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Infertility ; Sign, Female Causes, male causes, Diagnosis, Treatments

infertility definition

Infertility is a disease of the reproductive system, it is defined by the failure to achieve a clinical pregnancy after 11 to 12 months or more of regular unprotected sexual intercourse


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signs of infertility in women


Pain during sex

Pain during sex, which is called , Dyspareunia, can be a sign of an underlying health problem that may influence a woman’s fertility, infertility in women, I can cause such health issues include infections, endometriosis, and fibroids.


Heavy, long, or painful periods

Heavy,painful periods may indicate an underlying condition, that effects fertility.


Some of women may experience a few days of light flow, while others regularly experience heavy periods and painful cramps also.


Some of women who experience very heavy, painful periods may be they showing signs of endometriosis, it is a medical condition where tissues usually found in the womb are present elsewhere in the body.

Endometriosis is a risk factor for infertility.


Other symptoms of endometriosis include:


chronic pelvic pain is happen, not only during menstruation but also some other time.


pain during sex, may cause female infertility


back pain


fatigue


nausea


irregular periods and spotting


bowel problems or pain with bowel movements


Dark or pale menstrual blood


This may be a cause for concern if your menstrual blood is regularly paler than usual, Blood of menstruations is usually bright red at the beginning of a period and may get darker over the following days.


It is also a sign of endometriosis if you are passing very dark or old blood at the beginning of a period . If you have other symptoms, you may wish to speak to a doctor.


Irregular menstrual cycle


 It may cause or sign of female infertility

The length of a menstrual cycle varies between women to women, and also over the time. But however, many women have a regular cycle, meaning that the time between each period is roughly the same.


Having an irregular cycle, and also including missing periods, can contribute to infertility, because it means a woman may not be regularly ovulating. Ovulation is occur when the ovary releases an egg.


Irregular period and irregular ovulation can be due to many issues, including polycystic ovary syndrome (PCOS), obesity, being underweight or overweight and thyroid issues.



Hormone changes


A person may not notice their hormonal changes, as the signs of hormonal changes can be nonspecific. A person may not know the underlying cause. A doctor can test for some hormonal issues. It may cause female infertility


Fluctuations in hormone levels can cause:


unexplained weight gain

severe acne

cold feet and hands

reduced sex drive or loss of sexual desire

nipple discharge

facial hair in females

thinning hair on the top of the head

Underlying medical conditions


Other  factors that may affect infertility in women include:


damage to the fallopian tubes or ovaries

premature menopause

PCOS

endometriosis

cancer and cancer treatments


Obesity 


A study found that obesity might negatively affect reproductive health.In may cause infertility in women

Women with obesity have a higher risk for issues during pregnancy than those without weight issues, and they have a lower probability of conceiving.


Not getting pregnant


If you are not getting pregnant after trying for a certain length of time. Then it is the primary sign of female infertility


If a woman has not become pregnant after 1 year of trying, a doctor may diagnose infertility


If a women has not become pregnant after 6 months of trying, and the woman is over the age of 35 years old, she may be infertile.


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signs of infertility in men


signs of male infertility can include the following:


Hormonal imbalances


A variety of hormonal imbalances can affect a man’s fertility also.


 The key hormone for male fertility is Testosterone,so problems with the testes that produce this hormone may lead to infertility.


There is two hormones in male body which signal to the testes to make sperm and testosterone, they are luteinizing hormone and follicle-stimulating hormone.


There is a pituitary gland which produces these hormones, so any problems with this gland may also influence infertility.



Erectile dysfunction


It  Is difficult to get or keep an erection, if there is hormonal changes, psychological factors, or some physical issues. It may be a signs of male infertility


If Erectile dysfunction becomes a regular it may interfere with sexual intercourse or be a sign of an underlying issue.


Problems with ejaculation or ejaculate


It may be a signs of infertility in men

If a man having difficulty in ejaculation or noticing changes in the ejaculate, such as a drop in volume, may also be a sign of an underlying issue related to a man’s fertility.


Changes in testicles


It is an important aspect of male fertility, having a healthy testicles . Small or firm testicles that feel “tight” may be another sign of hormone issues.


But swollen, painful, or tender testicles may be a sign of an underlying issue, like an infection, that can also impact sperm quality and male fertility.


