What is infertility?

A couple that is unable to conceive naturally after 12 months of regular unprotected sexual intercourse is said to be infertile. Infertility is a disease that affects the reproductive systems of men and women. 

If a woman can conceive but is not able to carry a pregnancy to term, it is also infertility. Infertility is not only a problem for women, both men and women are equally likely to have fertility problems.

Female infertility contributes to one-third of infertility cases while men account for another third of infertility cases. The balance is a combination of male and female infertility.

Certain disorders of the reproductive system can result in an impaired ability to conceive. 

In men, infertility is most commonly caused by problems in the production of semen of good quality and quantity. In women, infertility may be caused by abnormalities of the ovaries, uterus, fallopian tubes, and the endocrine system, among others.

For a successful pregnancy to occur, a number of events must happen properly. A healthy egg has to develop and be ovulated. The sperms have to be of sufficient quantity and quality. The uterus and fallopian tubes have to function normally. 

There must not be hormonal abnormalities, and the timing has to be right. Abnormalities in any of these processes, and several others can result in infertility.

Primary infertility

Infertility can be primary or secondary. Despite having unprotected sex for 12 months or more, if a couple is unable to conceive, it is primary infertility. Particularly, a woman who has never been pregnant and hasn’t conceived after one year of unprotected sex has primary infertility. 

Generally, a couple that has never conceived and has been unsuccessful in making a baby has primary infertility.

The good news is that primary infertility is treatable. Treatment differs from case to case. Factors such as the age of both partners, tests, and the cause of infertility, can affect the line of treatment. 

The treatment of primary infertility includes the use of fertility drugs and Assisted Reproductive Technology (ART). 

In women with ovulation disorders, fertility drugs are used to stimulate ovulation. The drugs help women to produce good quality eggs by stimulating the ovaries. Some women do not ovulate due to conditions like polycystic ovulation syndrome (PCOS), or insulin resistance. When a woman is unable to get pregnant naturally and with the help of fertility drugs, ART is adopted. 

ART is often considered the best option in primary infertility. The ART methods include all fertility treatments in which eggs or embryos are handled. In Vitro Fertilization (IVF) is the most widely known form of ART. In this, a woman’s egg is fertilized with the sperm of choice in the laboratory. The fertilized egg (embryo) is implanted into the woman’s uterus within 3-5 days. The fertilized eggs can also be donated to another woman. There are many variations of IVF that can be utilized depending on each couple’s needs. 

Secondary Infertility 

There is another term known as secondary infertility in which a couple has conceived in the past but conceiving the second time is difficult. In secondary infertility, the couple cannot become pregnant or carry a baby to term after a successful birth previously.

The couple’s failure to conceive a baby, in spite of being parents of a healthy child, is classified as secondary infertility..Secondary infertility in women is common. It is more common than being unable to conceive for the first time. 

The causes of secondary infertility may be a previous complication that has become worse. There is also a probability of developing new infection or a surgical procedure that impedes fertility.

These include damaged uterus or blocked fallopian tubes, and ovulation disorders, among others. Several tests are done to diagnose secondary infertility apart from the general gynecological examinations. 

Depending on the circumstances, both partners might need medical evaluations. 

One of the treatment procedures is Intrauterine insemination (IUI) in which healthy sperm is artificially inserted directly into the uterus. 

This is done at the time when the ovary releases the eggs for fertilization. The IUI timing is usually matched with the regular ovulation cycle and to suit fertility medicines.

Women infertile due to ovulation disorders can also be treated with fertility drugs. 

These drugs help in inducing and regulating ovulation. 

More than often, it is the age of women that is responsible for the likelihood of success. If a woman is below the age of 36 then the chances are brighter than if she is older. 

Invitro fertilization (IVF) is the preferred method of impregnation for couples with secondary infertility. It is also the treatment of choice depending on the semen quality. Semen problems for primary and secondary infertility are treatable with IUI or IVF and sometimes sperm microinjection – Intracytoplasmic Sperm Injection (ICSI) where a single sperm is injected into an egg in an attempt to fertilize it.

In either case, the older you get, the more difficult it is to conceive. If your sex life is good and yet you are unable to conceive, you should meet a good doctor.

Combined infertility

Infertility may result from one or more issues with either the man or the woman. It could also be a combination of the man and woman factors that prevent pregnancy. Infertility can be acquired or genetic. It may be that each partner is independently fertile but cannot conceive together as a couple without assistance.

Combined infertility means that both the man and the woman that are facing infertility have issues. Normally, a couple is regarded infertile if it has been unable to conceive after 12 months of unprotected intercourse. However, if the woman is above 36 years of age, medical advice should be sought after six months of trying. 

Combined infertility is established when both the man and woman are infertile in some way. It is not distinguished on the basis of reasons causing infertility, but on the presence of infertility-linked problems in both the man and woman. Combined infertility doesn’t indicate which partner has a more serious fertility problem but may give rise to unexplained infertility.