Conception is often treated as a simple natural step in life, but the biological reality behind it ishighly complex. From delicate hormonal fluctuations down to cellular health, the margin for error isexceptionally small. This requires a flawlessly synchronized chain reaction to occur.
When a couple faces months of negative results, it is rarely due to a single issue that can be easily guessed at home. In many cases, the issue may involve a minor biological mismatch or a subtle physiological obstruction that warrants further assessment.
Shifting your perspective from a place of frustration to one of basic understanding is often the most empowering step you can take for your future family, which is why sitting down with an infertility specialist in Siliguri may bring clarity to the situation.
What is infertility?
Infertility is a reproductive problem where you are unable to conceive after 12 months or more of regular unprotected sex. Women over the age of 35 are usually advised to seek an evaluation after 6 months. However, women over 40 or those with known issues with their reproductive health may wish to seek an evaluation earlier.
Infertility can be categorised into two types:
● Primary infertility: Where you have never conceived.
● Secondary infertility: Where you are having difficulty conceiving after previously having a pregnancy.
This can be related to factors associated with female or male reproductive health. It isimportant to investigate both partners' reproductive health.
What can cause infertility?
Many factors can cause infertility. This can include:
● Irregular ovulation:
Ovulation is the release of a mature egg from the ovary. Polycystic ovary syndrome (PCOS), thyroid issues, or hormonal issues may cause irregular ovulation. Women with irregular or absent periods may require a medical examination.
● Fallopian tube abnormalities:
The fallopian tubes are where fertilization usually takes place. Scarring or blockage can occur due to previous pelvic infections, endometriosis, or certain procedures. This may cause issues with the movement of the egg.
● Male reproductive issues:
Sperm issues can be investigated. This can include low sperm count, poor sperm motility, and changes to sperm shape. Certain hormonal issues and anatomical issues may also need investigating.
● Uterine abnormalities:
Some women will have changes in their uterus. This can include fibroids, endometrial polyps, adhesions, and certain congenital issues. These can be significant depending on their size, position, and effect.
● Age:
Generally, female reproductive health can change with age. As women age, the number and quality of their eggs can decrease. Age will be taken into consideration along with ovarian reserve, medical history, and reproductive findings.
● Unexplained infertility:
Some couples may not find a specific cause for their infertility. However, they may not have had investigations to look at their reproductive health on a molecular or cellular level. Depending on their age, length of infertility, and previous treatment options, further treatment may be required.
What investigations are available?
Depending on your symptoms, medical history, and initial investigations, different tests may be recommended. Both partners may require a medical examination.
● Medical and reproductive history:
Your doctor may ask questions about your menstrual cycle, previous pregnancies, how long you have been trying to conceive, previous operations, and any medical issues.
They may also ask about current medications, previous fertility treatments, and lifestyle factors.
● Hormonal blood tests:
Some blood tests may be recommended to look at your hormonal levels. Depending on what condition you are suspected to have, this can include:
● Thyroid-stimulating hormone (TSH)
● Prolactin
● Follicle-stimulating hormone (FSH)
● Luteinizing hormone (LH)
● Anti-mullerian hormone (AMH)
Depending on your clinical findings, certain tests will be requested. For example, the AMH will give information about your ovarian reserve but cannot be used alone to predict if you will conceive naturally.
● Pelvic ultrasound:
A pelvic ultrasound uses sound waves to look at your uterus, ovaries, and surrounding anatomy. This can help identify any fibroids, ovarian cysts, endometrial changes, and certain anatomical issues.
This can also help assess your antral follicle count if your ovarian reserve needs investigation.
● HSG:
HSG is an imaging investigation. This can help look at your uterine cavity and identify if your fallopian tubes are patent. Contrast is inserted into your cervix, and then an X-ray is performed. This can help identify any blockages in your tubes or issues within your uterine cavity.
● Semen analysis:
Semen analysis is an important investigation for male infertility. This looks at your sperm count, motility, and morphology. If there are any abnormalities found, further investigations or repeat tests may be considered.
What treatment options are available?
Based on the medical issues found, different treatment options may be considered. Some cases may require medication, while others may be considered for assisted reproduction. Different treatment options are available for different infertility-related issues.
● Ovulation induction: Medication can be used to stimulate the development and release of an egg from your ovary. This can be considered if you are not ovulating regularly.
Based onyour diagnosis, medication such as Atroxol or clomiphene citrate may be prescribed. In some cases, injectable gonadotropins may be considered. You may have ultrasound scans while undergoing treatment to monitor your follicles. Your medication will depend on your individual medical findings.
● Intrauterine insemination (IUI): Intrauterine insemination is a fertility treatment where prepared sperm is placed into the uterus. The sperm is prepared in the lab and then placed into the uterus using a fine catheter.
This generally involves:
● Collection of a semen sample
● Preparation of the semen in the lab to select the correct sperm
● Timing of ovulation
● Placement of the prepared sperm into the uterine cavity
IUI may be considered in certain cases of unexplained infertility, mild male factor infertility, or certain sexual intercourse issues. The status of your tubes, ovulation, and semen will be considered.
Final thoughts
Difficulty conceiving may be related to several reproductive health conditions, and the contributing factors are not always the same for every couple. Irregular ovulation, reduced sperm quality, blocked fallopian tubes, and certain uterine conditions may affect the chances of pregnancy.
There are also situations where standard fertility investigations do not identify a specific cause. A fertility consultation generally begins with an examination of the reproductive health of both partners, revewingtheir medical history and identifying any concerns that may require further investigation.
An infertility specialist in Siliguri can discuss the relevant diagnostic procedures and treatment options based on the couple’s age, previous medical history, and clinical findings.
FAQs:
How long does infertility treatment take?
This will depend on your treatment, medical findings, and how you respond. Some treatments may require you to have treatments over several menstrual cycles. IVF involves several stages of investigations.
Can PCOS cause issues conceiving?
PCOS can cause issues with regular ovulation. Depending on your clinical findings, you may require medication to stimulate ovulation or other fertility treatments.
Do both partners require fertility treatment?
Generally, both partners will be investigated, as infertility can be related to either or both partners. The investigations will depend on your medical history and clinical findings.
Does age affect fertility treatments?
Yes. Female age is an important factor. As female age increases, the number and quality of their eggs can decrease. Ovarian reserve, reproductive history, and underlying cause can affect treatment.
Is IVF always required for unexplained infertility?
No. Depending on your age, reproductive history, and previous attempts to conceive, expectant management or IUL may be discussed. This will depend on your individual medical findings.
