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Infertility Therapy

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Infertility Therapy

Infertility is the inability to conceive a child. A couple may be considered infertile if they fail to conceive even after two years of regular sexual intercourse without contraception. An infection may cause infertility in the man or woman, but often there is no obvious underlying cause.  

Infertility is connected with difficulty in conceiving or getting pregnant. This general term does not identify the cause of the problem or whether it will be permanent. World Health Organization defines infertility as follows:

Often, physicians and researchers consider a couple to have infertility issues if they have not conceived, despite regular intercourse without using birth control, for at least a year. As per the world survey, 15 to 20 % of couples do not conceive despite a year of trying.   

However, this does not mean they will not conceive later or even without treatment. Some investigators believe that if a couple cannot conceive even after 2 years, they surely require some medical assistance.

It is sometimes called sterility when an individual has no chance to conceive without treatment (for example, a woman does not ovulate nor has two blocked fallopian tubes).

Is infertility a male or female problem?   

In the past, infertility was commonly considered a female problem. It is now recognized that a couple's infertility is just as likely to root problems in the male partner. In infertility testing, about 40 % of the cases stem from female factors and another 40 % from male factors. In 10 % of couples, infertility factors are found in men and women. In the remaining 10 %, infertility remains unexplained after testing. The statistical data clearly shows that male infertility can also cause the failure of conception.

General factors causing female and male infertility:    

DNA damage: reduces fertility in female eggs caused by smoking or radiation and fertility in male sperm caused by drugs or chemotherapy. Other factors causing female and male infertility both are given below:

  • Genetic factors
  • Hormonal factors
  • Diabetes mellitus
  • Thyroid disorders
  • Environmental factors
  • Toxins such as glues, volatile organic solvents or silicones, physical agents, chemical dusts, and pesticides. Tobacco smokers are 60% more likely to be infertile than non-smokers.

Male infertility causes:

  • low semen quality
  • testicular malformations
  • hormone imbalance
  • blockage of the man's duct system

Female infertility causes:

  • Severe endometriosis
  • Pelvic Inflammatory Disease (PID)
  • Ovulation disorders
  • Elevated prolactin (hormone)
  • Polycystic ovary syndrome (PCOS)
  • Early menopause
  • Benign uterine fibroids
  • Pelvic adhesions

Infertility treatment for females

To a woman with infertility issues, doctors usually prescribe medicines that help them to get pregnant. These medications are often referred to as infertility drugs. These drugs function by causing your body to release hormones that trigger ovulation (the process of releasing an egg from the ovary). Even if you already use another method to improve your chance of getting pregnant, such as in-vitro fertilization, fertility drugs are still an important part of infertility therapy.

Fertility treatment comprises many medicines that address various problems. The fertility drugs for the infertility treatments are mentioned below:

Clomifene is a medicine that has been used to help with fertility for many years. It is taken as a tablet. It works by blocking a feedback mechanism to the pituitary gland. This results in the pituitary gland making and releasing more gonadotropin hormones than normal. The extra amount of gonadotropin hormones may stimulate the ovaries to ovulate.

Metformin may be offered to women with polycystic ovary syndrome (PCOS) who have infertility but have not responded to clomifene. Metformin is a medicine commonly used to treat some people with diabetes. Some studies have suggested that metformin may help improve fertility problems in some women with PCOS, usually in addition to clomifene.

Medicines that contain gonadotropin are another type of treatment. These need to be injected. They are used when clomifene does not work or before IUI and IVF, to cause ovulation. Gonadotropin medicines may also improve men's fertility with certain hormonal problems affecting sperm count.

Medicines that contain gonadotropin-releasing hormone are sometimes used. These stimulate the pituitary to release gonadotropin (which stimulates the ovaries).

  1. Surgical treatments for infertility treatment are as follows:
  • Ovarian drilling (surgical method of ovulation induction)
  • Fallopian tube surgery
  • Uterine surgery
  • Surgery for endometriosis

     3. Assisted Reproductive Technology (ART)

  • Intrauterine Insemination (IUI)
  • In Vitro Fertilization (IVF)
  • Gamete Intrafallopian Transfer (GIFT) & Zygote Intrafallopian Transfer (ZIFT)
  • Intracytoplasmic Sperm Injection (ICSI)
  • Donor insemination (sperm or egg donation)
  • Preimplantation Genetic Diagnosis and Screening
  • In Vitro Maturation (IVM)
  • Factors affecting the outcome of ART
  • Risks and adverse effects associated with ART
  • Egg donation
  • Embryo donation
  1. Other infertility treatments

Doctors suggest that supplements including zinc, selenium, and vitamin E may be helpful for men who have abnormal sperm counts due to an unknown cause.

Male infertility Treatment

The male infertility treatment includes general sexual problems or lack of healthy sperm. Treatment may include:

Medication or behavioral approaches: Addressing impotence or premature ejaculation with one or both approaches may improve fertility.

Surgery, hormones or assisted reproductive technology: If the lack of healthy sperm is suspected as the cause of a man's infertility, surgery or hormones to correct the problem or the use of assisted reproductive technology is sometimes very useful.

Sperm retrieval: These techniques are used when ejaculation is a problem:

Surgical sperm aspiration, which allows retrieval of sperm if the ejaculatory duct is blocked

Electric or vibratory stimulation to achieve ejaculation can help retrieve sperm in men with spinal cord injury.

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