Health and LifeStyle

Archive for the ‘Infertility and Pregnancy’ Category

Treatment of infertility depends on the cause, how long you’ve been infertile, the age of the partners and many personal preferences. Some causes of infertility can’t be corrected. However, a woman can still become pregnant with assisted reproductive technology or other procedures to restore fertility.

Restoring fertility
These approaches can involve steps related to the male or to the female, or both.

Increase frequency of intercourse. Having intercourse two to three times a week may improve fertility. However, too-frequent ejaculation can lessen sperm quality. Sperm survive in the female reproductive tract for up to 72 hours, and an egg can be fertilized for up to 24 hours after ovulation.

Treatment for men
Other approaches that involve the male include treatment for:

• General sexual problems. Addressing impotence or premature ejaculation can improve fertility. Treatment for these problems often is with medication or behavioral approaches.
• Lack of sperm. If a lack of sperm is suspected as the cause of a man’s infertility, surgery or hormones to correct the problem or use of assisted reproductive technology is sometimes possible. For example, varicocele can often be surgically corrected. For blockage of the ejaculatory duct or in the case of retrograde ejaculation, sperm can be taken directly from the testicles or recovered from the bladder and injected into an egg in the laboratory setting.

Treatment for women

Stimulating ovulation with fertility drugs
Fertility drugs are the main treatment for women who are infertile due to ovulation disorders. These medications regulate or induce ovulation. In general, they work like natural hormones — such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH) — to trigger ovulation. Commonly used fertility drugs include:

• Clomiphene citrate (Clomid, Serophene). This drug is taken orally and stimulates ovulation in women who have PCOS or other ovulatory disorders. It causes the pituitary gland to release more FSH and LH, which stimulate the growth of an ovarian follicle containing an egg.
• Human menopausal gonadotropin, or hMG (Repronex). This injected medication is for women who don’t ovulate on their own due to the failure of the pituitary gland to stimulate ovulation. Unlike clomiphene, which stimulates the pituitary gland, hMG and other gonadotropins directly stimulate the ovaries. This drug contains both FSH and LH.
• Follicle-stimulating hormone, or FSH (Gonal-F, Follistim, Bravelle). FSH works by stimulating the ovaries to mature egg follicles.
• Human chorionic gonadotropin, or HCG (Ovidrel, Pregnyl). Used in combination with clomiphene, hMG and FSH, this drug stimulates the follicle to release its egg (ovulate).
• Gonadotropin-releasing hormone (Gn-RH) analogs. This treatment is for women with irregular ovulatory cycles or who ovulate prematurely — before the lead follicle is mature enough — during hMG treatment. Gn-RH analogs deliver constant Gn-RH to the pituitary gland, which alters hormone production, so that a doctor can induce follicle growth with FSH.
• Letrozole (Femara). This drug is in a class of medications called aromatase inhibitors, which are approved for treatment of advanced breast cancer. Doctors sometimes prescribe letrozole for women who don’t ovulate on their own and who haven’t responded to treatment with clomiphene citrate. Letrozole is not approved by the Food and Drug Administration for inducing ovulation. The drug’s manufacturer has warned doctors not to use the drug for fertility purposes because of possible adverse health effects. These adverse effects may include birth defects and miscarriage.
• Metformin (Glucophage). This oral drug is taken to boost ovulation. It’s used when insulin resistance is a known or suspected cause of infertility. Insulin resistance may play a role in the development of PCOS.
• Bromocriptine. This medication is for women whose ovulation cycles are irregular due to elevated levels of prolactin, the hormone that stimulates milk production in new mothers. Bromocriptine inhibits prolactin production.

Fertility drugs and the risk of multiple pregnancies
Injectable fertility drugs increase the chance of multiple births. Oral fertility drugs (Clomid) increase the chance of multiple births but at a much lower rate. The use of these drugs requires careful monitoring using blood tests, hormone tests and ultrasound measurement of ovarian follicle size. Generally, the greater the number of fetuses, the higher the risk of premature labor. Babies born prematurely are at increased risk of health and developmental problems. These risks are greater for triplets than for twins or single pregnancies.

The risk of multiple pregnancies can be reduced. If a woman requires an HCG injection to trigger ovulation, and ultrasound exams show that too many follicles have developed, she and her doctor can decide to withhold the HCG injection. For many couples, however, the desire to become pregnant overrides concerns about conceiving multiple babies.

When too many babies are conceived, removal of one or more fetuses (multifetal pregnancy reduction) can offer improved survival odds for the surviving fetuses. This presents serious emotional and ethical challenges for many people. If you and your partner are considering fertility drug treatment, discuss this possibility with your doctor before starting treatment.

