• Radiation therapy
• Illegal drugs.

One study has found that high cholesterol levels may have an impact on fertility in women.

In Men:

• Low sperm count
• Varicocele or other testicle problems
• Hormone problems
• Exposure to certain chemicals or toxins
• Abnormal spam

Abnormal semen may not be able to carry the sperm effectively too.

This can result from:

• A medical condition
• Overheated testicles the scrotum, the use of saunas or hot tubs, wearing tight clothes, and working in hot environments.
• Ejaculation disorders
• Hormonal imbalance.

In some cases, lifestyle factors such as obesity, smoking, and heavy alcohol or drug use can affect ovulation and sperm count and decrease levels of fertility.

Are infertility Treatments Covered by Health Insurance?

And follow with this paragraph text linking to our site: Infertility treatments may or may not be covered by health insurance. This depends on different factors, including your insurance plan and the state you live in. Find and compare health insurance plans in your area.

Diagnosis of Infertility

During the initial infertility evaluation, both the female and male partner will undergo a full physical examination and their complete medical histories will be reviewed. In addition, blood tests and urine tests will be performed. Additional tests to determine the cause of infertility will also be performed and may include:

For Women:

• Hysterosalpingography to evaluate the condition of the uterus and fallopian tubes
• Hormone testing to check levels of hormones that control reproductive processes
• Ovulation testing
• Imaging tests of reproductive organs

• Semen analysis
• Hormone level testing to check testosterone levels
• Transrectal and scrotal ultrasound

Treatment of Infertility And Fertility Drugs

Treatment for infertility aims to maximize the couple's fertility potential and allow for successful conception. Recommendations for increasing fertility may be as simple as quitting smoking, avoiding alcohol and losing weight.

The couple may be advised to have sexual intercourse more often around the time of ovulation. Sperm can survive inside the female for up to 5 days, while an egg can be fertilized for up to 1 day after ovulation. In theory, it is possible to conceive on any of these 6 days that occur before and during ovulation.

Treatments may vary depending on the cause and may include:

Fertility drugs might be prescribed to regulate or induce ovulation.

They include:

• Clomifene (Clomid, Serophene): This encourages ovulation in those who ovulate either irregularly or not at all, because of PCOS or another disorder. It makes the pituitary gland release more follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
• Metformin (Glucophage): If Clomifene is not effective, metformin may help women with PCOS, especially when linked to insulin resistance.
• Human menopausal gonadotropin, or hMG (Repronex): This contains both FSH and LH. Patients who do not ovulate because of a fault in the pituitary gland may receive this drug as an injection.
• Follicle-stimulating hormone (Gonal-F, Bravelle): This hormone is produced by the pituitary gland that controls estrogen production by the ovaries. It stimulates the ovaries to mature egg follicles.
• Human chorionic gonadotropin (Ovidrel, Pregnyl): Used together with clomiphene, hMG, and FSH, this can stimulate the follicle to ovulate.
• Gonadotropin-releasing hormone (Gn-RH) analogs: These can help women who ovulate too early—before the lead follicle is mature—during HMG treatment. It delivers a constant supply of Gn-RH to the pituitary gland, which alters the production of the hormone, allowing the doctor to induce follicle growth with FSH.
• Bromocriptine (Parlodel): This drug inhibits prolactin production. Prolactin stimulates milk production during breastfeeding. Outside pregnancy and lactation, women with high levels of prolactin may have irregular ovulation cycles and fertility problems.

• Surgery to correct a varicocele
• Medication to correct impotence
• Sperm retrieval
• Hormone treatments

Reducing the risk of multiple pregnancies

Infertility treatments may have side effects and the most common complication is multiple births, and as a result the greater the number of fetuses, the higher the risk of premature labor and delivery. Also, some infertility treatments that stimulate ovulation may cause a serious condition called ovarian hyperstimulation syndrome.
Careful monitoring during treatment and pregnancy can help reduce the risk of complications. The more fetuses there are, the higher the risk of premature labor.

If a woman needs an HCG injection to activate ovulation and ultrasound scans show that too many follicles have developed, it is possible to withhold the HCG injection. Couples may decide to go ahead regardless of the desire to become pregnant is very strong.

If too many embryos develop, one or more can be removed

Intrauterine insemination may also be performed to assist with pregnancy. In this procedure, a large amount of healthy sperm is implanted directly into the uterus at the time of ovulation through a thin catheter. If these infertility treatments are unsuccessful, the couple may decide to use other assisted reproductive technology options such as in vitro fertilization, intracytoplasmic sperm injection, eggs donor or sperm, or a surrogate.

Many couples may experience physical and psychological stress during infertility treatments, which can be costly, and may not be covered by insurance. The couple should discuss all fertility treatment options with a physician in order to determine the best approach to treat issues of infertility.

Types of Infertility

Infertility can be primary or secondary.

Primary infertility is when a couple has not conceived after trying for at least 12 months without using birth control

Secondary infertility is when they have previously conceived but are no longer able to.

Diagnosis of Infertility

Most people will visit a physician if there is no pregnancy after 12 months of trying.

If the woman is aged over 35 years, the couple may wish to see a doctor earlier, because fertility testing can take time, and female fertility starts to drop when a woman is in her 30s.