Last modified on October 2020
With inputs from Dr. Uma M - Consultant Family Physician, and Diabetologist
For many couples, giving birth to a baby and expanding their family is an event they eagerly plan for and await. In many cases, however, the road to parenthood isn’t always smooth.
In India, approximately 27.5 million couples are battling infertility
and struggling to conceive.
Increase in problems of Infertility in India has been linked to various factors such as the rising prevalence of environmental toxins, usage of plastic, growing problems of obesity, diabetes, and other health conditions influenced by a fast-paced lifestyle. Infertility can be a mentally, physically and emotionally draining experience for couples.
Fortunately, modern medicine has come up with several viable treatment options for infertility that can significantly increase the chances of a couple conceiving. In order to determine the best treatment plan, we first need to understand the signs and causes of infertility in males and females.
The World Health Organization defines infertility as “a disease of the reproductive system, defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.” Since infertility is also connected with age, women above the age of 35 should seek professional help if they have not been able to get pregnant after 6 months of unprotected intercourse.
Studies have shown that at least 50 million couples around the world are dealing with problems of infertility. Another interesting observation is that it is more common for couples to experience secondary infertility, or the inability to conceive after having at least one biological child compared to primary infertility, which refers to women who have not had biological children before.
In India, the conventional assumption is that women must be solely affected by infertility. However, in reality, both parties are equally likely to be affected. In fact, one study on infertility in India found that less than 30 percent of Indian males had normal semen characteristics, meaning that up to 70 percent could have issues with fertility.
Let us try and understand how infertility manifests in both genders.
Signs of infertility in Indian men:
Abnormalities in semen is almost always a reliable indicator of infertility in men. Common infertility signs in men include low sperm count, abnormalities in the function of sperm or blockages that do not allow sperm ejaculation.
Signs of infertility in Indian women:
Some of the signs of infertility in women include advancing age, physical conditions, presence of STDs, and fibroids in the uterus. However, the most common indicator of infertility in women continues to be irregularities in the menstrual cycle. Women whose periods are irregular, too long, too short, or absent, might have trouble ovulating.
Infertility in both men and women does not typically manifest as visible symptoms. It is, sometimes, hard to detect/predict if you may have such an issue on your own unless you are planning a pregnancy. While it may be hard to determine the cause of the condition, some factors increase the possibility of infertility in both men and women. These include:
Over the course of her reproductive years, a woman loses an egg with every menstrual cycle through the process of ovulation. As a woman grows older, she has fewer eggs in her ovaries and the quality of these might not be very good. Thus, age plays a significant role in a woman’s fertility.
Smoking, in both males and females, can impact fertility. In women, smoking can damage the fallopian tubes and cervix and impact uterine health. In men, smoking can reduce sperm count and sperm motility and also lead to the production of abnormal sperm.
Alcohol dependence in both males and females can reduce fertility rates. While women are advised to avoid consuming alcohol during pregnancy, they must minimize their intake even when trying to conceive.
Increased levels of stress can affect physiological and mental health. Conditions like depression, anxiety, and trauma can lower fertility levels. Stress can also cause an imbalance in hormone levels, which can affect sex drives and rates of fertility in both men and women.
Men and women with obesity and weight-related issues are more likely to be infertile. Diets can impact fertility rates in the long run and thus, switching to a wholesome and nutritious diet early on in life can contribute to fertility.
History of STDs
The importance of baby weaning or infant weaning lasts a lifetime as they not only help meet the nutritional needs of the baby but also help in developing important skills.
– Infertility is defined as a disease of the reproductive system, defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.
– Abnormalities in semen, uterine health, STD’s, and age are some signs of infertility. Smoking, alcohol, stress, and diet are factors that increase the risk of infertility.
Q1. What is infertility?
Infertility can be explained as a disease or disorder that can prevent the conception of a child or decrease the chances of carrying a child to term. Couples who have been trying unsuccessfully to get pregnant for at least a year may need a complete checkup to diagnose any underlying issues.
Q2. What factors influence fertility?
Some of the main factors that influence fertility are sexual health, age, diet and lifestyle habits. Excessive smoking, drinking, STDs and advancing age can reduce fertility levels of individuals.
Q3. How common is infertility?
According to a study by the Indian Society of Assisted Reproduction, approximately 10-15% of couples in India have fertility issues. Moreover, couples in urban cities are more likely to face infertility than couples in rural areas.
Q4. Is infertility a condition in men or women?
About one-third of the cases can be traced to male factors of infertility, while another third can be caused due to factors in females. Among the remaining third, most cases are attributed to combined causes, and a few cases are unexplainable.
