Today we are going to discuss the fertility and infertility. Nowadays infertility is a major problem in this modern society. In ten out of a hundred couple suffer from this major problem in India and USA. Every person will have a strong will to raise a child at some phase of the life. In normal fertility is crucial to helping a couple (83%) will achieve the pregnancy within a year of trying. about seven percent of the couples achieve pregnancy in the second year. a person is considered as infertile after not achieving within a year. This test is done on the 15% of couples who not achieve the pregnancy during 12 months of attempts. Doctors suggest doing the endoscopy to diagnosis the reason for infertility. There are various reasons behind infertility where one may be advised to seek help earlier.
What is fertility?
when a couple is able to raise a child normally. or When a female get pregnant in a year without using any biotechnology is know as fertility. 85% of the couple normally makes a child. but 15% of couples face problems in raising a child within a year.
How is Infertility Defined?
Every couple is different so the rate of getting pregnant is different for everyone. the rate of getting pregnant depends on various factors like genes, sexual history, and other factors.
Some of the couples are able to get pregnant almost immediately after the sexual activity. while others try for a week, month or even years. Now you probably think that when a couple is considered as an infertility problem.
well, if a couple tries to getting pregnant having regular intercourse activity without using any contraceptive for a year. They would be diagnosed with infertility.
Infertility is categories int0 two types:
- Primary Infertility
- Secondary Infertility
Primary infertility when a couple never been able to conceive. They are diagnosed with primary infertility. In other words, primary infertility means that the couple never successful in making a child. 10% of the population of India and USA is suffered from this serious problem. Primary infertility caused by various reasons like sexual history, genes, and other various reasons.
Causes of Primary infertility:
Primary infertility can be caused by the following reasons:
Advancing maternal age: In the history, in the 20th century, the age of marriage is eighteen to twenty which is best for raising a child because the generation of eggs is good in this age. This lead to the less amount of infertility rate. but in modern time the ladies delaying the childbirth until the thirties to forties of their age. which affects the generation of the egg and leads to the problem of infertility. Egg function is affected by advanced maternal age. In fact, today the most common reason for infertility in women is advanced maternal age. This age is not suitable for giving birth because the egg numbers are decreases at a rapid rate.
The quality of eggs is genetically normal but as but decrease as well. So the ability to be pregnant normally is decreased for women from when women cross their early thirties into her forties. women are rarely fertile at the age of 45. This applies the ability to be pregnant with her egg, not with donors egg.
Ovulation disorders: Ovulation is a process of releasing the mature egg. ovulation is an essential process to a woman for getting pregnant. It is a normal and regular process. Ovulation can be predicted by keeping a menstrual calendar or using an ovulation predictor kit. There is much disorder that may affect the normal ovulation of women. the main disorders which affect the normal ovulation in women are polycystic ovary syndrome (PCOS), hypogonadotropic hypogonadism (from signaling problems in the brain), and ovarian insufficiency (from problems of the ovary). if the menstrual cycle is abnormal or irregular of the women. Your doctor will examine you and perform some test to find a reason behind your infertility problem.
Endometriosis: Endometriosis (en-doe-me-tree-O-sis) is a regularly difficult disorder in which tissue that typically lines within your uterus — the endometrium — becomes outside your uterus. Endometriosis most normally includes your ovaries, fallopian tubes and the tissue coating your pelvis. Infrequently, endometrial tissue may spread past pelvic organs.
With endometriosis, dislodged endometrial tissue keeps on going about as it normally would — it thickens, separates and seeps with each menstrual cycle. Since this displaced tissue has no real way to leave your body, it becomes trapped. At the point when endometriosis includes the ovaries, growths called endometriomas may form. surrounding tissue can end up disturbed, inevitably creating scar tissue and attachments — irregular groups of fibrous tissue that can make pelvic tissues and organs adhere to each other.
Endometriosis can cause pain — sometimes severe — especially during your period. Fertility problems also may develop.
Endometrial polyps: Uterine polyps are developments appended to the inner wall mass of the uterus that stretch out into the uterine cavity. overgrowth of cells in the coating of the uterus (endometrium) prompts the development of uterine polyps, otherwise called endometrial polyps. These polyps are normally noncancerous (benevolent), albeit some can be cancerous or some can, in the long run, transform into growth (precancerous polyps).
Uterine polyps range in size from a couple of millimeters — no bigger than a sesame seed — to a few centimeters — golf-ball-measure or bigger. They join to the uterine divider by a vast base or a thin stalk.
