Infertility is the inability to conceive after a year of unprotected intercourse in women under 35, or after six months in women over 35, or the inability to carry a pregnancy to term.
Both male and female factors contribute to infertility. Some studies suggest that male and female factors contribute equally. In many cases it may not be possible to definitely explain the reasons for infertility. It is essential that both the male and female partners be evaluated during an infertility work up.
Many things can change a woman’s ability to have a baby. These include age, smoking, excess alcohol use, stress, poor diet, being overweight or underweight, sexually transmitted infections (STIs), health problems that cause hormonal changes, such as polycystic ovarian syndrome and primary ovarian insufficiency.
Anything that raises the temperature of the scrotum such as the use of hot tubs or long baths or over-tight clothing can harm sperm production. A variety of medicines and recreational drugs can also decrease male fertility. These include alcohol, cigarettes as well as certain medications. Studies have also shown that environmental factors have contributed to decreasing sperm counts over the years.
Most physicians advise you not to be concerned unless you have been trying to conceive for at least one year. If the female partner is over 30 years old, has a history of pelvic inflammatory disease, painful periods, recurrent miscarriage, or irregular periods, it might be prudent to seek help sooner. If the male partner has a known or suspected low sperm count, then it would also be prudent to seek help sooner than waiting a year.
For a normal couple, it often takes a number of perfectly timed cycles before pregnancy is achieved. The chances of getting pregnant each cycle decreases as you get older. If you are 20-25, your chance per cycle is about 25%. At 25-30 your chances are about 20%. At 30-35 it is about 15%. After 35 it may be about 10% per ovulatory cycle, and the chances continue the downward trend.
The treatment options for infertility depend on the profile of the patients, male and female factors related to infertility and the choice of the couple. Usually, the common techniques available are Ovulation Induction with Timed Intercourse, Intra Uterine Insemination and In Vitro Fertilization.
The success rates for IVF treatment depend on the individual patient profile, the quality of oocytes obtained, the embryo after fertilization and many other factors. The maternal age plays a large role in the success rate of the treatment. As a woman ages, her ovarian reserve is depleted and the probability of obtaining good quality oocytes and embryos reduces. Although many infertility clinics showcase success rates of 50%, 60% etc., it might not be so for every patient they handle. In many cases, the success rates mentioned could be for more than one cycle.
The duration of the treatment largely depends on the individual profile of the patients. Since no infertility treatment has a 100% success rate, the treatment duration would depend on a number of factors. Most infertility treatments, from initial work-up to the treatment would take between 6 months to one year.
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