Infertility has become a common clinical problem, affecting 13 to 15 percent of couples worldwide. This prevalence is higher in the developed world than in developing countries. However, it is still a social problem that impacts a couple’s life. Given infertility diagnosis, couples feel depression, shame, guilt, inadequacy, and social isolation.
According to the infertility guidelines, couples who experience problems conceiving can use different fertility treatments based on evidence-based information from the Gynecologist in Islamabad. Additionally, couples should seek counseling about the psychological effects of fertility treatments and the added stress it may add to the couple’s relationship.
Studies show that the probability of pregnancy per reproductive cycle is 20 to 25 percent for young, healthy couples, and the likelihood of conceiving within the first six months of regular sexual intercourse is more than 60 percent. However, some couples can have difficulty getting pregnant despite such high probabilities, and assistance is needed. In this case, fertility treatments such as using donor eggs become beneficial for those on their journey to having a child.
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What Are the Causes of Infertility?
The causes of infertility can be region based. For instance, in Africa, the commonest causes are pelvic inflammatory diseases (PID) and sexually transmitted infections (STI). In addition, some personal habits are considered risk factors, such as smoking, and drinking alcohol.
In males, the causes of infertility involve sperm abnormalities, including immotile sperm. In females, on the other hand, factors impacting fertility include tubal pathologies and ovulation dysfunction. In some cases, infertility can be due to combined male and female factors, while in others, the causes are unexplained.
What Is the Next Step?
Once the couple comes to the healthcare providers, a thorough history and examination is performed to determine any underlying pathology. Questioning of the couple and examination alone can help to make a provisional diagnosis. Thereafter, investigations are run to verify the diagnosis and to rule out other possibilities.
The investigations include:
Semen analysis which examines the sperms for any abnormality in quality and quantity.
Hormonal assay with LH and follicular FSH levels, and mid-luteal progesterone for the women. Serum testosterone, DHEA, DHEAS and prolactin can be evaluated if need be.
Tubal investigations include hysterosalpingography to evaluate the patency of the fallopian tubes.
Other investigations can be done as per the discretion of the healthcare provider.
Treatment Options
For men, infertility treatment options include:
Surgery if the cause is varicocele i.e. widening of the veins of the scrotum. Surgery is also the treatment of choice if vas deferens is blocked.
Antibiotics also help to treat the infections of the reproductive tract.
Hormone treatment is helpful in cases there is fluctuation of hormones.
In women, infertility treatment options include:
Hormones and fertility drugs help to restore the hormone level and help in ovulation.
Surgery is the treatment of choice for tubal blockages for instance due to any pelvic inflammatory disease, or endometriosis.
Assisted reproductive technology (ART) is a more invasive way of treating infertility. There are different types of ARTs including intrauterine insemination (IUI), in vitro fertilization (IVF), Zygote intrafallopian transfer (ZIFT) and gamete intrafallopian transfer (GIFT). The best ART that works for a couple, can only be suggested after thorough check-up by top Gynecologist in Islamabad.
