Infertility treatments available today

This definition not quite complete, because women who are able to get pregnant but then have repeat miscarriages are also said to be infertile. Thus, if a woman keeps having miscarriages, her condition is also called infertility.

People are often silent about this, although lots of couples have infertility problems. In about one third of cases, the woman is the cause of a couple’s infertility, while in another third of cases, it’s because of the man. The last third represents the unknown causes. What treatments are available against infertility today? Medications and surgery are most commonly used, and effective in almost two thirds of the cases.

Conditions required for pregnancy

Pregnancy is a very complex process which requires that several anatomical structures, in both man and woman, are healthy and fully functional. In order to stay pregnant, several things must happen:

• Ovulation must take place, which means that a woman must release an egg from one of her ovaries 
• This released egg must pass all along the fallopian tube toward the uterus 
• On the other side, a man's spermatozoid must fertilize the egg 
• After this happens the fertilized egg must be implanted on the inside of the uterus  

Infertility can result from problems that interfere with any of these steps. Everything must be in perfect order for pregnancy to take place. Most pregnancies occur during the first six cycles of intercourse in the fertile phase, which can be translated into the fact that, after 12 months of unprotected intercourse, approximately 85 percent of couples will become pregnant.

Frequency of infertility problems

About 7.3 million women (or about 12 percent) in the United States aged 15-44 had difficulty getting pregnant or carrying a baby. This has been established during several studies done by the National Center for Health Statistics of the Centers for Disease Control and Prevention.

Causes of male fertility

There are several things that can cause impaired sperm count or mobility, or impaired ability to fertilize the egg.

The most common causes are:

• abnormal sperm production or function
• impaired delivery of sperm
• general health and lifestyle issues
• overexposure to certain environmental elements

Impaired production or function of sperm

Impaired delivery of sperm

·     Impaired shape and movement of sperm

·     Low sperm concentration

·     Varicocele

·     Undescended testicle

·     Testosterone deficiency

·     Genetic defects

·     Infections

·        Sexual issues

·         Retrograde ejaculation

·         Blockage of epididymis or ejaculatory ducts

·         No semen (ejaculate

·         Misplaced urinary opening (hypospadias)

·         Anti-sperm antibodies

·         Cystic fibrosis

Causes of female infertility

There are also several different medical conditions that could be considered a cause of female infertility.

Some of the most common are:

• Polycystic ovary syndrome (PCOS)
• Early menopause (premature ovarian failure)
• Cancer and its treatment
• Excessive caffeine consumption
• Benign uterine fibroids
• Ovulation disorders
• Elevated prolactin (hyperprolactinemia)
• Medications
• Thyroid problems
• Pelvic adhesions
• Fallopian tube damage or blockage
• Endometriosis
• Other medical conditions such as Cushing's disease, sickle cell disease, HIV, kidney disease, diabetes

Treatment of infertility

There are several different approaches to treating infertility; besides the treatment of the underlying condition, two most attractive and effective treatment forms are medications and ART (assisted reproductive technology).

Medications

Some of the most commonly used medications are:

Clomiphene citrate (Clomid®)
An oral medicine used to treat infertility by inducing ovulationacting on the pituitary gland. It is often used in women who have PCOS, a condition that interferes with normal ovulation. 

Human menopausal gonadotropin or hMG
Most commonly used medications from this group are Repronex and Pergonal. Unlike the previous group, these medications act directly on the ovaries to stimulate ovulation, and are usually administrated via injection. Another group of medications works the same way – the Follicle-stimulating hormones.

Gonadotropin-releasing hormone (Gn-RH) analog
These medications also work on the pituitary gland to cause ovulation, often administered in the the form of a nasal spray.

Metformin (Glucophage®)
This drug is widely used by women who have insulin resistance or Polycystic Ovarian Syndrome (PCOS). It helps lower the level of male hormones in women with these conditions, which normally induces ovulation.

Bromocriptine (Parlodel®)
Sometimes ovulation is blocked because of high levels of Prolactin, a hormone which normally induces milk production, but can block ovulation when present in excessive amounts.
 

Assisted reproductive technology

ART is an extremely effective method that has revolutionized the treatment of infertility.

The most common forms of ART include:

In vitro fertilization
This method involves fertilization done outside of the body. The main indications for this method are blockade of fallopian tubes or a low sperm count. First, women are injected with a medication that causes them to produce lots of eggs, which are later removed from the woman. In the lab, they are mixed with spermatozoids, and after fertilization, implanted into the woman's uterus again.

Zygote Intra-fallopian transfer (ZIFT)
This is a similar method with only one difference - fertilization does occur in the laboratory, but the young embryo is transferred to a fallopian tube instead of the uterus.

Gamete intrafallopian transfer (GIFT)
Using this method, fertilization occurs in the woman's body instead of a lab.

Intracytoplasmic sperm injection (ICSI)
A single sperm is injected directly into a mature egg. This method is used only in cases of serious conceptive problems.
 

Prevention of infertility

Unfortunately, in a vast majority of cases, infertility isn't preventable. However, simple avoidance of drugs, tobacco, and alcohol consumption may contribute to a higher sperm count. A high atmosphere or water temperature can also lower the sperm count by affecting sperm production and motility, which is why it’s recommended to avoid hot tubs and steam baths.

A woman, on the other hand, can directly affect her ability to become pregnant.

Some of the most common methods are:

• Regular exercises could be the key because research has shown that it can help in maintaining a normal ovulatory cycle. Of course, exercising intensively can make woman’s periods irregular or even absent.
• Obesity can modify certain hormones in your body and make pregnancy difficult.
• As previously mentioned, alcohol, tobacco, and drugs should be avoided. Also try to limit your daily intake of caffeine to no more than 250 milligrams per day.