Q5. At what age are women most fertile?
Women are usually fertile between the ages of menarche and menopause. If one were to predict at what age are women most fertile, it would be between 15 and 30.
Q6. Does infertility affect health?
While there are no health complications that can arise from infertility, couples face psychological issues like depression, anxiety, fear, isolation, and rejection. In some cases, infertility can arise from pre-existing health conditions such as PCOS and STDs. Infertility and PCOS are often seen together, so if you have symptoms of PCOS, you should try to manage the condition to bring it under control.
Q7. What is secondary infertility?
Secondary infertility refers to the couple’s inability to conceive a child after having already given birth to one. There are many causes of secondary infertility. There might have been issues with the previous pregnancy or birth, damage to fallopian tubes or decreased sperm production.
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One of the most common reasons why infertility goes undiagnosed for a long time is because there are no characteristic symptoms for infertility.
In most cases, couples only realize they might be suffering from infertility after they actively try to conceive a baby and fail to do so. Often, certain conditions can lead to infertility, so it’s important to look out for symptoms of infertility to get timely treatment.
Here are some signs of infertility in Indian men and women.
Several factors can play a role in contributing to infertility in women. Some female infertility symptoms include:
It is even harder to notice male infertility symptoms unless you get yourself examined. Signs of infertility in Indian males can also be attributed to certain conditions that cause infertility in the first place. Here are some of these male factors of infertility.
– While there are no distinct symptoms of infertility, certain symptoms like hormonal changes (indicated by hair thinning and acne), reduction in libido and erectile dysfunction can be signs of infertility.
– Comprehensive tests need to be conducted to diagnose infertility and determine the best treatment for it.
Q1. What are the symptoms of infertility?
There are no classic symptoms for infertility in either males or females. You may notice symptoms that are typical to certain conditions that may cause infertility. However, you cannot be sure unless you get yourself checked after trying to conceive for a considerable period.
Q2. What are the signs of infertility in Indian women?
Women who have hormonal problems, menstrual irregularities, pain during their period, milky discharge from their nipples, or pain during intercourse could be at risk for infertility. However, further tests need to be conducted for a conclusive diagnosis.
Q3. Can erectile dysfunction be a sign of infertility in males?
Problems with erections, ejaculation and libido are among the signs of infertility in males. It is best to have yourself checked if you seem to have these symptoms.
Q4. Are there any signs of fertility in women?
Although there are no typical fertility signs in women, those who experience regular menstrual cycles with normal bleeding, have minimal to no pain, and have hormone levels within the normal range are more likely to be fertile.
Q5. Are hormonal changes a likely indicator of infertility in males?
Hormonal changes can affect fertility in males, however, these changes are difficult to identify. Loss or thinning of hair due to hormonal imbalances can sometimes be a sign of infertility.
Q6. Can men and women both be infertile?
It is rare, but possible for both partners to have problems with their fertility.
Q7. If a woman experiences pain during intercourse, does it mean she is infertile?
Pain during sex is among the signs of infertility in women. However, it does not necessarily mean that the woman is infertile. Tests need to be conducted to confirm infertility.
Q8. Does endometriosis cause infertility?
Endometriosis is a painful condition where the uterine lining tissue grows outside the uterus. This can result in heavy blood flow and severe cramps. If you’re wondering, ‘can endometriosis cause infertility?’, the answer is yes. Endometriosis can make it difficult to conceive and to carry a pregnancy to term.
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“Failing to conceive despite repeated attempts can be very frustrating for a couple. To understand the root cause of the problem, you and your partner should undergo a complete examination. With strides in modern medicine, many causes of infertility can be successfully treated, so you shouldn’t lose hope.”
– Dr Uma M, Consultant Family Physician and Diabetologist
It takes a healthy male and female, as well as the right environment and timing, to be able to get pregnant. With so many factors in play, it may require some time and effort to conceive a baby. Either partner can lower the chances of conception if they face reproductive health issues or any other disorder. Here are some leading causes of infertility in men and women.
– Several causes and complications can lead to infertility in men and women. Understanding the underlying causes of infertility in women and men will enable the right course of remedy.
– For women, infertility and PCOS, scarring of the fallopian tube, and early menopause are among the causes of infertility.
– For men, unhealthy lifestyle habits, changes in hormone production, and damage from medical treatment can cause infertility.
Q1. What causes infertility in men?
Sperm health is among the major causes of infertility in men. Other complications include genetic, environmental, and lifestyle factors. Side effects of medical treatment can also contribute to infertility. Knowing what causes infertility in men can help plan the necessary treatment.
