infertility

A normal fertile couple in their mid-20s having regular sex has a one in four chance of conceiving each month. This means that around nine out of ten couples trying for a baby will conceive within a year. However, one in ten will not - and these couples are either subfertile or infertile. Infertility is usually defined by fertility specialists as the inability to conceive after at least one year of trying. Many 'infertile' couples can be helped by assisted-conception treatments.

Causes Of Male Infertility

  • Low sperm count; normally, men produce at least 15 million sperms per milliliter of semen (WHO 2010 criteria); fewer is judged to be subfertile.
  • Poor sperm motility; sperms will then be unable to swim through the cervix to meet the egg in the fallopian tube.
  • Abnormal shape (known as 'morphology'), so that an individual sperm is unable to penetrate the outer layer of an egg.
  • Non-production of sperm. (because of testicular failure)
  • Complete absence of sperm (perhaps because of an obstruction that causing male infertility eg absent vas deferens)
  • Excessive heat around the scrotum due to varicoceles leading to defective sperm production.

Causes Of Female Infertility

  • Hormonal disorders; as a result, egg follicles might not grow within the ovary, or an egg might not be released (ovulation).
  • Damaged or blocked fallopian tubes, which will prevent an egg and sperm meeting.
  • Endometriosis, in which womb tissue invades and damages neighbouring reproductive tissue.
  • Excessively thick cervical mucus, which prevents sperm passing through that may also cause female infertility

Assisted conception may help most (though not all) of these conditions, and there is evidence that repeated cycles of treatment can help to achieve a pregnancy.

Assisted Conception

Assisted conception is not usually a first resort in the treatment of infertility. Other options such as advice on the timing of intercourse may have been tried first. In fact, the treatment route, which a gynaecology chooses will mainly depend on the result of investigations. For example, fertility drugs with timed intercourse will be no help to a couple whose infertility is a result of the female's blocked fallopian tubes; only surgical repair or assisted conception will help in this case.

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