Fertility Problems

Fertility problems refer to failure to conceive even after one year of unprotected intercourse. The incidence of such common problem increases with age with probability of 15% incidence rate after 30 years of age.

Causes

Associated features with infertility may comprise of pelvic infection, reproductive tract obstruction, thyroid dysfunction, sexual dysfunction, ovulation abnormality, menstrual cycle abnormalities, hirsutism, obesity or endometriosis in females. In case of males, the associated complaints may be premature ejaculation, abnormality in spermatogenesis, impotency, testicular injury or even mumps.

Sometimes, the reason may be psychogenic factor, nutritional abnormality, metabolic disorder such as diabetes or even occupational and environmental factors. Most of the couples have more than one factor as the cause of infertility.

Lab Investigations

Thorough clinical history and physical examination should be performed on both the partners. Investigations include semen analysis to analyze the volume, viscosity, count and motility, post coital test to evaluate sperm / cervical mucus interaction, basal body temperature charting to assess ovulation, hormonal assays including progesterone, thyroid, prolactin, testosterone, FSH and LH.

Special tests to determine the aspects of reproduction include hamster egg penetration assay. These are available only in specialized labs.

Hysterosalpingogram (HSG) is done to evaluate tubal patency and uterine conditions. HSG has some therapeutic benefit as well. Laproscopy is also done after basic evaluation is complete.

Natural Treatment

The couples must not resort to myths but provide accurate information. Treatment aims at tracing the exact cause and correcting the same. In case there is no response to the treatment regime, the couple must be provided proper information on adoption. Emotional support is equally important for the couple.

Males with low sperm counts should avoid hot baths or saunas as increased scrotal temperature leads to decreased spermatogenesis. Also, with low sperm count, intercourse should be timed to occur every 36 hours during the fertile period. Delaying the intercourse beyond 7 days, affects the semen quality adversely.

Prognosis

Prognosis is generally good and about 50% of the couples conceive during the second year of unprotected intercourse. If the couple has been infertile for more than 4 years, the prognosis tends to become poor.