If you and your partner are struggling to have a baby, you're not alone.
Ten to 15 percent of couples are infertile. Infertility is defined as not being able to get pregnant despite having frequent, unprotected sex for at least a year for most couples.
Infertility may result from an issue with either you or your partner, or a combination of factors that interfere with pregnancy. Fortunately, there are many safe and effective therapies that significantly improve your chances of getting pregnant.
Infertility treatment depends on:
What's causing the infertility
How long you've been infertile
Your age and your partner's age
Some causes of infertility can't be corrected.
In cases where spontaneous pregnancy doesn't happen, couples can often still achieve a pregnancy through use of assisted reproductive technology. Infertility treatment may involve significant financial, physical, psychological and time commitments.
Treatment for the women
Although a woman may need just one or two therapies to restore fertility, it's possible that several different types of treatment may be needed before she's able to conceive.
1- 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.
2- Intrauterine insemination (IUI). During IUI, healthy sperm are placed directly in the uterus around the time the woman's ovary releases one or more eggs to be fertilized. Depending on the reasons for infertility, the timing of IUI can be coordinated with your normal cycle or with fertility medications.
In vitro fertilization (IVF)
is the most common ART technique. IVF involves stimulating and retrieving multiple mature eggs from a woman, fertilizing them with a man's sperm in a dish in a lab, and implanting the embryos in the uterus three to five days after fertilization.
Other techniques are sometimes used in an IVF cycle, such as:
Intracytoplasmic sperm injection (ICSI). A single healthy sperm is injected directly into a mature egg. ICSI is often used when there is poor semen quality or quantity،or if fertilization attempts during prior IVF cycles failed.
Assisted hatching. This technique assists the implantation of the embryo into the lining of the uterus by opening the outer covering of the embryo (hatching). Donor eggs or sperm. Most ART is done using the woman's own eggs and her partner's sperm. However, if there are severe problems with either the eggs or sperm, you may choose to use eggs, sperm or embryos from a known or anonymous donor.
Gestational carrier. Women who don't have a functional uterus or for whom pregnancy poses a serious health risk might choose IVF using a gestational carrier. In this case, the couple's embryo is placed in the uterus of the carrier for pregnancy.
Treatment for men
Men's options can include treatment for general sexual problems or lack of healthy sperm. Treatment may include:
Altering lifestyle factors. Improving lifestyle and behavioural factors can improve chances for pregnancy, including discontinuing select medications, reducing/eliminating harmful substances, improving frequency and timing of intercourse, establishing regular exercise, and optimising other factors that may otherwise impair fertility.
Medications. Certain medications may improve a man's sperm count and likelihood for achieving a successful pregnancy. These medicines may increase testicular function, including sperm production and quality.
Surgery. In select conditions, surgery may be able to reverse a sperm blockage and restore fertility. In other cases, surgically repairing a varicocele may improve overall chances for pregnancy.
Sperm retrieval. These techniques obtain sperm when ejaculation is a problem or when no sperm are present in the ejaculated fluid. They may also be used in cases where assisted reproductive techniques are planned and sperm counts are low or otherwise abnormal.
Complications of infertility treatment may include:
Multiple pregnancy. The most common complication of infertility treatment is a multiple pregnancy — twins, triplets or more. Generally, the greater the number of fetuses, the higher the risk of premature labor and delivery, as well as problems during pregnancy such as gestational diabetes. Babies born prematurely are at increased risk of health and developmental problems. Talk to your doctor about ways to prevent a multiple pregnancy before you begin treatment.
Ovarian hyperstimulation syndrome (OHSS). Fertility medications to induce ovulation can cause OHSS, in which the ovaries become swollen and painful. Symptoms may include mild abdominal pain, bloating and nausea that lasts about a week, or longer if you become pregnant. Rarely, a more severe form causes rapid weight gain and shortness of breath requiring emergency treatment.
Bleeding or infection. As with any invasive procedure, there is a rare risk of bleeding or infection with assisted reproductive technology.
The main symptom of infertility is not getting pregnant. There may be no other obvious symptoms. Sometimes, an infertile woman may have irregular or absent menstrual periods. Rarely, an infertile man may have some signs of hormonal problems, such as changes in hair growth or sexual function.
Most couples will eventually conceive, with or without treatment.
When to see a doctor
You probably don't need to see a doctor about infertility unless you have been trying regularly to conceive for at least one year. Talk with your doctor earlier, however, if you're a woman and:
You're age 35 to 40 and have been trying to conceive for six months or longer
You're over age 40
You menstruate irregularly or not at all
Your periods are very painful
You have known fertility problems
You've been diagnosed with endometriosis or pelvic inflammatory disease
You've had multiple miscarriages
You've undergone treatment for cancer
Talk with your doctor if you're a man and:
You have a low sperm count or other problems with sperm
You have a history of testicular, prostate or sexual problems
You've undergone treatment for cancer
You have testicles that are small in size or swelling in the scrotum known as a varicocele
You have others in your family with infertility problems
Coping with infertility can be extremely difficult because there are so many unknowns.
