The process of becoming pregnant requires every stage to work perfectly right from ovulation to fertilization. In case any of these steps are incomplete or have issues, then the problem of infertility arises.

According to experts, approximately one in six couples has difficulty achieving pregnancy. There are numerous factors that can cause infertility. However, we can broadly categorize infertility as being caused due to either male or female factors.

  • Female factors in 30% of cases
  • Male factors in 30% of cases
  • Combined male and female factors in 20% of cases
  • Unexplained infertility in 20% of cases

Under normal circumstances the chances of pregnancy occurring as a result of unprotected intercourse during the fertile time of the cycle are about 10-12% per month only in young couples. After 12 months of trying, approximately 77% of couples will have conceived.

For women between 35 and 38 approximately 66% would have conceived within the first year and pregnancy rate per month would be approximately 8-9%.

For women over 38 the chances of pregnancy occurring as a result of unprotected intercourse during the fertile time of the cycle are about 5-7%After 12 months of trying, approximately 45% of women over 38 will have conceived.

 

IVF Process

  • Causes of Infertility

    Infertility in females is caused due a number of causes. A few of the major reasons of infertility in a woman can be summarized as follows:

    • Ovulatory problems including polycystic ovaries – problems with ovulation can be caused due to hormonal disorders like polycystic ovary syndrome which causes production of the male hormones which can impair ovulation.
    • Tubal blockage- a major cause of infertility, obstruction to the fallopian tubes makes it impossible to allow the ovum to engage with the sperm.
    • Endometriosis-it is a disorder which is painful in nature and happens when the tissue called the endometrium grows outside the uterus. This condition can block the fallopian tubes and form scar tissues making it harder for a woman to get pregnant.
    • Uterine fibroids
    • Poor egg quality due to age and hormones.
  • Polycystic ovaries

    It has been shown that the hormonal imbalances caused by stress, weight and polycystic ovarian (PCO) disease can be the most common causes of female infertility.

    Many women with PCO have normal regular cycles and don't have problems conceiving. However, some women may have polycystic ovarian syndrome (PCOS), which may lead to a hormone imbalance with irregular or absent periods. They may have difficulty conceiving because they are not ovulating regularly.

    PCOS can be treated with drugs to correct the hormone imbalance and to stimulate ovulation.

  • Tubal blockage

    Fallopian tubes release the mature eggs into the uterus and if the tubes are not functioning normally then there will be infertility issues.

    A condition such as hydrosalpinx can damage the tubes leading to infertility

  • Endometriosis

    Endometriosis arises when the tissue which normally lines the uterus is found at other sites in the pelvis. At the time of menstruation, bleeding occurs from this tissue which may give rise to abdominal pain and painful intercourse. Blood-filled cysts may also develop within the ovaries. And it is observed that due to endometriosis the fallopian tubes ability to function properly is also hampered hence inhibiting fertility. IVF is an appropriate treatment for infertility associated with endometriosis where the other methods have failed.

    They are non - cancerous growths occurring in the uterine cavity. They can be of varying size and are generally asymptomatic. Big growth in the uterus can cause blockage of the fallopian tubes ostia or uterine cavity leading to infertility.

  • Fibroids

    They are non-cancerous growths occurring in the uterine cavity. They can be of varying size and are generally asymptomatic. Big growths in the uterus can cause blockage of the fallopian tubes leading to infertility.

  • Age related change in ovarian reserve and egg quality

    From birth the number of eggs remaining in the ovaries declines steadily until a woman's late 30's and early 40's when the loss accelerates. When the reserve of eggs is depleted a woman goes through menopause.

    In addition to reduced ovarian reserve, the quality of eggs also deteriorates with age. Eggs become more susceptible to being genetically abnormal and when those eggs fertilize the resulting embryo might be abnormal resulting in implantation failure and miscarriages.

    Therefore, advancing age is a major factor which adversely affects the chances of a woman getting pregnant.

  • Male infertility problems

    In most cases of male infertility the cause is unknown; however the male problems can be due to either physical abnormalities of the male reproductive tract or abnormalities of the sperm themselves such as abnormal sperm parameters and antisperm antibodies.

    Sperm count is a major factor in determining male factor infertility. If there is not enough sperm in the sample then it decreases the chances of pregnancy. The percentage of "motile" sperm in the sample also helps to identify the number of sperms moving towards the egg. Increase in non-motile sperms results in infertility as it is difficult to reach and penetrate the egg.

    Certain drugs, radiation and radiotherapy may have a detrimental effect on the sperm production. Moreover, the presence of a varicocele may lead to a rise in the temperature around the testicles, which may adversely affect sperm production and motility.

  • Azoospermia

    Azoospermia is a medical condition in which there is absence of sperm in a man's semen. This condition prevents a man from getting a woman pregnant. There are a number of reasons why this condition would happen.A few of them have been detailed as follows:

    • An obstruction at the level of the vas deferens (A duct through which semen is carried from the epididymis of each testicle to an ejaculatory duct. ), epididymis, or even at the level of the testes.
    • Testicular failure which may have resulted from a chromosomal disorder or a previous infection such as mumps.
    • A history of undescended testes.

    In case of azoospermia, a testicular biopsy along with a number of tests may be recommended to determine whether any sperm are being produced by the testes.

  • Anti-sperm antibodies

    Anti-sperm are antibodies that are formed as a response to antigens which are present in the male's own body. Anti-sperm antibodies in the semen bind to the sperm, reducing their motility and their ability to penetrate and fertilize an egg. Antibodies may arise following reversal of a vasectomy or other surgery on the male genitals and may also be related to previous infections or injury.

  • Unexplained infertility

    Unexplained infertility affects 20-25% of infertile couples. In the majority of these cases, the reason of infertility cannot be assessed using conventional tests. For example, it is not currently possible to determine if the eggs are actually released at the time of supposed ovulation, picked up by the fallopian tubes or if the sperm are capable of reaching the site of fertilization.

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