Infertility
20 Case Studies
13 Member Stories
9 Research

What is Infertility?

Infertility is the failure of a couple to conceive a pregnancy after trying to do so for at least one year. In primary infertility, pregnancy hasn't happened. In secondary infertility, both members of the couple have already guessed, but are not able to conceive again after a full year of trying. In the event you and your spouse are fighting to have a baby, you are not alone. In US, 10% to 15% of couples are infertile. Infertility is defined as not having the ability to get pregnant despite having regular, unprotected sex for at least a year for most couples.

Infertility may result from a problem with you or your partner, or a combination of factors which prevent pregnancy. Fortunately, there are lots of safe and effective remedies that greatly enhance your chances of becoming pregnant.


Approximately 20 percent of couples struggle with infertility at any particular time. Some studies blame this growth on social phenomena, including the trend for marriage and starting a family to happen at a later age. For women, fertility decreases with increasing age, especially after 35 years.


Currently, individuals frequently have a lot of sexual part ners until they marry and attempt to have kids. This growth in numbers of sexual partners has resulted in a rise in sexually transmitted diseases. Scarring from these types of infections, especially from pelvic inflammatory disease (infection of the female reproductive cells ) appears to be in part responsible for the increase in infertility. Additional use of some kinds of this contraceptive called the intrauterine device (IUD) has led to an increased rate of pelvic inflammatory disease, with subsequent scarring.

To comprehend the causes of infertility, it's first necessary to comprehend the fundamentals of human reproduction. Fertilization occurs when a sperm from the man merges with an egg (ovum) in the female, creating a zygote which has genetic material (DNA) from both the father and the mother. If pregnancy is subsequently established, the zygote will develop into an embryo, then a fetus, and finally, if all goes well, a baby will be born.

Sperm are little cells which take the father's genetic material. The sperm are mixed to a fluid called semen, which is discharged from the penis during sexual intercourse. The whiplike tail of the sperm enables the sperm to swim up the female reproductive tract, in search of an egg.

The mother's genetic material is in a cell called the ovum. Once per month, one mature ovum is created, and leaves the ovary in a process called ovulation. This ovum enters a tube leading to the uterus (the fallopian tube) where fertilization occurs. When fertilization occurs, the resulting cell (which currently contains genetic material from both the mother and the dad ) is called the zygote. This single cell will divide into multiple cells and the subsequent cluster of cells (called a blastocyst) moves to the womb (uterus). The uterine lining (endometrium) has been preparing itself to be given a pregnancy by growing thicker. If the blastocyst successfully attaches itself to the wall of the uterus, then pregnancy was achieved.


Causes of Infertility

Unlike many medical problems, infertility is a problem requiring the careful analysis of two distinct individuals, in addition to an evaluation of the interactions with one another. In about 3--4 percent of couples, no cause for their infertility is going to be discovered. About 40 percent of the time, infertility is due to a problem with the male; roughly 40 percent of their time, infertility is because of the female; and about 20 percent of the time, there are fertility issues with both the male and the female.

The primary factors involved in causing infertility include male issues (35%), ovulation problems (20%), gastrointestinal problems (20%) Illness (10%), and cervical variables (5%).


Male factors

Male infertility may be caused by a variety of distinct features of the sperm. A ssemen analysisis needed check for these characteristics. Four basic characteristics are often appraised:

• Sperm count refers to the amount of sperm present in a semen sample. The normal number of sperm within only 1 teaspoon of semen is more than 20 million. A man with just 5--20 million sperm is deemed subfertile and a guy with fewer than 5 million sperm is deemed infertile.

• Sperm are also analyzed to determine how well they float (sperm motility) and also to be sure that many have normal structure.

• Not all sperm in a specimen of semen will be absolutely normal. Some can be immature, and a few may have abnormalities of the head or tail. A normal semen sample will comprise no more than 25% abnormal forms of sperm.

• Volume of the semen sample is crucial. An abnormal quantity of semen could influence the ability of the sperm to successfully fertilize an ovum.