Obesity


Research noted that many studies link obesity in men with infertility.


Obesity can increase the risk for other conditions also, that may impact a man’s fertility such as sperm quality and sexual dysfunction.


  Inability to conceive a child., is the main sign of male infertility There may be no other obvious signs or symptoms.


On the other hand in some cases, an underlying problem like, as an inherited disorder, hormonal imbalance, dilated veins around the testicle or a condition that blocks the passage of sperm causes the signs and symptoms.



Signs and symptoms you may notice include:


Problems with sexual function

example,
  fluid ejaculation is very small or
difficulty with ejaculation, sexual desire is reduced, or difficulty maintaining an erection (erectile dysfunction)


Pain, swelling or a lump in the testicle area


Recurrent respiratory infections

Inability to smell


Gynecomastia or
Abnormal breast growth

Some other signs of a chromosomal or hormonal abnormality like Decreasing body hair or facial hair.

A lower than normal sperm count



Diagnosis

Doctor understand your sexual habits and may make recommendations to improve your chances of getting pregnant,before infertility testing. It is also true that, in some infertile couples, no specific cause is found (unexplained infertility).


Infertility evaluation sometimes involves uncomfortable procedures, and it can be expensive. How ever some medical plans may not cover the cost of fertility treatment. There's also no guarantee — even after all the testing and counseling — that you'll get pregnant.



Tests for men or male fertility test


In male , it is required that, the testicles produce enough healthy sperm, and that the sperm is ejaculated effectively into the vagina and travels to the egg. In male fertility test, it is attempted to determine whether any of these processes are impaired.

Some peple may have a general physical exam, including examination of your genitals.


Specific male fertility test may include:

Semen analysis ; 


Doctor may ask for one or more semen specimens. A lab analyzes your semen specimen. In some of the cases, urine also tested for the presence of sperm.


Hormone testing; 


Some of You may have a blood test to determine your level of testosterone and other male hormones.


Genetic testing;


It may be done to determine whether there's a genetic defect causing infertility.


Testicular biopsy


In some of the select cases, a testicular biopsy may be performed to identify abnormalities contributing to infertility or to retrieve sperm for assisted reproductive techniques, such as IVF.


Imaging;


In some certain situations or some certain cases,  imaging studies such as a brain MRI, transrectal or scrotal ultrasound, or a test of the vas deferens (vasography) may be performed.


Other speciality male fertility test;


In some rare cases, other tests to evaluate the quality of the sperm may be performed, like evaluating a semen specimen for DNA abnormalities.


Tests for women


In the women fertility ovaries releasing healthy eggs. In this tests the reproductive tract of a women  must allow an egg to pass into the fallopian tubes and join with sperm for fertilization. After that, the fertilized egg must travel to the uterus and implant in the lining.


Most of the female infertility test is try to find out if any of these processes are impaired.


Youme of the women may have a general physical exam, including a regular gynecological exam. Specific fertility tests may include:


Ovulation testing;


 In this test blood test measures hormone levels to determine whether you're ovulating.


Hysterosalpingography;


This(his-tur-o-sal-ping-GOG-ruh-fee) process or test  evaluates the condition of your uterus and fallopian tubes and looks for blockages or other problems, In which X-ray contrast is injected into your uterus, and an X-ray is taken to determine if the cavity is normal and to see if the fluid spills out of your fallopian tubes.


Ovarian reserve testing;


Its helps to determine the quantity of the eggs available for ovulation. But in some cases this approach often begins with hormone testing early in the menstrual cycle.


Other hormone testing;


How ever, other hormone tests is done to check levels of ovulatory hormones, as well as pituitary hormones that control reproductive processes.


Imaging tests;


In this test, Pelvic ultrasound looks for uterine or ovarian disease. Sometimes a sonohysterogram, also called a saline infusion sonogram, it is used to see details inside the uterus that are not seen on a regular ultrasound.


Depending on patients situation, 

rarely your testing may include:

Hysteroscopy;


doctor may request a hysteroscopy to look for uterine disease, depending on your symptoms, . During this procedure, doctor or care giver inserts a thin, lighted device through your cervix into your uterus to view any potential abnormalities.


