Previously infertility was considered purely a female problem, however studies have proven it’s the female factor in 40% of the cases and the male factor in 40% of the cases.
Having a child of their own is what most married couples dream of. However, today for various reasons conceiving a baby naturally has become difficult for many couples. There is hope yet. Fertility Investigation & Treatment can help couples conceive a child naturally or with the help of medical intervention. In spite of a high success rate in fertility treatment, there are a lot of questions that couples have that needs to be clarified. Here are some of them:
Q:How long should you try to get pregnant before going to the doctor?
Ans:At least a year. There is no need to be concerned unless you have been trying to conceive naturally through unprotected sexual intercourse for at least a year with no success. Make an appointment with a Fertility Specialist or a Reproductive Endocrinologist fertility check-up.
Q:What should you expect in the first consultation?
Ans:The doctor will first need to do a complete background check in order to get an idea as to what could be preventing conception. Both members of the couple will be interviewed to get their medical history that will include: previous injuries, reproductive history, illness and infections, medications being used for any other condition, recreational drug use, known family history of infertility and possible exposure to harsh chemicals or fumes.
Q:Can stress impact fertility?
Ans:There are no definitive studies that relate stress to infertility. However, it has been noted that reducing stress increases chances of getting pregnant. How? Stress can hamper growth, release of eggs, and even cause low sperm count. Hence, worrying over delayed pregnancy will not help you and can get in your way instead. This is why providing emotional support to the couple before and during the Fertility Treatment is as important as the treatment itself.
Q:Do both members need to be tested or just the female?
Ans:Both members will be tested for infertility. Female and male factors can contribute towards the couple’s infertility. Previously infertility was considered purely a female problem, however studies have proven it’s the female factor in 40% of the cases and the male factor in 40% of the cases. In 10% of the cases, it’s because of both of them and in the remaining 10% the cause for infertility is unknown.
Q:How does age affect fertility?
Ans:A woman is born with all the eggs that she would ever have in her lifetime. She is considered to be at her peak of fertility through her 20s. The number and the quality of the eggs gradually decline after the age of 30 making it more difficult to conceive if delayed further. The woman’s Fertility graph takes a steep downward between the age of 35 and 45. As they approach menopause there are fewer eggs available and she might have other medical conditions such as diabetes or high blood pressure that might also delay or affect pregnancy. Men also, as they age can have a lower sperm count or have other medical conditions, however, it’s the woman’s age that really affects conception. Hence, women who are 35 and above, who want to get pregnant, must consult with the doctor to understand the reason for their infertility and what treatment options she has to get pregnant.
Q:How do you check for infertility?
Ans:Both of you will need to have a physical examination to see for any obvious physical abnormalities in reproductive organs. These can be caused by injury or infection or even gene mutations and can obstruct the passage of the sperm or the egg. An ultrasound scan will give imaging of internal reproductive organs. In the woman this can help identify cysts, number of eggs in the ovary, growth or any other abnormalities in any part of the female reproductive system. Semen Analysis will help identify the number of sperms, motility of sperms and any structural abnormality of sperms produced by the male. Hormone testing and genetic testing may also be done if required to check for anomalies. Depending on the findings of the basic tests, the doctor will prescribe specialized tests for an accurate diagnosis to find out cause of infertility.
Q:What is the most common treatment for infertility?
Ans:There is no one treatment that suits every couple. Just because there are a number of couples who have conceived via IVF, it does not mean that’s the way for you. Depending on the findings from your various tests and your general health, your doctor will prescribe a plan of action suited to you. In some cases, regulating the female’s ovulation cycle is all it takes, while in others artificial insemination will be the way to go. Each doctor has a process or way of approach. Trust in your doctor and be patient.
Q:Which is better IVF or IUI?
Ans:Both methods have shown great results. The cause for infertility calls for the treatment. In some cases, IUI is one step after a failed attempt at regulating the ovulation cycle to conceive naturally. In Intrauterine Insemination [IUI] the doctor will introduce semen into the woman’s uterus close to egg near the time she is ovulating – this is to overcome any physical blockages impeding the movement of the sperms towards the egg. In InVitro Fertilization [IVF] the man’s sperm and the woman’s eggs are combined outside of the body, and the resulting embryos are grown in the lab for a few days before being transferred to the woman’s uterus.
Q:Will you need a donor?
Ans:If it is the male member with the infertility issue – like in low sperm counts, you can get a sperm donor, if for some reason IVF is not an option. Also, if the male member has a genetic condition that can affect his child, donor sperm can be used for conception. Donor sperm can be gotten from a semen bank. Likewise, if the female has any genetic condition, the couple can opt for an egg donor. Also, women who are older than 40 years, can choose an egg donor if the prime of her fertility age to ensure a healthy pregnancy. Before going ahead with a donor, it is important to understand how the hospital has zeroed in on the donor and get a complete medical history to ensure the donor does not have a genetic condition that can be passed on to the child.
Q:Under what conditions does a couple need a surrogate?
Ans:If the female has health conditions that make it impossible for her to go through a pregnancy, then the couple can opt for surrogacy. Here another woman carries the couple’s baby with the sole intent of giving the baby to the couple. One type of surrogacy is when the surrogate gets pregnant through artificial insemination making her the genetic mother. The other type of surrogacy is when an embryo created by the intended parents through IVF is transferred to the surrogate’s uterus. Here the surrogate is only the birth mother and not the genetic mother. If surrogacy is what you and your doctor decide upon, seek legal guidance before starting the treatment.
Q:Why are multiple births so common with infertility treatments?
Ans:It is true that the chance for multiple births is increased with infertility treatment. The reason being the drug and procedures involved are designed to increase the chance of conception – which means in IVF instead of transferring only one embryo to the uterus, the doctor might choose two or three hoping that at least one will work. Similarly, injections or medication to improve ovulation might result in the release of more than one mature egg. And while it is common and often seen as a miracle, a woman pregnant with multiples is at risk. She and the babies must be monitored closely to prevent complications.
Q:Should you inform family and friends about your fertility treatment?
Ans:The decision is entirely yours. If you do not intend to inform your child about the way he/she was conceived especially if you are using a donor or a surrogate, then you might want to think twice about who you share details of your pregnancy with. This is a very private and personal choice made by you and your partner. Revealing details is also the same.
CONSULTANT – FERTILITY SPECIALIST
MS(OG),Fellowship in Andrology & Reproductive Medicine