What is infertility?
Infertility is defined as the inability of a heterosexual couple to achieve a pregnancy after 12 months of unprotected intercourse.
What causes infertility?
There are two types of infertility, primary infertility and secondary infertility. Primary infertility is the term used when a pregnancy has never been achieved. Secondary infertility is the term used when a pregnancy has been achieved at least once.
There are wide range of physical as well as emotional factors which can causes infertility.
It is estimated that 10% to 20% of couples will be unable to conceive after 1 year of attempting to become pregnant. The chances of pregnancy occurring in healthy couples both under the age of 30, having intercourse regularly, is only 25% to 30% per month. A woman reaches her fertility peak in her early 20s. As a woman ages beyond, the probability of conceiving is less than 10% per month.
Besides age-related factors, there is an increased risk of infertility if you or your partner have had:
- Multiple sexual partners (therefore increasing the risk for STI's)
- A sexually transmitted Infection
- A past history of pelvic inflammatory disease (after a single episode, 10% to15% of women may become infertile)
- A past history of orchitis or epididymitis ( men)
- Mumps (men)
- A varicocele (men)
- Eating disorders (women)
- Anovulatory menstrual cycles
- Endometriosis
- Abnormalities of the uterus (myomas) or cervical obstruction
- A chronic disease (such as diabetes)
Testing
If couples have been trying to conceive for over a year, medical advice may be sought. A complete history and physical examination of both partners may be taken. There are many tests which may be undertaken to determine the cause. These are usually done after referral to a fertility specialist.
Diagnosis
Probable cause can usually be identified for about 85% to 90% of infertile couples. Treatment often allows pregnancy to occur in a high percentage of these. Up to 20% of previously diagnosed infertile couples will conceive without intervention.
Treatment
The treatment for infertility depends on the cause. It may range from information and counselling, to taking medication to treat infection or promote ovulation, to technical medical procedures such as in-vitro fertilization.
Prevention
Because infertility is frequently caused by sexually transmitted infections, practising safer sex may minimize the risk of future infertility. Gonorrhoea and chlamydia are the two most frequent causes of STI-related infertility.
These infections often have no symptoms, until pelvic inflammatory disease or salpingitis develops. These can cause scarring of the fallopian tubes and reduce fertility, cause complete infertility, or increase the likelihood of ectopic pregnancy.
