No type of food is related to infertility not even so called healthy foods, but foods which are rich in fats and carbohydrates can lead to obesity which in turn can cause ovulatory problems.
Infertility in men is most often caused by:
- A problem called varicocele. This happens when the veins on a man’s testicle(s) are too large. This heats the testicles. The heat can affect the number or shape of the sperm.
- Other factors that cause a man to make too few sperm or none at all.
- Movement of the sperm. This may be caused by the shape of the sperm. Sometimes injuries or other damage to the reproductive system block the sperm.
Sometimes a man is born with the problems that affect his sperm. Other times problems start later in life due to illness or injury. For example, cystic fibrosis often causes infertility in men.
A man’s sperm can be changed by his overall health and lifestyle. Some things that may reduce the health or number of sperm include:
- Heavy alcohol use
- Smoking cigarettes
- Environmental toxins, including pesticides and lead
- Health problems such as mumps, serious conditions like kidney disease, or hormone problems
- Radiation treatment and chemotherapy for cancer
Seminal fluid consists of secretions from test is, seminal vesicles and prostate. Producing a good volume or thick semen does not mean that the semen is normal. Semen examination should be done for sperm count & motility.
No, infertility is not always a woman’s problem. Both women and men can have problems that cause infertility. About one-third of infertility cases are caused by women’s problems. Another one third of fertility problems are due to the man. The other cases are caused by a mixture of male and female problems or by unknown problems.
Most cases of female infertility are caused by problems with ovulation. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.
Ovulation problems are often caused by polycystic ovarian syndrome (PCOS). PCOS is a hormone imbalance problem which can interfere with normal ovulation. PCOS is the most common cause of female infertility. Primary ovarian insufficiency (POI) is another cause of ovulation problems. POI occurs when a woman’s ovaries stop working normally before she is 40. POI is not the same as early menopause.
Less common causes of fertility problems in women include:
- Blocked fallopian tubes due to pelvic inflammatory disease, endometriosis, or surgery for an ectopic pregnancy
- Physical problems with the uterus
- Uterine fibroids, which are non-cancerous clumps of tissue and muscle on the walls of the uterus
Many things can change a woman’s ability to have a baby. These include:
- Excess alcohol use
- Poor diet
- Athletic training
- Being overweight or underweight
- Sexually transmitted infections (STIs)
- Health problems that cause hormonal changes, such as polycystic ovarian syndrome and primary ovarian insufficiency
Many women are waiting until their 30s and 40s to have children. Age is a growing cause of fertility problems. About one-third of couples in which the woman is over 35 have fertility problems.
Aging decreases a woman’s chances of having a baby in the following ways:
- Her ovaries become less able to release eggs.
- 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.
Most experts suggest at least one year. Women 35 or older should see their doctors after six months of trying. A woman’s chances of having a baby decrease rapidly every year after the age of 30.
Some health problems also increase the risk of infertility. So, women should talk to their doctors if they have:
- Irregular periods or no menstrual periods
- Very painful periods
- Pelvic inflammatory disease
- More than one miscarriage
It is a good idea for any woman to talk to a doctor before trying to get pregnant. Doctors can help you get your body ready for a healthy baby. They can also answer questions on fertility and give tips on conceiving.
Painful periods do not necessarily mean infertility. Regular painful periods are an indication of ovulatory cycles. However progressive pain before the menses or during the sexual act may signify endometriosis. Irregular menses should be investigated especially if you are obese.
Day 1 is the first day you see a red flow, not just intermittent spotting.
As long as the periods are regular, this means ovulation is occurring. Some women have menstrual cycle lengths of as long as 40 days. Of course, since they have fewer cycles every year, the number of times they are “fertile” in a year is decreased. Also, they need to monitor their fertile period more closely, since this is delayed (as compared to women with a 30 day cycle).
Polycystic ovary syndrome (PCOS) is one of the most common causes of infrequent ovulation and irregular cycles in women. The exact cause is as yet unknown and in some cases may be genetic. In this syndrome, the ovaries produce an excess of androgens (male-type hormones) that prevent the egg from maturing normally, and the ovaries often have a multicystic appearance on ultrasound (hence the term polycystic ovaries) as a result of this arrest in maturation. Higher androgen production may also be associated with excess hair growth (hirsutism) on the face, chest, and abdomen. Because of fewer normal ovulations, women with PCOS often have difficulty conceiving. In addition, many patients with PCOS are resistant to the action of insulin and thus should be screened for diabetes.
Because ovulation is infrequent when PCOS is present, the uterine lining does not shed regularly. Women who don’t menstruate regularly are at increased risk for developing cancer of the lining of the uterus (endometrial cancer). This can be prevented by treatment with a medication known as Provera®, which will induce a menstrual flow. Provera® is a tablet taken daily for 12 to 14 days every two or three months.
If a woman with PCOS wishes to conceive, ovulation can usually be stimulated with a medication known as clomiphene citrate. If this treatment is unsuccessful, injectable medications, called gonadotropins, may be necessary. Gonadotropins are very successful in inducing ovulation, though they are more often associated with multiple pregnancies than is clomiphene citrate.
