The Treatment Survival Guide To Infertility
Published on 05/25/21
Infertility can be a scary word and we mostly associate it with women. However, infertility can affect both women and men. A woman can be considered infertile if she’s tried to get pregnant for at least one year and hasn’t been on birth control. Or, if she’s able to conceive but not able to carry a pregnancy to term. A woman may be considered to have primary infertility if she has never been able to become pregnant, and a woman who’s had at least one successful pregnancy in the past but struggles to conceive or carry may be considered to have secondary infertility.
Men are considered infertile if they produce too little sperm or the sperm is considered unhealthy to combine with a woman’s egg. It’s not too common that couples struggle to get pregnant, however, there are factors involved that can make it difficult for others.
Let’s go over what is considered infertility, the causes, and the treatments that your doctor may recommend for you and your partner to help you through a safe and healthy pregnancy.
What Is Infertility?
After one year of having sexual intercourse without using birth control, and not getting pregnant, is what defines infertility. If a woman is older than 35, an evaluation is recommended after 6 months of trying. Older than 40, she should talk to her OB/GYN about pregnancy.
What causes infertility? Normally the most common cause of female infertility is an issue with ovulation. With males, the most common cause is sperm cells and how they’re functioning. Other factors could be:
- Health conditions
In other cases, there is no sign of any causes found. This is called unexplained infertility.
For younger couples in their early 20s to early 30s, the chances of pregnancy is about 25 to 30% during any menstrual cycle. However, starting in the early 30s, this number starts to decrease and by age 40, the chances of pregnancy drops to about 10% per menstrual cycle. Men’s fertility cannot be entirely predicted, however it does decline with age.
Common factors that affect fertility are factors such as weight. A woman who might be overweight, underweight, or exercises too much, may find it’s harder to get pregnant. Other factors like smoking and drinking alcohol regularly or at heavy levels may also reduce fertility. For men, heavy drinking, smoking and marijuana may reduce sperm count and sperm movement.
In women, health problems can affect overall fertility such as:
- Problems with the reproductive organs or hormones
- Scarring or blockages of the fallopian tubes (from past sexually transmitted infections [STIs] or endometriosis)
- Problems with the thyroid gland or pituitary gland
- In men, infertility can be caused when the tubes that carry sperm from the testicles are blocked.
Doctors For Infertility
You should seek counsel from your OB/GYN first. They may recommend you to an OB/GYN with special training in infertility as a reproductive endocrinologist. Men may see a Urologist.
Treatment options that are available for infertility can vary spending on the type of problem causing infertility. Certain recommendations to start may be:
- Lifestyle changes
- Surgery, or
In certain cases, treatments may be coupled. Even if no cause is found, infertility can still be successfully treated with the right doctor recommendations.
In women, surgery may be used to:
- Repair blocked or damaged fallopian tubes
- Treat endometriosis, which is commonly associated with infertility
- Remove polyps or fibroids in the uterus
In men, surgery may be used to:
A common problem that leads to male infertility is swollen veins in the scrotum. These sometimes can be treated with surgery.
In women, hormone treatment can be:
- Abnormal levels of hormones can cause problems with ovulation. Your specialist may check your hormone levels. If a hormone problem is found, treatment often can correct it. This treatment also may improve your chances of getting pregnant.
- Ovulation stimulation is the use of drugs to help your ovaries release an egg. This treatment is used when ovulation is not regular or does not happen at all and other causes have been ruled out. Ovulation stimulation may be used with other infertility treatments.
Ovulation stimulation uses oral drugs to help stimulate ovulation. These drugs include clomiphene citrate and aromatase inhibitors. During these drug treatments, the doctor will monitor if and where ovulation occurs. This is normally done by tracking your menstrual cycle or with an ovulation prediction kit like an at-home urine test. In addition to a possible blood test or ultrasounds.
