INFERTILITY is treatable - Shivhare’s Clinic

Infertility is a significant medical and social problem affecting couples worldwide.

Infertility refers to an inability of a couple to conceive and reproduce. Infertility can affect either the male or the female. About 1 in every 10 couples is infertile.

What is infertility?

Infertility is defined as the failure to conceive after one year of regular intercourse without contraception or the inability of a woman to carry a pregnancy to live birth.

Types of infertility

Primary infertility – when a woman has never conceived.
Secondary infertility – Incapability to conceive in a couple who have had at least one successful conception in the past.

Presentation

The main symptom of infertility is the inability to get pregnant.

Other symptoms associated with infertility in females are prolonged (35 days or more), short (less than 21 days), absent (absence of ovulation) or irregular menstrual cycle. There may be no other outward signs or symptoms.

Is infertility a common problem?

Yes, it is a common problem about 6 percent of married women aged 15 to 44 years are unable to get pregnant after one year of trying to conceive. Also, about 12 percent of women aged 15 to 44 years have difficulty getting pregnant or carrying a pregnancy to term, regardless of marital status.

Is infertility just a female problem?

It is often thought that only females are responsible for infertility. Infertility is not always a women’s problem. Conception depends on the fertility potential of both male and female partners. The males are directly responsible for about 30-40 percent of infertility, the female for about 40-55 percent, and both are responsible for about 10 percent of infertility cases.

Before discussing infertility we should first understand the normal physiology of male and female reproductive function. (For detail please click on the link below.)

MALE AND FEMALE REPRODUCTIVE SYSTEM

How many eggs does a woman have?

During fetal life, there are about 6 million to 7 million eggs in the ovary. From this time onwards, no new eggs are produced. At the time of birth there are approximately 1 million eggs in the ovary, out of which, only about 300,000 eggs will remain by the age of puberty. Of these, only 300 to 400 will be ovulated during a woman’s reproductive lifetime.

Fertility decreases with a woman’s age due to the decreasing number and quality of the remaining eggs.

Causes of female infertility

The most common causes of female infertility include problems with ovulation, abnormality in the anatomy of fallopian tubes, uterus, or cervix.

1. Ovulation disorders

Ovulation disorders are among the most common causes of infertility in women. Caused by problems with the regulation of reproductive hormones. Ovulation disorders are defined as disturbances in the production of an egg (also known as an oocyte or ovum) during a woman’s menstrual cycle. The disorder often occurs as a result of conditions such as:

Hypothalamic dysfunction, hypothyroidism, hyperthyroidism.
Polycystic ovary syndrome (PCOS).
Premature ovarian failure.
Too much prolactin, a hormone that, among many other functions, promotes breast milk production.

2. Damage to fallopian tubes (tubal infertility)

Damaged or blocked fallopian tubes keep sperm from getting to the egg or block the passage of the fertilized egg into the uterus. Causes of fallopian tube damage or blockage can include:

Pelvic inflammatory disease
Endometriosis
Ectopic pregnancy

3. Uterine or cervical causes

Several uterine or cervical causes can impact fertility by interfering with implantation or increasing the likelihood of a miscarriage:

Benign polyps or tumors (fibroids or myomas).
Endometriosis, scarring, or inflammation within the uterus can disrupt implantation.
Uterine abnormalities present from birth, such as an abnormally shaped uterus, can cause problems in getting or maintaining pregnancy.
Cervical stenosis, a narrowing of the cervix, can be caused by an inherited malformation or damage to the cervix.
Sometimes the cervix can’t produce the best type of mucus to allow the sperms to travel into the uterus.

Risk factors for female infertility

More women are waiting until their 30s and 40s to have children. In fact, about 20% of women have their first child after age 35. About one-third of couples in which the woman is older than 35 years have fertility problems. Aging not only decreases a woman’s chances of having a baby, but also increases her chances of miscarriage and of having a child with a genetic abnormality.

