By Aisling Killoran & Ray Manning on Friday, 20 May 2022
Category: Fertility

Struggling To Get Pregnant?

Infertility can affect men & women for a variety of different reasons. There are a number of options available so it's recommended that couples attend the fertility clinic together.

​Struggling To Conceive - Infertility Causes & Treatments
In approximately one-fifth of infertility cases, the cause is unknown. In another fifth, it is due to female problems. A further fifth of cases are caused by male problems, while the remaining two-fifths are due to a combination of both male and female factors. In up to 50 per cent of couples, there will be some male factor involved, so it is recommended that couples attend the fertility clinic together.

Main Causes In Women Struggling To Conceive:-

Lifestyle factors When a woman reaches 35 her fertility starts to reduce dramatically; weight – being over-or underweight can affect ovulation; smoking; recreational drugs; sexually transmitted infections (STIs) such as chlamydia and gonorrhoea – these can affect fertility in both sexes.

Ovulation Issues

The most common is Polycystic Ovarian Syndrome (PCOS), which causes women to ovulate irregularly or not ovulate at all. "They will often have very irregular periods... or have no periods at all, and it is very much dependent on weight," according to Dr Wingfield. Women with PCOS can be put on medication or fertility drugs to stimulate ovulation. If these first-line treatments don't work, the next step would be IVF.

Early Menopause

Women under the age of 40 stop having periods; it is also a cause of infertility and in this case, the only option is IVF using donor eggs. Although not very common, she said women with a family history of early menopause "should be on high alert because it sometimes runs in families."

Pelvic Problems

Includes anything that damages the fallopian tubes, ovaries and or the womb. These include endometriosis, STIs such as chlamydia or gonorrhoea, ectopic pregnancies, fibroids, ovarian cysts and repeated surgery; which can cause adhesions or scarring in the pelvic region.

Health and other general medical difficulties: For endometriosis, infection or scar tissue, surgery can be carried out to get the pelvis or fallopian tubes back to normal. If that doesn't work, the next option is IVF. Sexual dysfunction, such as vaginismus, where women cannot have sex, can also cause infertility. Women who have had chemotherapy or radiotherapy as part of cancer treatment or those with certain conditions such as Cystic Fibrosis or Rheumatoid Arthritis may also need fertility assistance.

Causes of Infertility In Men:-

Serious Testicular Injury Or Infection

Injuries and surgery such as surgical intervention for undescended testes in childhood can cause problems. Testicular infection such as chlamydia or mumps affecting the testes.

Lack Of Sperm

Some men have no sperm at all, and in these cases, a testicular biopsy where sperm is surgically removed from the testes can be performed.

Sexual Dysfunction

Issues such as erectile difficulties can also cause infertility in men. "We would see some men who have had a vasectomy, but the majority of male sperm problems are unexplained," says Dr Wingfield stated. Lifestyle issues: Smoking, steroids or testosterone injections as well as recreational drugs such as cannabis.

According to Dr Wingfield men are encouraged to improve their lifestyle and to consider taking some vitamins if their diet is suboptimal.
However, in the majority of cases where there is a significant sperm problem, IVF would be recommended - and often ICSI, which is a type of IVF.

In A Nutshell, Dr Wingfield said:
"the woman needs to be producing an egg so she needs to be ovulating. The man needs to have sperm and then the sperm and the egg need to be able to meet up, so they need to be able to have sex. When they do have sex the woman's pelvis and her fallopian tubes need to be normal because the egg and the sperm meet in the fallopian tube, fertilise there and form an embryo. Then the embryo moves down to the uterus."

Unexplained infertility In unexplained infertility Dr Wingfield said that couples may have to keep trying for a little longer to conceive naturally. If that doesn't work then the next steps would be Intrauterine Insemination (IUI) or IVF.

Source: irishtimes.com

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