Numerous conditions result in abnormal findings in the semen analysis. Men could be born with testicles that haven't descended properly in the abdominal cavity (where testicles grow originally) to the scrotal sac, or may be born with only one instead of the two testicles. Testicle size could be smaller than usual. Past infection (like mumps) can affect testicular function, as can a past accident. The presence of abnormally large veins (varicocele) from the testicles can increase testicular temperature, which reduces sperm count. History of having been subjected to various toxins, drug use, excessive alcohol use, use of anabolic steroids, certain medicines, diabetes, thyroid problems, or other endocrine disturbances can have direct impacts on the formation of sperm (spermatogenesis). A study published in late 2001 linked certain organic solvents that men experience in the office as potential causes of low sperm count. The kinds of solvents are probably encountered in such professions as those of specialist printers, painters, and decorators. Theories suggest solvents like glycol ethers, which are know to affect animals' reproductive systems, are the most harmful.

Issues with the male anatomy can cause semen to be ejaculated not from the penis, but to the bladder; and scarring from previous infections can interfere with ejaculation. Studies continue to discover causes of male infertility. 


Female Factors:

Ovulatory Issues

The first step in diagnosing ovulatory problems is to be certain an ovum has been produced monthly. Turns out that around the time of ovulation, a woman's morning body temperature is slightly higher than normal. A woman can measure and record temperatures daily and a graph can be drawn to show whether ovulation has occurred. Just prior to ovulation, the Luteinizing hormone (LH) is released and a simple urine test could be done to check if LH has been released around the time that ovulation is anticipated.


Pelvic adhesions & Infection

Pelvic adhesions are fibrous scars that block the fallopian tubes and prevent the sperm from reaching the egg, thereby causing infertility. These scars may be the result of previous infections, such as pelvic inflammatory disease, or illnesses after abortions or prior births. Previous abdominal surgeries may also leave behind discoloration.

Endometriosis is the strange location of uterine tissue outside the uterus. When uterine tissue is implanted elsewhere in the pelvis, it still bleeds on a monthly basis together with the beginning of the normal menstrual period. This contributes to irritation within the pelvis around the website of the abnormal tissue and bleeding, and can lead to scarring. Endometriosis can result in pelvic adhesions.

A hysterosalpingogram (HSG) can reveal if the fallopian tubes are blocked. This is an x-ray examination that assesses whether dye material can travel through the patient's fallopian tubes. Scarring can also be identified by examining the pelvic region through the use of a laparoscope that's inserted into the abdomen through a small incision made near the navel.


Cervical factors

The cervix is the opening from the vagina to the uterus through which the sperm must pass. Mucus produced by the cervix helps to transfer the sperm to the uterus. Injury to the cervix or discoloration of the cervix after surgery or disease may lead to a smaller than normal cervical opening, which makes it difficult for the sperm to enter. Injury or infection may also decrease the amount of glands in the cervix, resulting in a smaller quantity of cervical mucus. In other scenarios, the mucus produced is the wrong consistency (maybe too thick) allowing sperm to undergo. Furthermore, some women produce antibodies (immune cells) which are specifically directed to detect sperm as foreign invaders and to kill them.

Cervical mucus can be analyzed under a microscope to diagnose if peripheral variables are leading to infertility. The interaction of a live sperm sample from the male partner and a sample of cervical mucus from the female partner may also be examined. This procedure is known as a post-coital test.


Infertility Natural Treatment Options

Traditional treatment for infertility normally involves invasive and, expensive processes. There are lots of alternative treatments available that may increase the probability of conception. Some have been proven effective in clinical studies.

General steps to increase fertility include tracking ovulation and timing intercourse (optimal chance for conception is within six days before and including the day of ovulation); and stopping smoking, excessive drinking, and drug use. To increase sperm quality, guys can wear boxer shorts instead of briefs.

Both people can increase fertility by ingesting a well-balanced diet. Superior food options include legumes (particularly soy), dark-colored veggies, seeds, fruits, nuts, and adequate good quality protein such as fish, poultry, and eggs. Some people today believe refined sugar, processed cheeses, foods made with white flour, as well as chemical preservatives should be avoided. Adequate sleep is also important.



Supplements

Dietary supplements that can improve fertility include:

• Multivitamins can help treat infertility in women.

• Vitamin E has antioxidant activity that prevents reproductive harm in women and men. It may increase sperm count and motility in men and balance hormones in women.

