Infertility overview
Infertility overview
Dr. Nafea ahmed suud- Department of Biology
eps.nafiea.suud@uoanbar.edu.iq
Infertility is usually defined as the inability of a couple to achieve pregnancy after repeated intercourse without contraception for one year.
Frequent intercourse without birth control usually leads to pregnancy:
1- In 50% of couples within 3 months
2- At 75% within 6 months
3- At 90% within 1 year
To increase the chance of pregnancy, couples should have frequent intercourse in the six — especially three — days before the ovaries release an egg (ovulation). Ovulation usually occurs in the middle of the menstrual cycle, about 14 days before the first day of the next period.
There are two of the most common methods a woman can use to estimate when ovulation will occur: Measurement of body temperature at rest (basal body temperature( Home ovulation kit (perhaps the best method(
If women have regular periods, they can estimate when ovulation will occur by taking a temperature each day before getting out of bed; a lower temperature indicates that ovulation is about to occur. An increase of 0.9 degrees Fahrenheit (0.5 degrees Celsius) or more It indicates that ovulation has just occurred. But this method is annoying to many women and is unreliable or accurate. At best, it only predicts ovulation within two days.
Home ovulation prediction kits are more accurate. These kits are used to detect an increase in luteinizing hormone in the urine. (LH stimulates the ovaries to induce ovulation). This increase usually occurs 24 to 36 hours before ovulation. Women usually need to repeat the test Several days in a row, so these kits usually include five to seven strips. The strips can be kept under a stream of urine or immersed in the urine being collected in a sterile container.
The role of estimating when ovulation occurs in a spouse who has regular intercourse is not known. But this estimation is likely to help couples who do not have regular intercourse know the best time for it.
About one in five couples in the United States do not conceive for at least a year, so they are considered infertile. However, among couples who do not conceive after a year of trying, more than 60% eventually do. , with or without treatment.
The reasons:
Infertility may be caused by problems in the man, the woman, or both:
Sperm problems (in 35% or more of couples)
Ovulation problems (in about 20%)
1- Problems with the fallopian tubes and pelvic abnormalities (in about 30%)
2- Problems with cervical mucus (5% or less)
3- unknown factors (in about 10%)
Consuming a lot of caffeine (for example, more than 5 to 6 cups of coffee per day) and excessive tobacco use can impair fertility in women and should therefore be avoided.
Diagnosis
1- Physician's evaluation: Diagnosing infertility problems requires careful evaluation of both partners. The evaluation is usually done at least 1 year after trying to achieve pregnancy. However, it is done sooner if
2- The woman is over 35 (usually 6 months after trying to become pregnant(.
3- When a woman's menstrual cycles occur irregularly (less than nine cycles per year).
4- The woman has a previously known abnormality of the uterus, fallopian tubes, or ovaries.
5- If doctors have identified or suspected problems with a man's sperm.
Age is an important factor, especially for women. As women become older, pregnancy becomes more difficult, and the risk of complications during pregnancy increases. Women also, especially after the age of 35, have limited time to resolve premenopausal infertility problems.
Treatment:
1- Treating the cause
2- Occasional medication
3- Sometimes assisted reproductive techniques
4- Measures to reduce stress, including counseling and support
The goals of treatment are:
1- Treat the cause of infertility, if possible
2- Make pregnancy more likely
3- Reducing the time required for pregnancy
Even when no cause of infertility can be identified, the couple may continue treatment. In such cases, the woman may be given drugs that stimulate several eggs to mature and be released, called fertility drugs. Examples include clomiphene, letrozole, and human gonadotropins. These medications are most beneficial for women who have problems with ovulation.
Alternatively, doctors may use assisted reproductive techniques, such as:
1- Intrauterine insemination technique that selects only the most active sperm, which are then placed directly into the uterus
2- IVF, which involves stimulating the ovaries, taking mature eggs, fertilizing them with sperm in culture dishes (in vitro), developing embryos in a culture, and placing one or more embryos in the woman's uterus
However, assisted reproductive methods may result in pregnancy with more than one fetus.
While an infertile couple is being treated, one or both partners may experience frustration, emotional stress, feelings of inadequacy, and guilt. They may alternate between hope and despair. Feeling isolated and unable to communicate, the couple may become angry or resentful toward each other, or toward Family members, friends, or a doctor. Emotional stress can lead to fatigue, anxiety, sleep or eating disorders, and an inability to focus. In addition, the financial burden and time commitment involved in diagnosis and treatment can cause marital conflict.
These problems can be mitigated if both partners share information about the treatment process (including the time it takes), regardless of which one has the diagnosed problem. Knowing what the chances of success are, as well as realizing that treatment may not be successful, can help. It can not continue indefinitely, the couple has to adapt to the distress.
Information on the following is also helpful:
1- When does the treatment end?
2- When are they seeking a second opinion?
3- When can adoption be considered?
For example, if pregnancy does not occur after 3 years of trying or after 2 years of infertility treatment, the chance of pregnancy becomes low and adoption may be considered. Ideally, couples should request this information before starting treatment.
Counseling and psychological support, including support groups such as RESOLVE and Path2Parenthood, can help.