Laparoscopy;


This is a minimally invasive surgery, it is involves making a small incision beneath your navel and inserting a thin viewing device to examine your fallopian tubes, ovaries and uterus. This process if laparoscopy may identify endometriosis, scarring, blockages or irregularities of the fallopian tubes, and problems with the ovaries and uterus.


It is not necessary that ,everyone needs to have all, or even many, of these tests before the cause of infertility is found. Patient and the doctor will decide which tests they will have and when.


Treatments of infertility


Infertility treatment depends on:

What's causing the infertility

How long you've been infertile

Your age and your partner's age

Personal preferences

Some cause of infertility can't corrected,

In some cases where spontaneous pregnancy doesn't happen, couples can often still achieve a pregnancy through use of assisted reproductive technology. Treatment of infertility may involve significant financial, physical, psychological and time commitments.


Treatment for men


Infertility treatments for Men's  for general sexual problems or lack of healthy sperm may include:


Changing lifestyle factors; 


Improving your lifestyle and certain behaviors can improve chances for pregnancy, including discontinuing select medications, reducing or eliminating harmful substances, improving frequency and timing of intercourse, exercising regularly, and optimizing other factors that may otherwise impair fertility.


Medications;


Medication is important, as Certain medications may improve sperm count and likelihood for achieving a successful pregnancy. These type of medicines may increase testicular function, including sperm production and quality.


Surgery;


For some certain conditions, surgery may be able to reverse a sperm blockage and restore fertility. In the other cases, surgically repairing a varicocele may improve overall chances for pregnancy.


Sperm retrieval


These process is needed ,when sperm  ejaculation is a problem or when no sperm are present in the ejaculated fluid. This proce may also be used in cases in which assisted reproductive techniques are planned and sperm counts are low or otherwise abnormal.


Treatment for women


Some of the women need only one or two therapies to improve fertility. But on the other hand some women may need several different types of treatment to achieve pregnancy.


Stimulating ovulation with fertility drugs. 


Women who are infertile due to ovulation disorders, fertility drugs are important for them, These drugs or medications regulate or induce ovulation. You should talk with your doctor about fertility drug options — including the benefits and risks of each type.


Intrauterine insemination or IUI; 


During IUI process, healthy sperm are placed directly in the uterus around the time the ovary releases one or more eggs to be fertilized. It is also depending on the reasons for infertility, the timing of IUI can be coordinated with your normal cycle or with fertility medications.


Surgery to restore fertility;


Some women have Uterine problems such as endometrial polyps, a uterine septum, intrauterine scar tissue and some fibroids can be treated with hysteroscopic surgery. Endometriosis, pelvic adhesions, and larger fibroids may require laparoscopic surgery or surgery with a larger incision of the abdomen.


Assisted reproductive technology;


There are several types of Assisted reproductive technology,


In vitro fertilization (IVF) 


It is the most common Assisted reproductive technology or technique. In vitro fertilization involves stimulating and retrieving multiple mature eggs, fertilizing them with sperm in a dish in a lab, and implanting the embryos in the uterus several days after fertilization.


Other techniques are sometimes used in an IVF cycle, such as:


Intracytoplasmic sperm injection (ICSI).
  Only A single healthy sperm is injected directly into a mature egg, in this process. But, when there is poor semen quality or quantity ,ICSI is often used, 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 Assisted reproductive technology is done using a couple's own eggs and sperm. But however, if there are severe problems with either the eggs or the sperm, you may choose to use eggs, sperm or embryos from a known or anonymous donor also.


Gestational carrier.;


Women might choose IVF using a gestational carrier, if they don't have a functional uterus or for whom pregnancy poses a serious health risk. However, in this case, the couple's embryo is placed in the uterus of the carrier for pregnancy.


Complications of treatment


Complications of infertility treatment may include:


Multiple pregnancy;


Multiple pregnancy is the most common complication of infertility treatment, multiple pregnancy is a — twins, triplets or more. It is generally, the greater the number of fetuses, the higher the risk of premature labor and delivery, as well as problems during pregnancy like as gestational diabetes. In this cases babies born prematurely are at increased risk of health and developmental problems. You should talk to the doctor about any concerns you have about a multiple pregnancy before starting treatment.


Ovarian hyperstimulation syndrome (OHSS):


OHSS can cause when, fertility medications to induce ovulation, but particularly with ART, In this process the ovaries become swollen and painful. Some of the symptoms may include mild abdominal pain, bloating, and nausea that lasts about a week, or longer if you become pregnant. More severe form of this may causes rapid weight gain and shortness of breath requiring emergency treatment.