Aging decreases a woman’s chances of having a baby in the following ways:

She has a smaller number of eggs left.

Her eggs are not as healthy.

She is more likely to have health conditions that can cause fertility problems.

She is more likely to have a miscarriage.

Smoking
Excessive alcohol use.
Extreme weight gain or loss.
Excessive physical or emotional stress that results in amenorrhea (absent periods)

Things that women can do to decrease the possibility of infertility:

Take steps to prevent sexually transmitted diseases
Avoid illicit drugs
Avoid heavy or frequent alcohol use
Adopt good personal hygiene and health practices
Have annual check-ups with a gynecologist.

Causes of male infertility

1. Sperm production defect

Low sperm count

Normally males ejaculate 20 million or more sperm per ml of semen. If the sperm count is lower than 15 million sperm per ml of semen is considered as low. Around one-third of couples have difficulty conceiving due to a low sperm count.

Low sperm mobility (motility)

Decrease motility leads to an inability of sperm to swim till the egg and get fertilized.

Anatomical defect of sperm

The sperm may have an unusual shape, making it harder to move and fertilize an egg. Conception may be difficult, If the sperm do not have the right shape or motility they cannot travel rapidly and accurately towards the egg. Up to 2 percent of men are thought to have suboptimal sperm.

Abnormal semen

Abnormal semen may not be able to carry the sperm effectively.

Following factors adversely affect sperm development

Overheated testicles
Ejaculation disorders
Hormonal imbalance
Hypogonadism
Varicocele
Genetic factors
Mumps
Hypospadias
Cystic fibrosis
Radiation therapy
Some diseases: Conditions that are sometimes linked to lower fertility in males are anemia, Cushing’s syndrome, diabetes, and thyroid disease.

Risk factors for male infertility

Age: Couples in which the male partner is 40 years old or older are more likely to report difficulty conceiving.
Overweight or obese.
Smoking.
Excessive alcohol use.
Use of marijuana.
Exposure to testosterone.
Exposure to radiation.
Frequent exposure of the testes to high temperatures, such as that which may occur in men confined to a wheelchair, or through frequent sauna or hot tub use.
Exposure to certain medications such as flutamide, cyproterone, bicalutamide, spironolactone, ketoconazole, or cimetidine.
Exposure to environmental toxins including exposure to pesticides, lead, cadmium, or mercury.

When to see the doctor?

When to seek help depends upon age:

Up to age 30 – Before testing or treatment, it is recommended to wait and try for a year.
Between 30 and 35 – Consult medical advice after six months of trying.
Older than 35 – Consult medical advice.

Evaluation of Infertility

Tests for men

General physical examination, including examination of genitals.

Specific fertility tests may include:

Semen analysis
Hormone testing
Genetic testing
Testicular biopsy
Imaging. In certain situations, imaging studies such as a brain MRI, transrectal or scrotal ultrasound, or a test of the vas deferens (vasography) may be performed.
Other specialty testing – In rare cases, other tests to evaluate the quality of the sperm may be performed, such as evaluating a semen specimen for DNA abnormalities.

Tests for women

Blood tests:

Progesterone levels (to see if you have ovulated).
Thyroid function (problems with the thyroid may cause infertility).
Levels of the hormone prolactin (high levels can disrupt ovulation).
Ovarian reserve (egg supply): The main tests for ovarian reserve are follicle-stimulating hormone (FSH), estradiol, anti-Müllerian hormone, and an ovarian antral follicle count. These tests are generally performed early in the menstrual cycle, usually on the second or third day after the start of full menstrual flow.

