Before you start undergoing any testing or medicines, you need to have a conversation about your health and goals with your doctor. This might shed some light on any additional testing you may require. Your pre-screening tests check for any infections or illnesses that could cause infertility, and in addition, any issues with the functioning of your reproductive organs. There are different tests utilized for female and male patients.
Male Factor Testing
Male factor fertility issues can come up because of multiple reasons, including:
- Abnormal generation of sperm
- Abnormal sperm functioning or mobility
- Because of blockage, complications in delivering sperm during ejaculation
Pre-screening of men for infertility incorporates semen investigation and blood test. Semen investigation will reveal any issues with sperm count, it’s mobility and shape, while blood testing will decide whether a patient has any infections or diseases that could influence sperm quantity, quality and general well-being, for example, HIV, Syphilis, Hepatitis B and C.
Regardless of the possibility that a male patient demonstrates symptoms of fertility problems, it is essential that the female partner in the couple, if present, gets the pre-screening done too. In heterosexual couples, fertility defects are usually a consequence of both male and female partners. Truth be told, 33% of fertility issues occur because of a combination of problems in both the male and female partners, as indicated by the American Pregnancy Association.
Testing female factors
Potential reasons leading to infertility are much more in females as compared to males. As per the University of Maryland Medical Center, around 10% of ladies with ages 15 to 44 (around 6.1 million ladies in the United States) experience problems getting pregnant or delivering a baby. Potential reasons can be:
- Ovulation issues, including Polycystic Ovarian Syndrome (PCOS)
- Uterine or cervical disorders
- Fallopian tube harm or blockage
- Ovarian deficiency
- Premature menopause
- Obstructive scar tissue and pelvic disorders
- Thyroid related problem
- Cancer medications, including chemotherapy and radiation
- Cushing’s ailment
- Sickle cell ailment
- Kidney ailment
- Genetic disorders
Female patients battling with infertility can be advised to undergo, x-ray, blood test, ultrasound investigation, hormone testing, and ovulation examination. Just like with male factor infertility, female factor barrenness can be healed by a patient’s way of life, and ecological components.
Elements that can lead to Infertility
Dangers factors that usually add to barrenness for both male and female patients include:
- Drug utilization(both medical and recreational)
- Overuse of alcohol and tobacco usage
- Excessive gain or loss of weight
- Overexposure to toxins and chemicals in nature, for example, pesticides and radiation
- Overexposure to heat over a period of time
- Too much or too less exercise
- Genetic disorders
The University of Rochester Medical Center’s online reference book incorporates a list of hazard factors that can add to infertility, isolated out by men and ladies’ different factors.
Surgical Treatments for Fertility problems
Surgical infertility treatment can rectify physiological complexities that are keeping egg or sperm from joining and making an incipient organism that effectively embeds on a female patient’s uterine divider.
Infertility surgery for male patients is frequently performed by a male reproductive health specialist or an andrologist. Your endocrinologist may allude you to an andrologist in the event that you or your male partner may have a physiological issue adding to infertility. Normally, andrologists perform following surgeries for following male fertility issues:
- Vasectomy Reversal – Vasectomy inversion is performed in the cases where the male patient has experienced vasectomy to keep sperm from entering semen. Inversion of this process, called vasovasostomy, is the re-connection of the external and internal layers of the vas deferens, the tube through which the sperm travels. This process can likewise rectify scar tissue that has been created because of an unsuccessful or inadequately executed vasectomy.
- Testicular Biopsy – A testicular biopsy takes a cross specimen of testicular tissue in which sperm is created. This makes in-depth examination possible and can share more light on the issues causing infertility.
- Varicocele Repair – Varicoceles, or broadened veins in the scrotum, can sometimes add to fertility issues by lessening the sperm check and its mobility. An andrologist performs surgery to shut off the blood supply to these veins to reduce them.
