Fertility 101

/Fertility 101

Fertility 101

What Is Infertility?

Infertility is  defined as not being able to get pregnant despite trying for one year. A broader view of infertility includes not being able to carry a pregnancy to term and have a baby.

These chain of events result in pregnancy;

  • A woman must release an egg from one of her two ovaries (ovulation)
  • The egg must travel through a fallopian tube toward her uterus (womb)
  • The sperm from a man must join with and fertilize the egg along the way
  • The fertilized egg must subsequently become attached to the inside of the uterus

Causes

The normal assumption that infertility is always a “woman’s problem” is wrong. About one third of infertility cases are due to problems with the man (male factors); one third are due to problems with the woman (female factors) and other cases are due to a combination of both or to unknown causes.

How is infertility tested?

A medical evaluation can help determine the reasons for a couple’s infertility and should include physical exams and medical and sexual histories of both partners. Obvious problems like improperly timed intercourse or absence of ovulation can be identified immediately or more tests may be needed to find out more about your unique situation.

For a man, testing usually begins with semen and/or hormone tests.

For a woman, the first step is to confirm ovulation. There are several ways to do this. You can keep track of changes in your morning body temperature and the texture of the cervical mucus or use a home ovulation test kit. 

Ovulation checks can also be done in the doctor’s office, using blood or ultrasound tests. If the woman is ovulating, more tests will need to be done. Some common female tests include:

  • Hysterosalpingogram: An x-ray of the fallopian tubes and uterus after they are injected with dye
  • Laparoscopy: An internal exam of the tubes and other female organs with a telescope-like instrument to check for disease

Treatment for infertility

85 to 90 percent of infertility cases are treated with drugs or surgery.

It’s important to talk with your specialist about the drugs suggested for treatment and make sure you understand the benefits and side effects. Depending on the type of fertility drug and the dosage of the drug used, multiple births (such as twins) can occur in some women.

Sometimes, surgery is required to repair damage to the reproductive organs that may be causing the female or male factor infertility.

Assisted Reproductive Technology (ART)

Assisted Reproductive Technology (ART) uses special methods to help infertile couples conceive. Success rates vary and depend on many factors.

In vitro fertilisation (IVF) is a procedure made famous with the 1978 birth of Louise Brown, the world’s first “test tube baby.” The egg is fertilized by the sperm outside of the body and strong, viable embryos are transferred back into the womb.

Gamete intrafallopian transfer (GIFT) is similar to IVF, but used when the woman has at least one normal fallopian tube. Three to five eggs are placed in the fallopian tube, along with the man’s sperm so fertilisation can occur inside the woman.

Zygote intrafallopian transfer (ZIFT), also called tubal embryo transfer, combines IVF and GIFT. Eggs are fertilized in the lab and placed in the fallopian tubes rather than the uterus.

ART procedures sometimes involve the use of donor eggs (eggs from another woman) or previously frozen embryos. Donor eggs may be used if a woman has impaired ovaries or a genetic disease that could be transferred to her baby.