In my practice, one in ten couples suffers from infertility. Delaying marriage, and not getting pregnancy early enough may contribute to this medical problem. The main causes are:
- Sperm disorders
- Ovulatory dysfunction
- Tubal dysfunction
- Abnormal cervical dysfunction
- Unidentified factors
We must examine the man and the woman — the earlier the better.
Emotional factors involved in infertility are:
- Feeling of inadequacy
The investigation and treatment is expensive. Counseling and psychological support are important. The treatment doesn’t always work. Further counseling might be necessary. If the couple wants, they can adopt.
Men must avoid high fever and excessive heat. High temperature destroys sperms. He might also be born without the ability to produce sperm. He might have an obstruction in the genital system. Abnormal dilation of certain veins in the testes raises the temperature, and results in no sperm. Men who have neurological dysfunction or prostatectomy would have retrograde ejaculation. He backfires. Semen does not come out.
We screen men and women with infertility for hormonal disorders.
We look for a history of mumps, infection of the testes, testicular injuries, toxin exposure from factories, and chronic medication use. A sperm count is a good evaluation from the man. Then, there is the immuno-bead test done in specialized clinics. Sometimes a testicular biopsy is necessary.
We treat varicocele (vein dilation) surgically. Clomifene increases sperm count. Artificial insemination might sometimes help the infertility.
We try to establish the cause of irregular periods or no periods before treatment. A woman may monitor her ovulation with the basal body temperature. The procedure is inaccurate. Pelvic ultrasound, serum progesterone (hormonal), and biopsy are more accurate. Bromocryptine is the drug of choice. Women with Polycystic Ovary Syndrome respond well to clomifene and progesterone. Your doctor works out the plan for you.
Salpingitis, or Pelvic Inflamatory Disease, in a woman may block the fallopian tubes. An operation called hysterosalpingogram establishes patency. A gynecologist does this. For abnormal cervical mucus, a postcoital test is necessary. In unexplained infertility, a trial of clomifene for several months may help.
Assisted reproductive techniques are now common: In vitro fertilization, gamite intrafallopian tube transfer (GIFT), and intracytoplasmic sperm injection.
Weather the infertility is primary (No babies), or secondary (one or more children), you will have to discuss the problem of infertility with your doctor. He is your best guide. We cure infertility. I’ve seen marriages wrecked because of male or female infertility. Take advantage of the opportunities, and enjoy the peace of mind and happiness you so deserve.