Infertility is defined as not being able to get pregnant despite having frequent, unprotected sex for at least a year for most couples. Infertility may result from an issue with either you or your partner or a combination of factors that prevent pregnancy.
- What can cause infertility in a woman and a man?
There are many factors that can cause infertility and it is important to remember that both female and male factors contribute almost equally. The most common causes are ovulatory disorders (25%), tubal pathology (15%), sperm dysfunction (30%), and uterine/peritoneal factors (10%). Twenty percent of infertility cases are unexplained.
- Is there any sign that will tell if someone is infertile?
No, there are no signs that will tell if someone is infertile. There may be signs associated with medical disorders linked to infertility but this does not translate to signs that someone is infertile.
- How long should one try to get pregnant before looking for a doctor?
More than 80% of couples having regular unprotected vaginal sexual intercourse will conceive within one year. By the second year, this figure increases to more than 90%. In view of this, couples trying to conceive should seek help if they have not fallen pregnant after one year. Women who are over the age of 35 years are advised to seek help after six months.
- What investigations are done to check for infertility?
Infertility investigations involve both the female and male partner. Pregnancy is achieved when a sperm fertilizes an egg, usually in the fallopian tube. Hence, infertility tests are aimed at assessing each of these components. The tests that are done include semen analysis, hormonal profile, ovarian reserve testing, and tubal testing.
Semen analysis checks to see how many sperms are present, do they look normal and are they moving? Ovulation is the release of an egg during the menstrual cycle and can be checked through a blood test measuring progesterone levels.
Ovarian reserve testing can be done through a blood test to check anti-Mullerian hormone (AMH) levels or with a pelvic ultrasound to measure the antral follicle count.
Tubal testing can be done with a hysterosalpingogram (HSG) which is a test using X-ray with dye to check if the fallopian tubes are blocked.
- How to manage infertility?
There are a variety of assisted reproductive technologies available which include timed intercourse, ovarian stimulation, intrauterine insemination (IUI) and in-vitro fertilization (IVF).
However, the management for infertility should be individualized based on the couple’s history, examination, and investigation results.
IVF specifically can be used for any cause of infertility and its success rate is influenced heavily by the age of the female partner. In addition, smoking habits, caffeine, and alcohol consumption as well as nutritional status and body mass index (BMI) all play a role in infertility management outcomes.
Article by:
Dr. Syeda Nureena Zaidi
Obstetrics & Gynaecology (O&G) Specialist at University Malaya Specialist Centre