Tubal occlusion (blockage): The fallopian tubes are two thin tubes, one on each side of the uterus, which help lead the developing egg from the ovaries to the uterus. At the point when an impediment keeps the egg from going down the tube, a lady has a blocked fallopian tube, otherwise called tubal factor infertility. This can happen on one or the two sides and is the reason for infertility in 40 percent of infertile ladies. It’s unusual for women with blocked fallopian tubes to experience any symptoms. Many women assume that if they are having regular periods, their fertility is fine. This isn’t always true.
Uterine fibroids are a common disorder approx 40% of the women are suffering from and this alone not necessarily cause infertility. There is three type of fibroids:
Subserosal: Subserosal fibroids that expand more than half outside of the uterus.
Intramural: where the majority of the fibroid is within the muscle of the uterus without any indentation of the uterine cavity
Submucosal: Fibroids the project inside the uterine cavity.
Submucosal fibroids are the category of fibroid that is directly decrease pregnancy rate, roughly 50%, and removal of which will double pregnancy rate. In few cases, the removable of Submucosal can cure infertility in women. This doesn’t work always. Due to submucosal heavy periods or bleeding and pain in periods. Subserosal fibroids do not any effect to pregnancy. Your doctor will examine you cautiously to determine if there are any fibroids and if removal is necessary.
Unexplained/other: Some of the time a full evaluation does not uncover the reason for infertility. This happens around 15% of the time. Gratefully, even when the reason for infertility isn’t known, different fertility medicines can defeat the roadblock that was anticipating pregnancy and in the long run prompt delivery of a healthy child.
Test for infertility
History and physical examination: As a matter of first importance, your fertility doctor will take an extremely careful medical and fertility history. Your specialist may ask you numerous from the following inquiries: How long have you been trying to get pregnant? How frequently would you say you are having sex? Do you have pain with menstrual periods or intercourse? Have you been pregnant previously? What occurred with your earlier pregnancies? Have you had any sexually transmitted diseases or anomalous pap smears? How regularly do you have menstrual cycles? Do you have any restorative issues or earlier medical procedures? Do you have a family history of medical issues? These and numerous different inquiries will enable your doctor to design a specific evaluation and potential treatment for you. In addition to a careful history, a physical evaluation may also be performed.
Transvaginal ultrasound: Ultrasound is a critical apparatus for assessing the structure of the uterus, tubes, and ovaries. Ultrasound can identify uterine abnormalities, for example, fibroids and polyps, distal fallopian tube impediment, and ovarian variations from the norm including ovarian sores. Furthermore, transvaginal ultrasound affords the open door for your doctor to survey the relative number of available eggs. This estimation is known as the antral follicle check and may connect with fertility potential.
Laboratory testing: Depending upon the aftereffects of the assessment examined over, your doctor may ask for particular blood tests. The most widely recognized of these tests incorporate estimations of blood levels of specific hormones, for example, estradiol and FSH, which are identified with ovarian capacity and general egg numbers; TSH, which assesses thyroid capacity; and prolactin, a hormone that can influence menstrual capacity if raised.
Hysterosalpingogram (HSG): This test is basic for assessing fallopian tubal patency, uterine filling issues, for example, fibroids and polyps, and scarring of the uterine cavity (Asherman disorder). Numerous uterine and tubal variations from the norm recognized by the HSG can be surgically corrected.
Semen analysis: The semen investigation is the fundamental test for the male partner. There are four parameters investigated:
1) semen volume – should be no less than 1.5 to 2 ml. A little sum may propose a basic or hormonal issue prompting insufficient semen generation;
2) sperm concentration – the ordinary focus should be no less than 20 million sperm for every 1 ml of semen. A lower focus may prompt a lower chance for origination without treatment;
3) sperm motility or development – a typical motility should be no less than half. Under half motility may fundamentally influence the ability for sperm to fertilize the egg without treatment; and
4) morphology, or shape – there are three sections of the sperm that are broke down for morphology: the head, midpiece, and tail. Variation from the norm in any of those districts may demonstrate irregular sperm capacity and trade off the capacity of sperm to fertilize the egg.
Preferably, utilizing strict morphology criteria, at least 5 – 15% typical structures prompts a superior capacity for sperm to fertilize the egg. An abnormal semen investigation warrants a further assessment typically by a conceptive urologist. Your doctor will allude you to a reproductive urologist if proper.