Surgery
Depending on the cause, surgery may be a treatment option for infertility. Blockages or other problems in the fallopian tubes can often be surgically repaired. Laparoscopic techniques allow delicate operations on the fallopian tubes.

Infertility due to endometriosis often is difficult to treat. Although hormones such as those found in birth control pills are effective for treating endometriosis and relieving pain, they haven’t been useful in treating infertility. If you have endometriosis, your doctor may treat you with ovulation therapy, in which medication is used to stimulate or regulate ovulation, or in vitro fertilization, in which the egg and sperm are joined in the laboratory and transferred to the uterus.

Assisted reproductive technology (ART)
ART has revolutionized the treatment of infertility. Each year thousands of babies are born in the United States as a result of ART. Medical advances have enabled many couples to have their own biological child. An ART health team includes physicians, psychologists, embryologists, laboratory technicians, nurses and allied health professionals who work together to help infertile couples achieve pregnancy.

The most common forms of ART include:

• In vitro fertilization (IVF). This is the most effective ART technique. IVF involves retrieving mature eggs from a woman, fertilizing them with a man’s sperm in a dish in a laboratory and implanting the embryos in the uterus three to five days after fertilization. IVF often is recommended when both fallopian tubes are blocked. It’s also widely used for a number of other conditions, such as endometriosis, unexplained infertility, cervical factor infertility, male factor infertility and ovulation disorders. IVF increases your chances of having more than one baby at a time because often multiple fertilized eggs are often implanted back into your uterus so that there is a greater chance one will develop into a baby. IVF also requires frequent blood tests and daily hormone injections.
• Electrical or vibratory stimulation to achieve ejaculation. Electric or vibratory stimulus brings about ejaculation to obtain semen. This procedure can be used in men with a spinal cord injury who can’t otherwise achieve ejaculation.
• Surgical sperm aspiration. This technique involves removing sperm from part of the male reproductive tract such as the epididymis, vas deferens or testicle. This allows retrieval of sperm if the ejaculatory duct is blocked.
• Intracytoplasmic sperm injection (ICSI). This technique consists of a microscopic technique (micromanipulation) in which a single sperm is injected directly into an egg to achieve fertilization in conjunction with the standard IVF procedure. ICSI has been especially helpful in couples who have previously failed to achieve conception with standard techniques. For men with low sperm concentrations, ICSI dramatically improves the likelihood of fertilization.
• Assisted hatching. This technique attempts to assist the implantation of the embryo into the lining of the uterus.

ART works best when the woman has a healthy uterus, responds well to fertility drugs, and ovulates naturally or uses donor eggs. The man should have healthy sperm, or donor sperm should be available. The success rate of ART gradually diminishes after age 32.

Complications of treatment
Certain complications exist with the treatment of infertility. These include:

• Multiple pregnancy. The most common complication of ART is multiple pregnancy. The number of quality embryos kept and matured to fetuses and birth ultimately is a decision made by the couple. If too many babies are conceived, the removal of one or more fetuses (multifetal pregnancy reduction) is possible to improve survival odds for the other fetuses.
• Ovarian hyperstimulation syndrome (OHSS). If overstimulated, a woman’s ovaries may enlarge and cause pain and bloating. Mild to moderate symptoms often resolve without treatment, although pregnancy may delay recovery. Rarely, fluid accumulates in the abdominal cavity and chest, causing abdominal swelling and shortness of breath. This accumulation of fluid can deplete blood volume and lower blood pressure. Severe cases require emergency treatment. Younger women and those who have polycystic ovary syndrome have a higher risk of developing OHSS than do other women.
• Bleeding or infection. As with any invasive procedure, there is a risk of bleeding or infection with assisted reproductive technology.
• Low birth weight. The greatest risk factor for low birth weight is a multiple pregnancy. In single live births, there may be a greater chance of low birth weight associated with ART.
• Birth defects. There is some concern about the possible relationship between ART and birth defects. More research is necessary to confirm this possible connection. Weigh this factor if you’re considering whether to take advantage of this treatment. ART is the most successful fertility-enhancing therapy to date.

Female infertility is a growing problem which has to be rooted out from the society. It means the disability to conceive or produce offspring. The main cause for infertility is poor reproductive system that impairs the ability of the body to perform necessary functions of reproduction.

The most common causes of female infertility include fallopian tube damage or blockage, endometriosis, ovulation disorders, elevated prolactin, polycystic ovary syndrome (PCOS), early menopause, benign uterine fibroids and pelvic adhesions.