Bleeding or infection; 


There is a rare risk of bleeding or infection with assisted reproductive technology or reproductive surgery,As with any invasive procedure

What Is The Common Myth About Infertility? 


Two of the most frequent myths are, (1) That infertility is a woman’s problem and
(2) That everyone requires IVF.
But research says that,both are false.  Men and women both are have equal responsibility for conception . Rescarch says that, couples that 40% of infertility is related to male factor alone; 40% is related to the female factor alone, and 20% of the time there’s a combination of male and female factors.


So, it is true that 50% of fertility can be related to a male factor. It is so true that, Without an evaluation of both male and female there is nothing to say.


This breakdown looks more like 70% male and 30% female, when couples are referred to a fertility specialist.


It is true that IVF is an incredible tool, but many of patients are amazed at the various treatment options available to them, such as acupuncture, massage, yoga, and other lifestyle and diet changes,


How Does Food Play a Role In Fertility? 


As it relates to fertility, the diet wasn’t a big topic of conversation, as food is not our focus. We all some how know that what we eat plays a huge role in helping our bodies function properly and that the reproductive system is interconnected with all of the other systems in the body. 


In human body the gastrointestinal tract is just next to the reproductive organs.so inflammation and heat there can impact sperm quality in men, and1 eggs, ovulation, and implantation in women.


Most of people eat way too many carbs, processed foods, and sugar, and way too little fat because we’ve blindly followed the food pyramid. We eat too much and too often. Result If this too often eating inflammation is up and disease is on the rise. 

Inflammation is one of the, leading cause of infertility, and food is the single biggest cause of inflammation,

It a big fact that ,Carbs and sugar cause inflammation. Some of us constantly eating 3-6 times a day means we’re always pumping insulin. Our eating bowels are constantly full and blood sugar is high. Study shows to us that, eating just 50 grams of carbohydrates increased levels of the inflammatory marker Nf-kB. Some of the fiber generates heat in the gut because our bodies aren’t really capable of digesting it, and heat can cause problems with reproductive organs in both men and women. 

Good fat forom the foods provides us the key building blocks for every cell in our body, and Fat is vital for fertility. Good fats essential for reducing inflammation and balancing and synthesizing hormones. A fertile diet must contain some good fat, and animal products are the best source.


Foods Thats Are Beneficial To Women Try To Conceive? Are There Some Foods That Have A Negative Effect? 


A balanced diet high in fats, moderate in proteins and low in carbohydrates are required. It is really important to limit or eliminate carbs, processed foods, and sugars. A diet called ketogenic diet is ideal and one that leans carnivore even better.

Foods like, bacon, eggs, butter, beef, full-fat ice cream, and salt. Some of the foods that we’ve gotten away from eating pack the biggest nutritional punch like liver. Steak is a great meal. Rib-eye is ideal. Eggs, salmon, sardines, and other seafood high in Omega-3s are some other fertility-enhancing foods, along with pork belly, butter, and full-fat dairy products like heavy cream,  mature cheeses like parmesan and aged cheddar. There are a handful of fruits and vegetables available in the market, that are low in carbs and high in antioxidants, like asparagus, pomegranates, walnuts, berries, sunflower seeds, beans, lentils, and some citrus. 

How often you eat is as important if not more important than what you’re eating. Many men and women are eating 3-6 times a day, which means insulin is constantly pumping, there’s glucose in the bloodstream, and our bowels never get a chance to empty. This glucose, takes a toll on the body and leads to inflammation and ultimately glycation. 

There is a word called,Intermittent fasting, it  gives the body ample time to digest and recover. It is recommendable to  eat one meal a day (OMAD) at night just before bedtime.  If you need a snack during the day, that’s fine too, you should make sure it’s keto-friendly. Yo have to make sure you’re spacing out your meals.

People are surprised to know that fruits and vegetables contain powerful toxins and antigens that are responsible for negative effects on our bodies. Soy-based foods can also be problematic because of the high levels of phytoestrogens. Ovarian function can be affected by high levels of soy.  Ao it's not recommendable to eat a lot of soy-based products in women trying to conceive.

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