What is infertility?

Infertility is an inability to achieve pregnancy in a couple trying to conceive with regular unprotected sexual intercourse 2-3 times per week for longer than one year. Statistically, 70 % of couples with regular sexual intercourse can conceive within the first six months, and 80% can become pregnant within 12 months.

That means 80 % of normal couples can have a child within one year. If you and your partner are barren, you should have a medical consultation and tests to diagnose if there is anything of concern.

However, this does not mean that you or your partner have issues that cause infertility. No abnormality may be detected, and in a due cause, you can become successfully pregnant. Pregnancy is also a matter of probability. Time is crucial, particularly for women. The odds of getting pregnant decrease with increasing age because eggs are less fertile when women get older.

Therefore, you should consult a doctor if you are a woman who is < 35 years old, trying to have a child, and has unprotected sexual intercourse 2-3 times weekly for one year. Women who are ≥ 35 years old and have been attempting to achieve pregnancy for more than six months should get tested without waiting up to one year.

Causes

Infertility can occur from many factors, such as male factors, female factors, or a combination of both.

• The most common male infertility is from abnormal semen.
• The causes of female infertility vary, including
  • Ovarian issues such as low ovarian reserve, anovulation
  • Tubal issues such as blocked fallopian tubes
  • Uterine problems such as implantation failure
  • Cervical problems
  • Inflammation or adhesions in the abdomen

Infertility Evaluation

For pregnancy to occur, both male and female fertility is required. In men, healthy sperm must be adequately produced and effectively ejaculated into the vagina. In women, the ovaries should release healthy eggs, and the fallopian tubes should provide a clear path for sperm to travel to the egg for fertilization and allow the fertilized embryo to migrate to the uterus for implantation.

Infertility Diagnosis

Your doctor will ask you about your sexual habits and explain how to improve the chance of pregnancy and order appropriate infertility tests to pinpoint the cause. However, in some people, infertility may be unexplained.

Tests for Men:

Semen Analysis
In case of abnormal semen analysis, the following tests could help find the causes:

1. Physical exam including genital examination
2. Hormone testing to check the level of testosterone
3. Genetic testing to find out if there are genetic disorders
4. Testicular biopsy
5. Imaging tests such as MRI, transrectal ultrasound, and vasography

Tests for Women:

• Physical exam, including a gynecological exam
• Ovulation testing
• Hysterosalpingography to see if there is a blockage in the fallopian tubes
• Ovarian reserve testing and pituitary hormone testing
• Imaging tests of the uterine cavity and ovaries (Transvaginal ultrasound)
• Hysteroscopy
• Laparoscopy to check if there are any abnormalities of the fallopian tubes, ovaries, or uterus

The doctor will choose personalized and appropriate diagnostic modalities.

Read more:

• Diagnosis and Treatment of Infertility
• Egg Freezing or Oocyte Cryopreservation
• Intracytoplasmic Sperm Injection (ICSI)
• IVF (In Vitro Fertilization)
• Preconception planning for expectant parents
• Pregnancy Care