• Fallopian tube damage or blockage. Fallopian tube damage usually results from inflammation of the fallopian tube (salpingitis). Chlamydia, a sexually transmitted disease, is the most frequent cause. Tubal inflammation may go unnoticed or cause pain and fever. Tubal damage is the major risk factor of a pregnancy in which the fertilized egg is unable to make its way through the fallopian tube to implant in the uterus (ectopic pregnancy). One episode of tubal infection may cause fertility difficulties. The risk of ectopic pregnancy increases with each occurrence of tubal infection.
• Endometriosis. Endometriosis occurs when the uterine tissue implants and grows outside of the uterus — often affecting the function of the ovaries, uterus and fallopian tubes. These implants respond to the hormonal cycle and grow, shed and bleed in sync with the lining of the uterus each month, which can lead to scarring and inflammation. Pelvic pain and infertility are common in women with endometriosis.
• Ovulation disorders. Some cases of female infertility are caused by ovulation disorders. Disruption in the part of the brain that regulates ovulation can cause low levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). Even slight irregularities in the hormone system can affect ovulation. Specific causes of hypothalamic-pituitary disorders include injury, tumors, excessive exercise and starvation.
• Elevated prolactin (hyperprolactinemia). The hormone prolactin stimulates breast milk production. High levels in women who aren’t pregnant or nursing may affect ovulation. An elevation in prolactin levels may also indicate the presence of a pituitary tumor. In addition, some drugs can elevate levels of prolactin. Milk flow not related to pregnancy or nursing can be a sign of high prolactin.
• Polycystic ovary syndrome (PCOS). In PCOS, your body produces too much androgen hormone, which affects ovulation. PCOS is associated with insulin resistance and obesity.
• Early menopause (premature ovarian failure). Early menopause is the absence of menstruation and the early depletion of ovarian follicles before age 35. Although the cause is often unknown, certain conditions are associated with early menopause, including immune system diseases, radiation or chemotherapy treatment, and smoking.
• Benign uterine fibroids. Fibroids are benign tumors in the wall of the uterus and are common in women in their 30s. Occasionally they may cause infertility by blocking the fallopian tubes.
• Pelvic adhesions. Pelvic adhesions are bands of scar tissue that bind organs after pelvic infection, appendicitis, or abdominal or pelvic surgery. This scar tissue formation may impair fertility.

Other causes. A number of other causes can lead to infertility in women:

• Medications. Temporary infertility may occur with the use of certain medications. In most cases, fertility is restored when the medication is stopped.
• Thyroid problems. Disorders of the thyroid gland, either too much thyroid hormone (hyperthyroidism) or too little (hypothyroidism), can interrupt the menstrual cycle and cause infertility.
• Cancer and its treatment. Certain cancers — particularly female reproductive cancers — often severely impair female fertility. Both radiation and chemotherapy may affect a woman’s ability to reproduce. Chemotherapy may impair reproductive function and fertility in men and women.
• Other medical conditions. Medical conditions associated with delayed puberty or amenorrhea, such as Cushing’s disease, sickle cell disease, HIV/AIDS, kidney disease and diabetes, can affect a woman’s fertility.
• Caffeine intake. Excessive caffeine consumption reduces fertility in the female.

The primary organs of reproduction of the male sex include just the penis and the testes. But these organs, especially the testes, are under a complex cycle of hormonal and chemical influences. Problems with any of these could result in infertility or poor fertility.

A number of things can cause impaired sperm count or mobility, or impaired ability to fertilize the egg. The most common causes of male infertility include abnormal sperm production or function, impaired delivery of sperm, general health and lifestyle issues, and overexposure to certain environmental elements.

Impaired production or function of sperm. Most cases of male infertility are due to problems with the sperm, such as:

• Impaired shape and movement of sperm. Sperm must be properly shaped and able to move rapidly and accurately toward the egg for fertilization to occur. If the shape and structure (morphology) of the sperm are abnormal or the movement (motility) is impaired, sperm may not be able to reach or penetrate the egg.
• Low sperm concentration. A normal sperm concentration is greater than or equal to 20 million sperm per milliliter of semen. A count of 10 million or fewer sperm per milliliter of semen indicates low sperm concentration (subfertility). A count of 40 million sperm or higher per milliliter of semen indicates increased fertility. Complete failure of the testicles to produce sperm is rare, affecting very few infertile men.
• Varicocele. A varicocele is a varicose vein in the scrotum that may prevent normal cooling of the testicle, leading to reduced sperm count and motility.
• Undescended testicle. Undescended testicle occurs when one or both testicles fail to descend from the abdomen into the scrotum during fetal development. Because the testicles are exposed to the higher internal body temperature, compared with the temperature in the scrotum, sperm production may be affected.
• Testosterone deficiency (male hypogonadism). Infertility can result from disorders of the testicles themselves, or an abnormality affecting the hypothalamus or pituitary gland in the brain that produces the hormones that control the testicles.
• Genetic defects. In the genetic defect Klinefelter’s syndrome, a man has two X chromosomes and one Y chromosome instead of one X and one Y. This causes abnormal development of the testicles, resulting in low or absent sperm production and possibly low testosterone.
• Infections. Infection may temporarily affect sperm motility. Repeated bouts of sexually transmitted diseases (STDs), such as chlamydia and gonorrhea, are most often associated with male infertility. These infections can cause scarring and block sperm passage. If mumps, a viral infection usually affecting young children, occurs after puberty, inflammation of the testicles can impair sperm production. Inflammation of the prostate (prostatitis), urethra or epididymis also may alter sperm motility.

