Infertility

Infertility is when a couple can not conceive (get pregnant) despite having regular unprotected sex. Around one in six or seven couples may have difficulty conceiving. A couple will only be diagnosed as being infertile if they have not managed to have a baby after two years of trying. There are two types of infertility:

• Primary infertility, where someone who has never conceived a child in the past has difficulty conceiving.

• Secondary infertility, where a person has had one or more babies in the past, but is having difficulty conceiving again.

The cause of infertility in women usually involves problems with ovulation. Signs of ovulation difficulties include non-existent or irregular menstrual cycles. Other causes of female infertility include birth defects within the uterus, uterine fibroids, and blocked fallopian tubes. For a woman to be fertile, the ovaries must release healthy eggs regularly, and her reproductive tract must allow the eggs and sperm to pass into her fallopian tubes to become fertilized by a sperm. Her reproductive organs must be healthy and functional.

The cause of infertility in men can usually be traced to problems with the production of sperm. Men who produce no sperm suffer from a condition called azoospermia, and those with a low sperm count suffer from oligospermia. In addition, blocked reproductive tracts, malformed sperm, or inactive sperm can be a cause of male infertility. For a man to be fertile, the testicles must produce enough healthy sperm, and the sperm must be ejaculated effectively into the woman's vagina. Tests for male infertility attempt to determine whether any of these processes are impaired.

Treatment of infertility depends on the cause, how long the person has been infertile, the age of the partners and many personal preferences. Some causes of infertility can't be corrected. However, a woman can still become pregnant with assisted reproductive technology or other procedures to restore fertility.

Medical treatment of infertility generally involves the use of fertility medication, medical device, surgery, or a combination of the following. If the sperm are of good quality, and the mechanics of the woman's reproductive structures are good (patent fallopian tubes, no adhesions or scarring) physicians may start by prescribing a course of ovarian stimulating medication.

Injectable fertility drugs increase the chance of multiple births. Oral fertility drugs such as Clomid increase the chance of multiple births but at a much lower rate. The use of these drugs requires careful monitoring using blood tests, hormone tests and ultrasound measurement of ovarian follicle size. Generally, the greater the number of foetuses is the higher the risk of premature labour. Babies born prematurely are at increased risk of health and developmental problems. These risks are greater for triplets than for twins or single pregnancies.

If conservative medical treatments fail to achieve a full term pregnancy, the physician may suggest the patient undergo in vitro fertilization. There are also a number of alternative fertility treatments that have been found to be affective, both on their own and as a complementary treatment to traditional infertility solutions.