Imaging tests and procedures may include:

Ultrasound exam
Sonohysterography
Hysterosalpingography
Hysteroscopy
Laparoscopy

Treatment for men

Men’s treatment for general sexual problems or lack of healthy sperm may include:

Lifestyle modification: Improving lifestyle and certain behaviors can improve chances for pregnancy. Lifestyle modification includes discontinuing select medications, reducing or eliminating harmful substances, improving frequency and timing of intercourse, regular exercise, yoga, healthy diet, regular sleep, etc.
Medications: Certain medications may improve sperm count and the likelihood of achieving a successful pregnancy. These medicines may increase testicular function, including sperm production and quality.
Surgery: For some conditions, surgery may be able to reverse a sperm blockage and restore fertility. In other cases, surgically repairing a varicocele may improve overall chances for pregnancy.
Sperm retrieval: Sperm retrieval is done when pregnancy is the goal but not possible without help. It is for men who have little or no sperm in the semen, or men who aren’t able to ejaculate. In these cases, sperm can be collected from other parts of the reproductive tract.

Treatment for women

Some women need only one or two therapies to improve fertility. Other women may need several different types of treatment to achieve pregnancy.

Stimulating ovulation:- Fertility drugs like clomiphene citrate are the main treatment for women who are infertile due to ovulation disorders. These medications regulate or induce ovulation.
Intrauterine insemination (IUI):- This is a simple procedure that puts sperm directly inside a woman’s uterus around the time of ovulation. It helps healthy sperm get closer to the egg. It’s also sometimes called donor insemination, alternative insemination, or artificial insemination.
Surgery to restore fertility. Uterine problems such as endometrial polyps, a uterine septum, intrauterine scar tissue, and some fibroids can be treated with hysteroscopic surgery. Endometriosis, pelvic adhesions, and larger fibroids may require laparoscopic surgery or surgery with a larger incision of the abdomen.
Assisted reproductive technology (ART) is any fertility treatment in which the egg and sperm are handled? There are several types of ART.

In vitro fertilization (IVF):- It is a method in which a man’s sperm and a woman’s eggs are combined outside of the body in a laboratory dish. One or more fertilized eggs (embryos) may be transferred into the woman’s uterus. In the uterus, the transferred embryo gets implanted in the uterine lining and develops. Initially, IVF was used to treat women with blocked fallopian tubes. Other techniques are sometimes used in an IVF cycle, such as:
Intracytoplasmic sperm injection (ICSI):- A single healthy sperm is injected directly into a mature egg. ICSI is often used when there is poor semen quality or quantity, or if fertilization attempts during prior IVF cycles failed.
Assisted hatching:- This technique assists the implantation of the embryo into the lining of the uterus by opening the outer covering of the embryo (hatching).
Donor eggs or sperm:- Most ART is done using a couple’s own eggs and sperm. If either or both partners are incapable of providing healthy gametes (the eggs or the sperm), there is an option of taking donations from a known or anonymous donor.
Gestational carrier:- Women who don’t have a functional uterus or for whom pregnancy poses a serious health risk might choose IVF using a gestational carrier. In this case, the couple’s embryo is placed in the uterus of the carrier for pregnancy. Carrier is popularly called a Surrogate mother.

Complications of infertility treatment

Multiple pregnancy
Ovarian hyperstimulation syndrome (OHSS)
Bleeding or infection

HOMEOPATHY AND INFERTILITY

Homeopathy treats infertility not as a disease, but as an imbalance to be corrected. It can reverse infertility by targeting the root cause of infertility and stimulates the body’s ability to heal itself. Homeopathic treatment for infertility is stimulating and supporting a natural conception progressively.

Here we prescribe advanced constitutional therapies based on individuals’ genetic constitution. The success rate is high if both partners are included in constitutional treatment.

Most suitable constitutional homeopathic medicines found after a detailed case analysis of the patient. A detailed case analysis includes the general physical and mental constitutional make-up of the patient. It also includes the symptoms in the sexual sphere and the underlying cause that is hindering the fertility process. Homeopathic medicine is individualized for each person.

Homeopathic medicines for infertility are natural medicines that help by raising the patient’s immunity to remove the obstruction that is hindering the process of fertility in a couple. Homeopathic medicines for infertility are cheap, physiological, painless, non-toxic with no risk of side effects.