• medical_centre
  • April 18, 2020

Infertility is defined as not being able to get pregnant despite having frequent and unprotected sex for a long period say a year. Infertility may result from an issue with either partner of the couple.

To determine whether the couple is infertile, certain tests are recommended by the fertility specialist for both the partners respectively.

Fortunately, there are many safe and effective treatment options available these days that significantly improve the chances of getting pregnant.

Male Infertility is responsible in about 40% of infertile couples. Male factors can include blocked sperm ducts, Varicocele, low or zero sperm count, abnormal shape of sperm, poor speed or motility of the sperm.

Female Infertility is responsible in 40% of infertile couples. Female issues contributing to infertility may include irregular or absent ovulation, blockages in the Fallopian tubes, or abnormalities in the reproductive organs.

While remaining 20% of infertile couples show no specific cause.


CAUSES OF INFERTILITY IN MALES may include one or more of the following factors:

  • Abnormal or difficulty in sperm production or function: due to absent or undescended testicles, genetic defects, health problems such as diabetes, or infections such as chlamydia, gonorrhoea, mumps or HIV in some cases.
  • Varicocele: Enlarged veins in the testes also can affect the production as well as quality of sperm.
  • Difficulty with the delivery of sperm: due to a few sexual problems including premature ejaculation, certain genetic diseases such as cystic fibrosis; or structural problems such as a blockage in the testicle; or injury to the reproductive organs.
  • Overexposure to certain environmental factors: Pesticides and other chemicals may affect fertility in both men and women.
  • Smoking: alcohol, marijuana, supplements to enhance muscles, high blood pressure and depression also can impact fertility in men.
  • High temperature: Frequent and overexposure to heat, such as in saunas or hot tubs can raise body temperature and may affect sperm production.
  • Cancer and its treatment: Treatment for cancer including radiation or chemotherapy can impair sperm production.

CAUSES OF INFERTILITY IN FEMALES may include one or more of the following factors:

  • Ovulation disorders: These include hormonal disorders such as polycystic ovary syndrome, Hyperthyroidism- too much thyroid hormone, Hypothyroidism-too less of thyroid hormone, Hyperprolactinemia- a condition in which woman has too much prolactin can affect the menstrual cycle or cause infertility. These disorders affect the release of eggs from the ovaries.
  • Uterine or cervical abnormalities: Fibroids in uterus may cause infertility by blocking the fallopian tubes or stopping a fertilized egg from implanting in the uterus. Other may include abnormalities with the cervix, polyps in the uterus or the shape of the uterus.
  • Blockage in Fallopian tube: Fallopian tube can be blocked due to pelvic inflammatory disease, which is usually caused by a sexually transmitted infection, endometriosis or adhesions.
  • Endometriosis: is a condition when endometrial tissue grows outside of the uterus affecting the function of the ovaries, fallopian tubes and uterus.
  • Early menopause: When a woman’s menstruation ends before age 40.
  • Cancer treatment: Certain cancer treatments including radiation and chemotherapy may affect fertility in females.


Most of the risk factors for infertility in both Male and Female are the same. These include:

  • Age: Women’s fertility gradually declines with age, especially in the mid-30s, and it drops rapidly after age 37 due to the lower number and quality of eggs. While, Men lose fertility after age 40.
  • Tobacco use: Smoking and heavy consumption of alcohol put men at more risk of erectile dysfunction and a low sperm count in men. Miscarriages are more frequent in females who smoke.
  • Overweight: An inactive lifestyle and being overweight may increase the risk of infertility in both men and women.
  • Strenuous exercise: In some cases, ovulation problems may be associated with frequent strenuous, intense exercise in women.
  • Improper or imbalanced Diet: A woman’s diet that lacks folic acid, iron, zinc, and vitamin B-12 can affect fertility.
  • Stress: This may impact both female as well as male fertility.


With the advancement of science and technology, there are lot of options available to help people with all kinds of fertility issues. The best suited treatment for any couple depends on the causing factor of infertility in them.

Fertility treatments include medications to sort the issues with hormones and ovulation, minor surgical procedures in some cases.

The most common fertility treatments are as follows:

ICSI-Intracytoplasmic sperm injection

ICSI is often recommended when the semen is poor in quality or quantity, or if fertilization attempts during prior IVF cycles failed. In ICSI procedure, a single healthy sperm is injected directly into a mature egg which is left for few days in the laboratory. The embryologist observes the eggs over this duration to check if the fertilized egg would be suitable to transfer into the womb or not.

IUI-Intrauterine Insemination

In IUI, woman is recommended to take prescribed medicines to stimulate ovulation. Success rate is lower as compared with IVF, but this procedure is less expensive and less invasive, hence it may be attempted first.

IUI works by putting sperm cells directly into the uterus at the time of ovulation. This help the sperm get closer to the egg. This process makes it easier to fertilize the egg by reducing the time and distance sperm has to travel.

A woman may take fertility medicines as prescribed by her IVF specialist before having the insemination procedure. Quality sperm is extracted from semen through a process called sperm washing. Next step is putting the sperm right into the uterus. If sperm fertilizes the egg, and the fertilized egg implants in the lining of the uterus, pregnancy happens.

IVF-In Vitro Fertilization

IVF can be considered as an option when other treatments have failed, this procedure combines the egg and sperm in a laboratory. Embryos created in the laboratory are placed inside the uterus. In IVF process, eggs from the female partner are retrieved using minor surgical procedure. Success rates are high. Several cycles of treatment may be necessary.

How does IVF work?
It is one of the more widely known types of assisted reproductive technology (ART). IVF works by using a combination of medicines and surgical procedures to help sperm fertilize an egg and help the fertilized egg implant in the uterus.

Initially certain medications are recommended by the fertility specialist to woman to make several of her eggs mature and ready for fertilization. Then the IVF specialist takes the eggs out of her body and mixes them with her partner’s sperm in a laboratory, to help the sperm fertilize the eggs. One or more fertilized eggs (embryos) are transferred directly into the uterus. If any of the embryos implant in the lining of the uterus, pregnancy happens.

“In men with low sperm count or even zero sperm count, sperm is extracted with the help of surgical procedures including TESE, PESA, Micro TESE.”

Micro TESE- Microsurgical testicular extraction of sperm.

In this procedure, the Andrologist extracts multiple samples of sperm from a man’s semen using a microscope. Those samples are evaluated by the embryologist, who selects the quality sperm for further process of IVF. “Micro TESE is a boon for men who have nil or zero sperm count as they can have their own biological offspring with the help of this process”.

A good microscope and skills of the Andrologist to use the microscope proficiently makes the procedure successful.


Blockage or scarring of the Fallopian tubes prevents pregnancy in some women. As mentioned above in this article, this may be due to endometriosis, previous surgeries, or damage as a result of previous pelvic infections. Scar tissue in some women can be removed successfully through laparoscopic surgery, increasing their chances for pregnancy.


Donor embryos are embryos donated by couples who have completed the IVF process. Transferring donor embryos is less costly than standard IVF or IVF with donor eggs. This procedure allows the experience of pregnancy. The baby will be biologically unrelated to either parent.


A few lifestyle changes can increase the chances of a healthy pregnancy. These include:

  • Quitting smoking
  • Eating nutritious diet
  • Maintaining a healthy body weight
  • Managing stress

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