In many instances, no cause for reduced sperm production is found. When sperm concentration is less than 5 million per milliliter of semen, genetic causes could be involved. A blood test can reveal whether there are subtle changes in the Y chromosome.

Impaired delivery of sperm. Problems with the delivery of sperm from the penis into the vagina can result in infertility. These may include:

• Sexual issues. Often treatable, problems with sexual intercourse or technique may affect fertility. Difficulties with erection of the penis (erectile dysfunction), premature ejaculation, painful intercourse (dyspareunia), or psychological or relationship problems can contribute to infertility. Use of lubricants such as oils or petroleum jelly can be toxic to sperm and impair fertility.
• Retrograde ejaculation. This occurs when semen enters the bladder during orgasm rather than emerging out through the penis. Various conditions can cause retrograde ejaculation including diabetes, bladder, prostate or urethral surgery, and the use of certain medications.
• Blockage of epididymis or ejaculatory ducts. Some men are born with blockage of the part of the testicle that contains sperm (epididymis) or ejaculatory ducts. Some men lack the tube that carries sperm (vas deferens) from the testicle out to the opening in the penis.
• No semen (ejaculate). The absence of ejaculate may occur in men with spinal cord injuries or diseases. This fluid carries the sperm from the penis into the vagina.
• Misplaced urinary opening (hypospadias). A birth defect can cause the urinary (urethral) opening to be abnormally located on the underside of the penis. If not surgically corrected, this condition can prevent sperm from reaching the woman’s cervix.
• Anti-sperm antibodies. Antibodies that target sperm and weaken or disable them usually occur after surgical blockage of part of the vas deferens for male sterilization (vasectomy). Presence of these antibodies may complicate the reversal of a vasectomy.
• Cystic fibrosis. Men with cystic fibrosis often have missing or obstructed vas deferens.

General health and lifestyle. A man’s general health and lifestyle may affect fertility. Some common causes of infertility related to health and lifestyle include:

• Emotional stress. Stress may interfere with certain hormones needed to produce sperm. Your sperm count may be affected if you experience excessive or prolonged emotional stress. A problem with fertility itself can sometimes become long term and discouraging, producing more stress. Infertility can affect social relationships and sexual functioning.
• Malnutrition. Deficiencies in nutrients such as vitamin C, selenium, zinc and folate may contribute to infertility.
• Obesity. Increased body mass may be associated with fertility problems in men.
• Cancer and its treatment. Both radiation and chemotherapy treatment for cancer can impair sperm production, sometimes severely. The closer radiation treatment is to the testicles, the higher the risk of infertility. Removal of one or both testicles due to cancer also may affect male fertility.
• Alcohol and drugs. Alcohol or drug dependency can be associated with poor health and reduced fertility. The use of certain drugs also can contribute to infertility. Anabolic steroids, for example, which are taken to stimulate muscle strength and growth, can cause the testicles to shrink and sperm production to decrease.
• Other medical conditions. A severe injury or major surgery can affect male fertility. Certain diseases or conditions, such as diabetes, thyroid disease, Cushing’s syndrome, or anemia may be associated with infertility.
• Age. A gradual decline in fertility is common in men older than 35.

Environmental exposure. Overexposure to certain environmental elements such as heat, toxins and chemicals can reduce sperm count either directly by affecting testicular function or indirectly by altering the male hormonal system. Specific causes include:

• Pesticides and other chemicals. Herbicides and insecticides may cause female hormone-like effects in the male body and may be associated with reduced sperm production and testicular cancer. Lead exposure may also cause infertility.
• Overheating the testicles. Frequent use of saunas or hot tubs can elevate your core body temperature. This may impair your sperm production and lower your sperm count.
• Substance abuse. Use of cocaine or marijuana may temporarily reduce the number and quality of your sperm.
• Tobacco smoking. Men who smoke may have a lower sperm count than do those who don’t smoke.