Q2. What causes infertility in women?
Age, hormonal imbalance and lifestyle factors are some of the main causes of infertility in women. A woman’s risk of infertility increases with age because the quality of her eggs starts to deteriorate. Hormonal or reproductive issues like PCOD and endometriosis can also make it more difficult to get pregnant. Excessive smoking and drinking can reduce fertility in women.
Q3. What causes blocked fallopian tubes?
Blocked fallopian tubes can be a result of an inflammation caused by STDs, adhesions, and endometriosis. Studies on what causes blocked fallopian tubes have revealed pelvic inflammatory disease as the most common cause.
Q4. Can abortion cause infertility?
Elective abortions are not known to cause complications or issues with future pregnancies. Sometimes, when the termination of pregnancy is done at a stage later than 12 weeks, or if there is a requirement of a repeat surgical procedure, there are chances of developing Asherman syndrome (formation of scar tissue in the uterus) which can be a likely cause of infertility after abortion.
Q5. Do women get infertility in PCOS?
Infertility and PCOS do appear to have a strong connection. PCOS is among the most common reasons for infertility. It is a condition that causes irregular periods, cysts in the ovaries and can impact the egg’s development and release during ovulation.
Q6. Can ovarian cyst cause infertility?
Ovarian cysts are common. They do not impact fertility unless they get infected, triggering a series of potential problems, including pelvic infections and fallopian tube scarring.
Q7. Is ovulating with PCOS possible?
Hormonal imbalances caused due to PCOS make it difficult for women to ovulate regularly and naturally. However, female infertility treatment and certain medications available today, make ovulating with PCOS possible.
Q8. Can a yeast infection cause infertility?
Yeast infection does not by itself cause infertility. The condition is usually very simple to treat through topical treatments and by maintaining proper hygiene.
Q9. Can fibroids cause infertility?
Fibroids are usually harmless and do not cause infertility in women. In some cases, however, where the fibroids are very large and are present within the uterus, they can affect the fertility of a woman.
Q10. Can chlamydia cause male infertility?
Chlamydia can result in changes in the structure of sperm, which can lead to infertility in males. It’s vital to get treatment for chlamydia in the early stages itself to prevent complications.
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It is important to get a good, timely diagnosis of infertility to improve your chances of having a baby. Diagnoses for both men and women begin with a medical examination and understanding of their medical history. Following this, a series of diagnostic tests are conducted to help understand the reasons for not ovulating or conceiving, suggesting suitable treatment plans after that.
Depending on your medical history and your physical examination outcome, your physician may ask to undergo one or more of the following tests:
A physical examination and some fertility tests can help provide an accurate diagnosis of infertility and suggest the right course of action.
– Diagnostic tests are critical as they help reveal important information about the reasons for not conceiving.
– Depending on the case and its presentation, the doctor may advise either or both partners to undergo a series of tests.
– Once diagnostic tests have been carried out, it is easier for doctors to suggest the best treatment course.
Q1. What is a fertility test?
A fertility test can help couples understand and identify any underlying problems leading to infertility issues. It also suggests the most fertile windows that can allow couples the best chance of getting pregnant. To know what is a fertility test that can help you conceive, check with your physician.
Q2. How can you determine the reasons for male infertility?
It is possible to ascertain the reasons for male infertility through several diagnostic tests available, including semen analysis and testicular biopsy. Your doctor can suggest the right diagnostic tests following a consultation.
Q3. What are the female infertility causes?
Reasons for female infertility can be determined through several tests available, such as hormone tests and HSG tests. Following a consultation with your OB, you will receive a list of suggested tests to help get you an answer.
Q4. How can ovulation problems be diagnosed?
Ovulation problems are diagnosed using tests that check hormone levels to know if you are ovulating. Further investigation, including hormone testing and imaging, may also be suggested.
Q5. Do both individuals need to be tested?
A preliminary consultation with your physician will help you decide if both of you need to be tested, or if only one of you needs an evaluation.
Q6. How long will it take for us to have an answer?
You will need to wait for at least a month to get the results of all your tests. In some cases, repeated tests may need to be conducted, which may make the wait longer.
Q7. What if all the tests are normal?
In some cases, all your tests may come back normal. This does not mean the absence of a problem. You may want to ask for more tests or consider getting a second opinion.
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Infertility treatment in women is determined only after the doctor conducts a complete examination and identifies the best course of action. You may even need a combination of female infertility treatment options to help you have a baby. The course of treatment is chosen depending on age, causes, and duration of infertility and personal preferences.