Another drug used to help trigger ovulation is called Gonadotropins. These are used if other drugs are not successful and if many eggs are needed for infertility treatments. Gonadotropins are administered as a series of shots during the early part of the menstrual cycle. To track this progress, blood tests and ultrasound exams are used to monitor the development of the follicles.
Once the test results show that the follicles have reached a certain size, another drug may be administered to signal a follicle to release its matured egg.
Are There Any Risks?
- Multiple pregnancy is a risk when women are treated with clomiphene citrate, aromatase inhibitors, and gonadotropins. The risk is higher with gonadotropins. If too many eggs are developing, your specialist may postpone the cycle to reduce the chance of a multiple pregnancy.
- Ovulation stimulation, especially with gonadotropins, can lead to ovarian hyperstimulation syndrome. Most cases of this condition are mild. In severe cases, a hospital stay may be needed. Women taking medication to stimulate ovulation are monitored for this condition.
Intrauterine insemination or IUI, is when the healthy sperm is placed inside the uterus. Combined with ovulation stimulation, the sperm is timed to be placed as close to ovulation as possible.
Are There Any Risks?
If IUI is combined with ovulation drugs like Gonadotropins, the risk of multiple pregnancy can occur. This means too many eggs developed at the same time around insemination. If this is the cae, insemination may be postponed.
Assisted Reproductive Technology (ART)
This means all fertility treatments are used and both the sperm and the eggs are handled. The art of ART normally also involved IVF or vitro fertilization. IVF is when the sperm is combined with the egg in a lab and then the entire embryo is transferred into the uterus. IVF may be used when the causes of infertility include:
- Damaged or blocked fallopian tubes that cannot be treated with surgery
- Severe endometriosis
- Primary ovarian insufficiency
- Some male infertility factors
- Unexplained infertility
This treatment happens in cycles. These cycles don’t always work the first time and may take more than one to have a successful conception and pregnancy. The steps for vitro fertilization are:
- Obtaining an egg. Ovulation usually is triggered with gonadotropins so that multiple eggs are produced. When your eggs are ready, a needle is used to remove mature eggs from the ovaries.
- Fertilization of eggs by the sperm. This can be done in two ways: 1) the sperm can be added to the eggs in a laboratory, or 2) a single sperm can be injected into each egg. The eggs are checked the next day to see if they have been fertilized.
- Embryo transfer. A few days after fertilization, one or more embryos are placed in the uterus through the vagina. Healthy embryos that are not transferred may be frozen and stored.
Are There Any Risks?
There’s an even higher risk for multiple pregnancy with IVF. Doctors will run tests that help suggest if too many eggs are developing at once. The shot that helps trigger ovulation may be delayed or postponed if this is the case. Your healthcare provider may also limit the number of embryos transferred to your uterus.
There are so many treatment options and combinations to help with infertility. Remember, they take time, commitment and sometimes can be costly.
The doctors at Rosh Maternal & Fetal Medicine specialize in high-risk obstetrics. Simply put, they’re trusted experts in high-risk pregnancies, so you’ll receive the highest quality care. They provide comprehensive prenatal care and all the advanced medical procedures you may need!
If You’re Dealing With Infertility, Our Doctors at Rosh Maternal & Fetal Medicine in NYC Are Here For You!
The doctors at Rosh Maternal & Fetal Medicine are experts at determining the precise cause of your issues and can help in initiating a customized treatment plan to correct the underlying cause. Don’t wait to get medical help!
Any underlying health problems should be treated to prevent more serious problems from developing. You can count on the extensive experience of the doctors at Rosh Maternal & Fetal Medicine to identify the cause and effectively treat and guide you through your infertility concerns. If you have any questions about your fertility and treatments they offer, call their office in the Midtown East area of New York City, or schedule an appointment online.
Talk to our team by phone or book an appointment online to get started. Call one of our six convenient NYC locations or schedule a video consultation online today! They’ve helped thousands of women. Come visit your NYC OBGYN.
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