• Vitamin C has antioxidant activity that prevents reproductive harm in women and men. Additionally, a study found that vitamin C supplementation led to enhanced sperm count and decreased sperm clumping in infertile men.

• Folic acid (using a multivitamin) improved fertility in a study of infertile women.

• Zinc deficiency is frequently associated with low sperm count. Studies have found that zinc supplementation may improve male fertility.

• Selenium has antioxidant action. Selenium supplementation resulted in increased sperm count and motility and decreased number of sperm in a study of infertile men.

• Beta-carotene supplementation may increase sperm count and motility.

• B vitamins (B2, B6, and B12) are important for optimum fertility.

• Arginine supplementation resulted in significant gains in sperm count and motility at a study of infertile men.




Chinese and Ayurvedic herbal medicine

After consulting with an Acupuncture or Ayurveda practitioner, the following herbal medicines may be prescribed to women to treat infertility:

• Dong quai (Angelica sinensis) has been used to regulate menstrual cycles and for infertility.

• Licorice helps to balance levels of testosterone and estrogen and can be used for infertility.

• Shatavari (Asparagus racemosus) is an Ayurvedic treatment for infertility and works by balancing hormones.

• Rehmannia is an Ayurvedic treatment for infertility.

• Myrrh (Commiphora myrrha) is an Ayurvedic treatment for infertility.

• False unicorn (Chamaelirium luteum) balances hormone levels.

• Pomegranate character balances the reproductive system.

• Chasteberry (Vitex agnus-castus) balances hormone production.

• Ladies mantle (Alchemilla vulgaris) balances hormone production.

• Red clover (Trifolium pratense) has a favorable effect on the uterus, can calm the nervous system, and may balance hormone levels.

• Nettle (Urtica dioica) supports the uterus and hormonal system.

• Raspberry leaf strengthens the mucous lining of the uterus.



Similarly, after consulting with an Acupuncture or Ayurveda practitioner, the following may be prescribed to men to treat infertility

• Ginseng may increase the formation of semen, testosterone levels, and sexual activity.

• Pygeum can help infertile men that have a diminished secretion of semen.

• Shatavari (Asparagus racemosus) is an Ayurvedic treatment for infertility and works by balancing hormones. May increase sperm production.

• Saw palmetto (Serenoa serrulata) increases the production of testosterone and strengthens the reproductive system.

• Ashwaganda (Withania omnifera) is an Ayurvedic remedy that improves the quality of semen and sperm count.

• Chinese herbals have to be especially designed and used to treat infertility in men.

• Pine bark extract enhances sperm form.

• Chasteberry (Vitex agnus-castus) balances hormone production.


Other alternative and complementary treatments

A range of other alternative treatments may be used for infertility:

• stress reduction

• cognitive behaviour therapy

• visualization

• homeopathy

• reflexology

• essential oils

• acupuncture


Prevention of Infertility

Some kinds of infertility are not preventable. But several strategies and lifestyle changes might increase your odds of pregnancy.


Couples: Have regular sex many times around the time of ovulation for the maximum pregnancy rate. Intercourse starting at least five days before and until a day after childbirth improves your odds of getting pregnant. Ovulation usually occurs in the middle of the cycle - halfway between menstrual periods -- for many women with menstrual cycles about 28 days apart.


Men: Although most types of infertility are not preventable in men, these strategies may help:

• Prevent drug and tobacco use and drinking a lot of alcohol, which might result in male infertility.

• Avoid high temperatures found in hot tubs and hot tubs, because they may temporarily affect sperm production and mobility.

• Avoid exposure to industrial or environmental toxins, which may affect sperm production.

• Limit drugs that may impact fertility, both prescription and nonprescription drugs. Talk to your doctor about any medications you take regularly, but do not stop taking prescription drugs without medical advice.

• Exercise moderately. Regular exercise can improve sperm quality and increase the likelihood of achieving a pregnancy.


Women: For women, a number of approaches may increase the chances of becoming pregnant:

• Quit smoking. Tobacco has many negative effects on fertility, and of course your overall health and the health of a fetus. If you smoke and are thinking of pregnancy, quit today.

