Infertility is defined as the inability of a couple to conceive after engaging in regular, unprotected sexual activity for a minimum of one year.

Causes of Infertility

Infertility may stem from issues related to either the male, the female, or both partners.

Common Factors in Women

  • Hormonal imbalances affecting ovulation
  • Obstruction or damage to the Fallopian tubes due to conditions like pelvic inflammatory disease, endometriosis, or pelvic surgery
  • Uterine complications
  • Cervical issues obstructing sperm migration to the uterus
  • Onset of early menopause

Common Factors in Men

  • Sperm production and motility issues
  • Blockage in the vas deferens
  • Sexual dysfunction, decreased libido, or ejaculatory issues
  • Genetic disorders affecting sperm generation
  • Varicoceles that degrade sperm quality
  • Reproductive system diseases like liver disease or prostate infections
  • Hormonal imbalances

Tests and Diagnosis Procedures for Infertility

It's crucial for both partners to undergo diagnostic tests simultaneously, starting with an in-depth medical history and general health examination.

For Women

  • Hormonal and genetic screenings
  • Uterine and ovarian ultrasound
  • Uterine cavity endoscopy
  • Hysterosalpingography (an x-ray procedure to examine the uterus and Fallopian tubes)

For Men

  • Sperm quality assessment
  • Ultrasound of testicles and surrounding blood vessels
  • Abdominal and testicular endoscopy

Treatment Options

Treatment plans are tailored to the underlying cause of infertility with the aim of either restoring natural fertility or aiding conception through medical intervention. Options may include:

Medication and Surgery

  • Hormonal treatments to stimulate testicular or ovarian function
  • Surgical procedures to remove uterine growths or fibroids

Advanced Reproductive Techniques

  • Intrauterine Insemination (IUI): A procedure to place processed sperm directly into the uterus after ovarian stimulation, suitable for couples with relatively straightforward fertility issues.
  • In Vitro Fertilisation (IVF): The fertilisation of an egg by sperm occurs outside the body in a lab. It is recommended for conditions such as blocked Fallopian tubes, multiple uterine fibroids, chronic anovulation, and sperm-related issues.

Special Cases

If semen contains no sperm, direct extraction from the testicles may be advised for both treatment and diagnosis purposes. Techniques include:

  • Testicular Epididymal Sperm Extraction (TESE): Sperm is obtained by surgically extracting testicular tissue.
  • Percutaneous Epididymal Sperm Aspiration (PESA): A needle is inserted through the testicle into the vas deferens to gather sperm.
  • Microsurgical Epididymal Sperm Aspiration (MESA): A needle aspirates epididymal fluid and sperm through the scrotum and into the epididymis.