Prescription of certain fertility drugs forms the first course of treatment, especially for women with ovulatory disorders. Some commonly prescribed drugs for ovulatory disorders include clomiphene citrate and Gonadotropins. The purpose of these drugs is to induce ovulation. It is important to discuss the options carefully with your doctor since almost all of them have risks and side effects.
Assisted Reproductive Technology (ART) is a treatment option that handles sperms and the egg in various ways. IVF is among the most common forms of ART. It may involve combining a sperm and egg outside the woman’s body allowing fertilization, assisting implantation and hatching of the embryo in the uterine lining, using donor eggs, or seeking a gestational carrier’s assistance.
No procedure comes without risk. Some complications with fertility treatments include:
Fertility treatments commonly lead to multiple pregnancies, with twins, triplets, or even more babies in the uterus. This can lead to greater risk to the mother and babies, premature labour, developmental complications, gestational diabetes, and complications during delivery.
Ovarian hyperstimulation syndrome (OHSS):
This is a common complication of ART. Painful and swollen ovaries typify this condition. You may also experience nausea, bloating, and abdominal pain if you get pregnant. These symptoms are likely to last for about a week. In some rarer cases, the woman may experience shortness of breath and rapid weight gain, which may require emergency care.
Infection and bleeding:
In certain rare cases, bleeding and infection may be noticed when invasive forms of treatment have been used.
– There are several treatment options available to help women with infertility, including medication, surgical treatment, and artificial insemination.
– Factors like age, causes, and duration of infertility and personal preferences are considered before suggesting an optimal treatment plan.
– It is important to discuss the plan, its course, and possible risks and complications before making a final decision.
Q1. How can you treat ovulation disorders?
The best course of treatment for ovulation disorders will be determined by your doctor. In general, treatment will include medication to induce ovulation and surgical procedures if the cause of infertility can be surgically remedied.
Q2. What is IVF in medical terms?
In Vitro Fertilization or IVF can be explained as fertilizing the female egg with the male sperm outside the female body. Fertilization occurs in a laboratory dish when the sperm attaches to and enters the egg.
Q3. What insurance covers IVF?
Not every insurance plan covers IVF. Some plans may cover IVF, but not fertility injections. Other plans may only cover a certain number of attempts. If you are waiting to begin female or male infertility treatment, check carefully to determine what insurance covers IVF and just how much you will be protected.
Q4. What is the procedure for IUI?
Intrauterine insemination or IUI involves transferring specially washed semen into the uterus through a catheter.
Q5. Who is a gestational carrier?
A gestational carrier may be suggested when a woman’s uterus cannot carry the baby to term, especially in congenital malformations of the uterus. The embryo is placed in the uterus of another woman to carry the baby.
Q6. How much does the treatment for infertility cost?
Costs vary significantly depending on the course of treatment involved. It is important to get a proper estimate of treatment costs and check your insurance plan for coverage.
Q7. What options exist apart from treatment?
In case of treatment is not an option, you may discuss available choices with a counsellor. Adoption is among the most preferred options for couples who cannot have children.
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Men have an equal chance of having issues with fertility. However, there are several treatment options available today, which can significantly improve their chances of having a baby.
Treatment options for male infertility can be classified into the following two types:
– While the incidence of male infertility is on the rise, there is comfort in that several surgical and non-surgical treatment options are available to help them have a baby.
– Treatment options are considered keeping in mind the cause of infertility, age, as well as preferences.
Q1. What is fertility treatment?
The use of medical procedures to help treat infertility using assisted reproductive technology defines fertility treatment. Different forms of treatment are devised for males and females.
Q2. How can male fertility doctors help?
Male fertility doctors can help test you for infertility and enable you to understand your condition, its cause, and possible treatment options.
Q3. How is infertility in men treated?
Close to 90 percent of infertility cases in males are treated with conventional forms of therapy like drugs and surgery.
Q4. How is IVF used in male fertility treatment?
The IVF procedure collects the sperm from the male and uses a special washing technique to obtain the most potent sperm for fertilization.
Q5. What is ICSI?
Intracytoplasmic sperm injection or ICSI forms a part of the IVF treatment. The process involves injecting a single, healthy male sperm into a mature egg to help them fertilize.
Q7. Can a vasectomy be reversed?
Vasectomies can be reversed to help couples have children through a surgical procedure called vasovasostomy.
Q7. How can varicocele infertility be treated?
The only course of varicocele treatment is surgery. Medication may be prescribed to relieve pain. Temporary respite may be sought through embolization or the temporary blocking of veins. If you are experiencing varicocele infertility, then your doctor might recommend these methods to you.
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