Another treatment that has helped some patients is surgical “drilling” of the ovaries or wedge resection. This laparoscopic procedure temporarily reduces androgen production by the ovaries and may result in spontaneous ovulation or may improve the response of the ovaries to ovulation inducing medications.
If your mother, grandmother or sister has had difficulty becoming pregnant, this does not necessarily mean you will have the same problem! Most infertility problems are not hereditary, and you need a complete evaluation.
Some common medicines used to treat infertility in women include:
- Clomiphene citrate (Clomid): This medicine causes ovulation by acting on the pituitary gland. It is often used in women who have polycystic ovarian syndrome (PCOS) or other problems with ovulation. This medicine is taken by mouth.
- Human menopausal gonadotropin or hMG (Repronex, Pergonal): This medicine is often used for women who don’t ovulate due to problems with their pituitary gland. hMG acts directly on the ovaries to stimulate ovulation. It is an injected medicine.
- Follicle-stimulating hormone or FSH (Gonal-F, Follistim): FSH works much like hMG. It causes the ovaries to begin the process of ovulation. These medicines are usually injected.
- Gonadotropin-releasing hormone (Gn-RH) analog: These medicines are often used for women who don’t ovulate regularly each month. Women who ovulate before the egg is ready can also use these medicines. Gn-RH analogs act on the pituitary gland to change when the body ovulates. These medicines are usually injected or given with a nasal spray.
- Metformin (Glucophage): Doctors use this medicine for women who have insulin resistance and/or PCOS. This drug helps lower the high levels of male hormones in women with these conditions. This helps the body to ovulate. Sometimes clomiphene citrate or FSH is combined with metformin. This medicine is usually taken by mouth.
- Bromocriptine (Parlodel): This medicine is used for women with ovulation problems due to high levels of prolactin. Prolactin is a hormone that causes milk production.
Many fertility drugs increase a woman’s chance of having twins, triplets, or other multiples. Women who are pregnant with multiple fetuses have more problems during pregnancy. Multiple fetuses have a high risk of being born too early (prematurely). Premature babies are at a higher risk of health and developmental problems.
Infertility means not being able to get pregnant after one year of trying, or six months, if a woman is 35 or older. Women who can get pregnant but are unable to stay pregnant may also be infertile.
Pregnancy is the result of a process that has many steps. To get pregnant:
- A woman’s body must release an egg from one of her ovaries (ovulation).
- The egg must go through a fallopian tube toward the uterus (womb).
- A man’s sperm must join with (fertilize) the egg along the way.
- The fertilized egg must attach to the inside of the uterus (implantation).
Infertility can happen if there are problems with any of these steps.
You should approach a fertility unit for help if the female partner is:
- Under 35 years of age and trying for more than 1 year.
- Between 35 and 39 years and trying to conceive with adequately timed intercourse for a period of 6 months or more.
- 40 years or more and attempting a pregnancy for 3 months or more.
We do this because we recognize that female age is one of the most important predictors of subsequent conception.
When female age is a factor, moving more aggressively towards completing the evaluation and initiating treatment can help to maximize the chances of pregnancy.
There is no normality, but for a young couple 2-3 times a week is considered normal for conception to occur. The sexual act should be had in the fertile window of the menstrual cycle.
Doctors will do an infertility checkup. This involves a physical exam. The doctor will also ask for both partners’ health and sexual histories. Sometimes this can find the problem. However, most of the time, the doctor will need to do more tests.
In men, doctors usually begin by testing the semen. They look at the number, shape, and movement of the sperm. Sometimes doctors also suggest testing the level of a man’s hormones.
In women, the first step is to find out if she is ovulating each month. There are a few ways to do this. A woman can track her ovulation at home by:
- Writing down changes in her morning body temperature for several months
- Writing down how her cervical mucus looks for several months
- Using a home ovulation test kit (available at drug stores)
Doctors can also check ovulation with blood tests. Or they can do an ultrasound of the ovaries. If ovulation is normal, there are other fertility tests available.
Finding the cause of infertility can be a long and emotional process. It may take time to complete all the needed tests. We are here to support you every step of your journey.
For the male partner a semen examination with 4 – 5 days abstinence. For the female partner a day 2 or day 3 hormonal evaluation i.e. FSH, LH, Prolactin and TSH. A sonography in the form of ovulation studies is done from Day 9 of the cycle. However in some patients due to some clinical findings the doctor may ask for a laparoscopy/ hysteroscopy.
A routine gynecology examination does not provide all the probable causes of infertility. So you will need a schematic work up. Since infertility can also be due to a male factor, a simple semen examination will rule out a male factor. Later on, hormonal assays, a trans-vaginal sonography, a hysterosalpingography and if required alaparo/ hysteroscopy would be done.
Infertility can be treated with medicine, surgery, artificial insemination, or assisted reproductive technology. Many times these treatments are combined. In most cases infertility is treated with drugs or surgery.
Doctors recommend specific treatments for infertility based on: