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Infertility Whys & Hows

Stress Or Poor Diet?

Infertility is a problem that affects both men and women. But it is not a disease. Life changes and unhealthy lifestyles such as excessive alcohol and coffee consumption, smoking, chronic stress and anxiety can adversely impact fertility. Being overweight or excessively underweight too can affect a woman’s fertility as do certain medications. So, before you plan to have a child, here’s what you should know.

Infertility: Preliminary Investigations

Before a doctor treats a couple for infertility, he will undertaken detailed investigations. A gynecologist will examine a woman’s reproductive system via ultrasound to check the health of the follicles. He will also possibly determine various hormones in the blood, especially luteinising hormone (LH), which triggers ovulation.

If your reproductive cycle is irregular, the doctor will advise certain urine tests that help determine your fertile days with increased accuracy. The male partner will also be investigated. An andrologist or urologist will perform a semen analysis to check the seminal fluid, especially density of the sperm, their mobility and their form. At least 20 million sperm per millilitre of semen, half of which should be flexible, are required to facilitate pregnancy. The sperm will be re-examined after an interval. Since male fertility can be influenced by factors such as acute infections, another analysis may be performed a few weeks later for a clearer picture.

If the male cycle and sperm are normal, the next question is: are the woman’s fallopian tubes normal and healthy? A laparoscopy will reveal the condition of the oviduct funnel via a laproscope introduced through the abdominal wall into the peritoneal cavity. At the same time, an assistant will inject a coloured fluid into the fallopian tubes. If the liquid flows freely into the abdominal cavity, it means the fallopian tubes are open and are all right. Fibroids, cysts or unusual shapes of organs can be determined by ultrasound, and to check the uterus, the doctor will perform hysteroscopy. Urine tests or a swab of the fallopian tubes provide information about possible infections. 

Reproductive Disorders In Women

• Failure of oocyte maturation commonly due to corpus luteum insufficiency
• Lack of ovulation
• Tubal infertility due to Chlamydia infection
.• Endometriosis or growth of the uterine lining outside the uterus
• Closure of the cervix with a mucus plug, which is not liquefied by infection or hormonal imbalance during ovulation
• Fibroids or benign tumors in the uterus
• Antibodies to egg or sperm
• Hormonal disorders such as Poly-Cystic Ovarian Syndrome, overproduction of the hormone prolactin or thyroid dysfunction
• Premature menopause or loss of function of the ovaries
• More rare are congenital organic abnormalities of the ovaries, fallopian tubes or uterus
• A tendency for recurrent cysts

The hormone levels of the male can be checked via a blood test. An expert will also examine the testicles, scrotum and spermatic cord. In addition, he will examine the rectum, prostate and seminal vesicles. Possible infections can be detected by a urine test.

A postcoital Sims test is performed around ovulation and up to 12 hours after intercourse. Mucus is taken from the cervix and examined microscopically to see whether and how many moving sperm are present. This test also provides information on male infertility, an unhealthy environment in the vagina and possible allergy to semen. The cause of infertility is usually determined by this battery of tests. After this series of investigations, the cause of infertility is often unknown. In about 40 percent of the cases it is in men, also in about 40 percent in women. At 20 percent, both sides are involved, or it can find no cause.

Fertility Problems In Men

• The most common disgnosis is the OAT Syndrome, where the sperm count is too low, the perm has restricted mobility or they appear abnormal
• Closure of the vas deferens possibly by a Chlamydial infection
• Varicose veins in the scrotum
• Injuries to the testicles
• Autologous sperm antibodies
• Mumps in childhood
• Undescended testicles in childhood
• Chemotherapy
• Chromosomal abnormalities
• Blood circulation problems
• Diabetes
• Absence of the vas deferens, often in men with cystic fibrosis
• Impotence / erectile or ejaculation dysfunction


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