The emotional burden on a couple is considerable. Taking these steps can help you cope:
Be prepared. The uncertainty of infertility testing and treatments can be difficult and stressful. Ask your doctor to explain the steps, and prepare for each one.
Set limits. Decide before starting treatment which procedures, and how many, are emotionally and financially acceptable for you and your partner. Fertility treatments may be expensive and often are not covered by insurance companies, and a successful pregnancy often depends on repeated attempts.
Consider other options. Determine alternatives, donor sperm or egg, donor embryo, gestational carrier or adoption are ways of having a baby but may not be applicable in our society.—adoption or even having no children are another alternatives. This may reduce anxiety during treatments and feelings of hopelessness if conception doesn't occur.
Seek support. Locate support groups or counseling services for help before and after treatment to help endure the process and ease the grief should treatment fail.
Managing emotional stress during treatment
Try these strategies to help manage emotional stress during treatment:
Express yourself. Reach out to others rather than repressing guilt or anger.
Stay in touch with loved ones. Talking to your partner, family and friends can be very beneficial. The best support often comes from loved ones and those closest to you.
Reduce stress. Some studies have shown that couples experiencing psychological stress had poorer results with infertility treatment. Try to reduce stress in your life before trying to become pregnant.
Exercise and eat a healthy diet. Keeping up a moderate exercise routine and a healthy diet can improve your outlook and keep you focused on living your life.
Managing emotional effects of the outcome
You'll face the possibility of psychological challenges no matter your results:
Not achieving pregnancy, or having a miscarriage. The emotional stress of not being able to have a baby can be devastating even on the most loving and affectionate relationships.
Success. Even if fertility treatment is successful, it's common to experience stress and fear of failure during pregnancy. If you have a history of depression or anxiety disorder, you're at increased risk of these problems recurring in the months after your child's birth.
Multiple births. A successful pregnancy that results in multiple births introduces medical complexities and the likelihood of significant emotional stress both during pregnancy and after delivery.
Seek professional help if the emotional impact of the outcome of your fertility treatments becomes too heavy for you or your partner.
Some types of infertility aren't preventable. But several strategies may increase your chances of pregnancy.
Have regular intercourse several times around the time of ovulation for the highest pregnancy rate. Having intercourse beginning at least 5 days before and until a day after ovulation improves your chances of getting pregnant. Ovulation usually occurs at the middle of the cycle — halfway between menstrual periods — for most women with menstrual cycles about 28 days apart.
For men, although most types of infertility aren't preventable, these strategies may help:
Avoid drug and tobacco use and excessive alcohol consumption, which may contribute to male infertility.
Avoid high temperatures, as this can affect sperm production and motility. Although this effect is usually temporary, avoid hot tubs and steam baths.
Avoid exposure to industrial or environmental toxins, which can impact sperm production.
Limit medications that may impact fertility, both prescription and nonprescription drugs. Talk with your doctor about any medications you take regularly, but don't stop taking prescription medications without medical advice.
Exercise moderately. Regular exercise may improve sperm quality and increase the chances for achieving a pregnancy.
For women, a number of strategies may increase the chances of becoming pregnant:
Quit smoking. Tobacco has multiple negative effects on fertility, not to mention your general health and the health of a fetus. If you smoke and are considering pregnancy, quit now.
Avoid alcohol and street drugs. These substances may impair your ability to conceive and have a healthy pregnancy. Don't drink alcohol or use recreational drugs, such as marijuana or cocaine.
Limit caffeine. Women trying to get pregnant may want to limit caffeine intake. Ask your doctor for guidance on the safe use of caffeine.
Exercise moderately. Regular exercise is important, but exercising so intensely that your periods are infrequent or absent can affect fertility.
Avoid weight extremes. Being overweight or underweight can affect your hormone production and cause infertility.
3- Surgery to restore fertility. Uterine problems such as endometrial polyps, a uterine septum or intrauterine scar tissue can be treated with hysteroscopic surgery.
4- Assisted reproductive technology
IVF proces (In vitro fertilisation)
Intracytoplasmic sperm injection (ICSI)
Assisted reproductive technology (ART) is any fertility treatment in which the egg and sperm are handled. An ART health team includes physicians, psychologists, embryologists, lab technicians, nurses and allied health professionals who work together to help infertile couples achieve pregnancy.