Trying to Conceive? Understanding Infertility, Its Causes and Fertility Tests
The soft worry and silence during the weeks and months that follow when conception has thwarted even the most determined couple of lovers can become a heavy burden that’s not so easy to hold onto. For some, there’s a hope in understanding what infertility is and what they can do about it.
What Infertility Actually Means
What Is Infertility? According to WHO (World Health Organization), infertility is a disease of the reproductive system, defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sex. About one in six people who have reproductive potential experience infertility at some time in their lives- infertility is far more prevalent than most people realize and is a disease, not a character flaw, that affects men and women equally.
Types of Infertility
There are two types of infertility that can be broadly divided into based on reproductive history.
- Primary Infertility – pregnancy has not been achieved in a couple who have been attempting to conceive for a year or more.
- Secondary Infertility – when the couple previously had a successful pregnancy no matter if it went to term or not.
Additional classifications of causes of infertility are:
- Female Factor: The woman is the problem.
- Male Factor: The man is the issue.
- A Combination: There is not only one factor contributing to the problem, but several.
- Unexplained Infertility: The reasons for the failure of conception cannot be identified.
- Considerations: Causes of male infertility can be very complicated.
Reason for Not Getting Pregnant: Female Factors
There are several causes for this, most doctors will investigate your ovulation, reproductive system and hormone levels to find the reason. Ovulation dysfunction – The most common reason for female infertility is ovulatory dysfunction, Polycystic Ovary Syndrome (PCOS) and failure to ovulate regularly. Here are some other reasons;
- Blocked or damaged tubes, usually caused by a previous pelvic infection or operation.
- Endometriosis- When tissue that appears to be the tissue that lines the inside of the uterus grows outside of the uterus.
- Uterine or cervical abnormalities affecting implantation
- Fewer and poorer quality eggs with age (particularly after mid 30’s) which can be assessed with the Anti-Müllerian Hormone (AMH) Test
- Hormonal or thyroid disorders, including raised prolactin levels, which can be checked with a Prolactin Test
Difficulty Conceiving: Male Factors
A third of couples struggling to conceive have a problem with male fertility – often sperm quality, movement or shape. The following factors can also play a role:
- Low sperm count or poor sperm motility
· Abnormal sperm shape (morphology)
- Varicocele: Enlarged veins in the scrotum
· Hormonal imbalances affecting sperm production which can be evaluated with the Follicle-Stimulating Hormone (FSH) Test and Luteinizing Hormone (LH) Test
- Blockages in the tubes that carry sperm
You have had other infections, you are being treated for a disease, or you have a genetic condition.
Common Misconceptions
There are a few more myths that may cause concern which can all be avoided. Historically it has been assumed that infertility is a female problem, yet male infertility occurs equally as frequently as female infertility which is why the most recent WHO guidelines recommend investigating the causes of male infertility instead of just testing the woman alone.
Also, not always can we give an explanation of the infertility issue, of which between a quarter and a third of cases the causes can be unknown. Lastly, people may be concerned if their partner misses a single cycle of trying to conceive when in fact many normally healthy couples will take a few cycles to conceive and investigations are not justified until at least 12 months (or earlier in some unique situations as outlined below).
Factors Affecting Fertility & What You Can Do to Improve Male Fertility
Not all the causes of infertility are preventable but that doesn’t mean there isn’t a lot you can do about some of them. And any step in the right direction can only be a good thing. In men, keep a normal weight, don’t smoke or drink excess alcohol, don’t stick your testes in a hot tub, don’t wear tight underwear and hot showers, reduce stress and see your GP early for infections.
In women, keep a normal weight, avoid PCOS, avoid thyroid problems and avoid smoking.
They won’t necessarily make you pregnant but they are safe and sensible first steps to take with the help of your GP.
If you are having trouble conceiving…
If you and your partner have been trying for a baby without success, start off by not trying to google or to take supplements or "fertility hacks" and start simply tracking. The first step: Track when your period and intercourse happen, irregular periods, pelvic pain or issues with reproductive health and go to a doctor versus googling!
When to See a Doctor
As a general rule, you should see your doctor if it’s been one year in couples under 35 years or 6 months over 35 years of age. However, there are many reasons to see your doctor early with fertility problems, if there are risk factors such as irregular or no periods, a history of pelvic infection or abdominal surgery, endometriosis symptoms or previous sperm problems. Don’t despair! Many of the causes of infertility are treatable and the sooner they are diagnosed, the better.
How It’s Diagnosed
Investigation and diagnosis: Normally the first step in diagnosis for both the partners is taking a complete history and doing a detailed physical examination then moving on to various investigations. For the women, fertility investigations may include: Blood tests to check for hormonal levels, and hormone functioning for ovulation such as the Follicle-Stimulating Hormone (FSH) Test, Luteinizing Hormone (LH) Test, Prolactin Test and Anti-Müllerian Hormone (AMH) Test, pelvic ultrasound which may include a test to see if the fallopian tubes are open, called a Hysterosalpingogram (HSG) testing the ovaries.
Fertility Testing: Fertility testing is made up of a series of individual tests which need to be ordered at the right times and taken at the right times. This makes selecting a reputable diagnostics centre a critical decision, one to take very seriously. Apollo Diagnostics offers hormone blood testing, including the AMH Test, Prolactin Test, LH Test and FSH Test, semen analysis and imaging to help fertility specialists make diagnoses about possible causes of infertility and move one step closer to finding solutions.
Conclusion
Infertility may seem very personal but it’s very rarely inexplicable or unmanageable. It is not generally required to guess and explore on your own, the demarcation between primary and secondary infertility; the concept that causes are almost equally shared between genders; the appropriate time to visit a doctor and when to request diagnostic services, can make the hunt stress free and scientific. If you are a couple having faced infertility and have been unable to conceive in requisite duration, take one step ahead, bring a smile back and connect with a doctor for fertility testing with an eminent diagnostic partner.