Reproduction is one of the more important mechanisms, that we humans are equipped of. In the absence of this, some of us may consider the valuable loss of life. This is probably why once a couple does not conceive within a 1-year period of unprotected sexual intercourse, they become anxious that they may be subject to infertility.

In fact, the symptom of not conceiving in 1 year alone is one good basis for diagnosing infertility.

There is not much that the medical community hasn’t unraveled yet when it comes to infertility. This article will focus on the causes of infertility for both men and women.

Causes of Female Infertility

Endometriosis- this is a condition characterized by the growth of the endometrial tissue outside the uterus. This tissue is the substance women discharge during menstruation.

Ovulation problem- a condition that arises from abnormality in the release of hormones that drive the release of mature eggs from the ovaries.

Poor egg quality- the weakness or damage in the egg cells usually characterizes poor egg quality. Age is primarily the root cause since as women mature, their eggs mature with them. This condition eventually leads to menopause.

Polycystic ovary syndrome- formation of small cysts in the ovaries may be the result of irregular ovulation or hormonal imbalances.

Female tube blockages- once the passage of the eggs towards the uterus or the sperm towards the ovaries is blocked, conception would be impossible since the meeting of the two cells won’t facilitate. Causes of this condition may be pelvic inflammatory disease and several forms of sexually transmitted disease.

Causes of Male Infertility

Male tube blockages- this may occur either at the epididymis or the vas deferens, both of which are sperm passages. However, varicoceles located at the testicles account for the leading cause of this condition.

Sperm problems- this could be anything from the absence of sperm cells to low sperm count along with poor sperm quality and sperm deformation.

Sperm allergy- this may the product of the immune system’s reaction towards any phenomenon that attracts brain signals sending the reaction of the system. Men usually experience this after having vasectomy.

Combination of Female and Male Factors

This occurs when both couples present conditions that may be identified as causes of infertility

Many people may be infertile during their reproductive years. They may be unaware of this because they are not seeking to create a pregnancy. On any one occasion, the chance of pregnancy is just one percent. About one in seven couples in the United States are infertile. Age, lifestyle and physical problems can all contribute to infertility.

Infertility Cancer and its treatment may sometimes put female survivors at risk for infertility. Infertility means not being able to get pregnant or maintain a pregnancy, usually after you have been trying for over a year. There are many different causes for infertility in cancer survivors. While it’s best to discuss your risk for infertility before treatment begins, there are still options for cancer survivors who may experience infertility as a result of cancer or its treatment.

Infertility affects approximately 10% of the population. Since infertility strikes diverse groups-affecting people from all socioeconomic levels and cutting across all racial, ethnic and religious lines- chances are great that a friend, relative, neighbor or perhaps you are attempting to cope with the medical and emotional aspects of infertility.

If you’ve been trying to conceive for more than a year, there’s a chance that something may be interfering with your efforts to have a child. Infertility may be due to a single cause in either you or your partner, or a combination of factors that may prevent a pregnancy from occurring or continuing.

Infertility or possible infertility may affect you emotionally. If you want to have children, it’s perfectly understandable if thinking about being infertile makes you feel sad or upset. This document outlines the physical causes of infertility and options for survivors who may have difficulty having children. It does not explain how infertility can affect you emotionally, which is something you may want to discuss with a mental health professional.

Causes of infertility can be found in about 90% of infertility cases but, despite extensive tests, about 10% of couples will never know why they cannot conceive. Between 10 – 30% of cases of infertility have more than one cause. Male or female infertility each account for about 30 – 40% of cases. In men, sperm defects (their quality and quantity) are usually responsible. Female infertility is more complex.

Roughly one-third of infertility cases can be attributed to male factors and another one-third to factors that affect women. For the remaining infertile couples, infertility is caused by a combination of problems in both partners (about 13%) or is unexplained (about 10%). The most common causes of male infertility include azoospermia (no sperm cells are produced) and oligospermia (few sperm cells are produced). Sometimes, sperm cells are malformed or they die before they can reach the egg. In rare cases, male infertility is caused by a genetic disease such as cystic fibrosis or a chromosomal abnormality.

Infertility affects men and women equally. About one-third of the cases are due to a male factor, one-third to the female and the remaining to the combination of both partners. Causes of infertility include a wide range of physical as well as emotional factors. For a woman to be fertile, her reproductive organs must be healthy and functional. To conceive a child, the ovaries must release healthy eggs regularly and her reproductive tract must allow the eggs and sperm to pass into her fallopian tubes for a possible union.