• Prevent alcohol and street drugs. These chemicals may impair your ability to conceive and have a healthy pregnancy. Do not drink alcohol or use recreational drugs, such as marijuana, if you are trying to become pregnant.

• Restrict caffeine. Women trying to become pregnant might want to restrict caffeine intake. Consult your doctor for advice on the safe use of caffeine.

• Exercise moderately. Regular exercise is important, but exercising intensely that your periods are rare or absent may affect fertility.

• Prevent weight extremes. Your hormone production depends on being overweight or underweight and can adversely cause infertility.

Allopathic treatment for infertility

The first step in the treatment of infertility is to perform thorough physical exams and testing of both partners in the hope of finding the source of infertility. For the woman this involves blood testing and ultrasound examinations at specific days during the menstrual cycle. This may include an endometrial biopsy in which a sample of the lining of the uterus is taken and examined. Hysteroscopy, in which a special camera examines the inside of the uterus, may be performed.


Pelvic adhesions can be treated during laparoscopy. The adhesions are cut using special instruments. Endometriosis can be treated with certain medications, but may also require surgery to repair any obstruction caused by adhesions of anti-sperm antibodies, and artificial insemination techniques to completely bypass the cervical mucus.


Treatment of ovulatory problems depends on the cause. If it is determined that there is a a thyroid or pituitary problem, treating that problem can help fertility. Medications prescribed to stimulate ovulation are clomiphene citrate (Clomid) taken orally and follicle stimulating hormone (Pergonal, Fertinex, and Follistim) via injection. These drugs may increase the risk of multiple births (twins, triplets, etc.) and may cause side effects.


Treatment of male infertility includes identifying and fixing known reversible factors first such as discontinuing any medication known to have an effect on spermatogenesis or ejaculation, reducing alcohol, and treating thyroid or other endocrine disease. Varicoceles can be treated surgically. Testosterone in low doses can improve sperm motility.


Other treatments of male infertility include collecting semen samples from multiple ejaculations, pooling them, and depositing them into the female’s uterus during ovulation. If all else fails, the couple may consider a donor sperm via artificial insemination.


Two of the most common fertility treatments are:

A) intrauterine insemination (IUI), where a healthy sperm is collected and inserted directly into your uterus when you are ovulating.

B) in-vitro fertilization (IVF), where eggs are taken from your ovaries and fertilized by sperm in a laboratory, where they grow into embryos. Then a doctor puts the embryos into your uterus


These are usually used after other techniques such as surgery, medications, and/or insemination have proven futile.

IVF involves the use of drugs to induce the simultaneous production of many eggs from the ovaries, which are retrieved surgically or via ultrasound-guided needle aspiration through the vaginal wall. The fusion of the ova and sperm occurs in a laboratory and the cell division up to the pre-embryo stage is allowed to take place. While this takes place, the female may be given progesterone to ensure that her uterus is ready for implantation. Two or more pre-embryos are transferred to the female’s uterus.

Success rates of IVF are still rather low, but depends on the clinics.

References

1. Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/infertility/symptoms-causes/syc-20354317

2. UCLA Health, http://obgyn.ucla.edu/infertility

3. Planned Parenthood, https://www.plannedparenthood.org/learn/pregnancy/fertility-treatments

4. Maleskey, Gale. “Infertility.” Nature’s Medicines: from Asthma to Weight Gain, from Colds to High Cholesterol—the Most Powerful All-Natural Cures. Emmaus, PA: Rodale Press, 1999.

5. Martin, Mary C. “Infertility” In Current Obstetric and Gynecologic Diagnosis and Treatment, edited by Alan H. Cecherney and Martin L. Pernoll. Norwalk, CT: Appleton & Lange, 1994.

6. Ying, Zhou Zhong, and Jin Hui De. “Common Diseases of Gynecology.” In Clinical Manual of Chinese Herbal Medicine and Acupuncture. New York: Churchill Livingston, 1997.

7. Hornstein, Mark D., and Daniel Schust. “Infertility.” In Novak’s Gynecology, edited by Jonathan S. Berek. Baltimore: Williams and Wilkins, 1996.

8. https://americanpregnancy.org/infertility/acupuncture/

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