- Testicular Sperm Extraction (TESE) – Testicular sperm extraction includes the expulsion of sperm from the from the testicles with the end goal of treating an egg, instead of treating the issues in the reproductive organs. TESE removes sperm specifically from the testicles. Sperm that has been extricated directly from the balls is then utilized as a part of in vitro preparation (IVF) and intracytoplasmic sperm infusion (ICSI) methods.
Female infertility surgery may include:
- Polyp, Fibroid, or Scar Tissue Excision – Removing abundance or strange tissues in the uterus or ovaries can enhance ovulation and clear the pathway for sperm and egg to join. These extracted tissues are constantly biopsied to check for threatening malignancies and other sicknesses. These surgeries are performed by hysteroscopy and additionally laparoscopy.
- Endometriosis Surgery – Endometriosis happens when cells, that would regularly develop within the uterus, develop outside of it. These tissues can prompt scarring (grips) that leads to pain and can mutilate the fallopian tubes, which in turn influences fertility. Commonly, it is done to ease the pain. Rarely it is done with the aim of improving fertility, in infertile patients.
- Reversal of Tubal Ligation – Tubal ligation, normally alluded to as having one’s tubes tied, is a surgery performed to make ladies sterile by disengaging the fallopian tubes. Tubal inversion reconnects these tubes to revive the pathway for sperm and egg to join.
Commonly, surgery is performed in conjunction with another sort of treatment, be it medicine, intrauterine insemination, or IVF
Rarely it happens that the fertility issues get resolved by a single surgery. Normally, surgery is performed in conjunction with another sort of treatment, be it a drug, intrauterine insemination, or IVF. Surgery can expel physical problems that add to infertility while letting other treatment procedures to do their job more successfully.
Medication for fertility
Fertility drug is essentially used to redress ovulation issue in female patients. It is utilized as a first treatment alternative for some patients, and frequently after surgical medicines or in conjunction with IUI and IVF treatment.
There is a wide range of pharmaceutical qualities. Two of the most common gentle medicines in this range are Clomiphene (Clomid) and letrozole. These medicines, which are taken orally, fortify the procedure of ovulation. They can be utilized as a standard treatment or to catalyze ovulation before IUI.
Two normal medicines that are comparatively stronger are gonadotropins containing follicle-empowering hormones (FSHs). Gonadotropins are given by infusion at standard time intervals. These more serious drugs are more exorbitant and have higher achievement rates than Clomid and letrozole, in empowering ovulation. These types of medicines are normally used to invigorate egg creation the IVF treatment.
Since IVF prepares eggs in a controlled domain, it allows a certain level of control on the quantity of potential embryos a patient will get. Today, most of the authorities have quit utilizing injectable hormones with intercourse or insemination procedures, in light of the fact that there is no real way to control the quantity of eggs that will get fertilized, which can sometimes lead to multiple pregnancies. In vitro preparation is a more secure and more viable alternative.
Intrauterine Insemination (IUI)
IUI is the most well-known treatment utilized after fertility prescription alone has not brought about pregnancy. IUI is a sort of manual sperm injection, in which sperm are gathered and embedded specifically into you or your partner’s uterus while she is ovulating.
Intrauterine insemination can address a few issues. For the situation in which a male patient’s sperm are not mobile enough or are hard to come by, IUI can put sperm specifically at the places from where they are able to effortlessly reach the female’s egg. After they are gathered from semen, sperm cells are moved and placed in the female’s uterus. Sperm may originate from a donor or from a male partner in either a heterosexual or gay couple. IUI is fruitful when the sperms set in the uterus swim into the fallopian tube and prepare an egg.
On the off chance that one IUI treatment is not able to achieve pregnancy, it can be used repeatedly too. Studies demonstrate that for the most part if IUI is to succeed, it will work inside three or four rounds of treatment. At the point when IUI has been unsuccessful after a few medications consecutively, IVF is the next stage in treatment. You and your fertility doctor will examine when you are ready to start another sort of treatment.