Infertility Therapies Health Article

Definition

Infertility is the inability of a man and a woman to conceive a child through sexual intercourse. There are many possible reasons for the problem, which can involve the man, the woman, or both partners. Various treatments are available that enable a woman to become pregnant; the correct one will depend on the specific cause of the infertility.

Purpose

Infertility treatment is aimed at enabling a woman to have a baby by treating the man, the woman, or both partners. During normal conception of a child, the man's sperm will travel to the woman's fallopian tubes, where, if conditions are right, it will encounter an egg that has been released from the ovary. The sperm will fertilize the egg, which will enter the uterus where it implants and begins to divide, forming what's called an embryo. The embryo will develop during pregnancy into a baby.

Infertility treatment attempts to correct or compensate for any abnormalities in this process that prevent the fertilization of an egg or development of an embryo.

Precautions

It's important for a couple contemplating infertility treatment to examine their own ideas and feelings about the process and consider ethical objections before the woman becomes pregnant from such treatment.

Description

About 90% of women who are trying to get pregnant and use no birth control will do so within one year. If after one year of having frequent sexual intercourse with no contraception a couple has not conceived, they should seek the advice of a physician. Tests can be performed to look for possible infertility problems.

Treating an underlying infection or illness is the first step in infertility treatment. The physician may also suggest improving general health, dietary changes, reducing stress, and counseling.

Low sperm count treatments

The most common cause of male infertility is failure to produce enough healthy sperm. For fertilization to happen, the number of sperm cells in the man's semen (the fluid ejected during sexual intercourse) must be sufficient, and the sperm cells must have the right shape, appearance, and activity (motility).

Defects in the sperm can be caused by an infection resulting from a sexually transmitted disease, a blockage caused by a varicose vein in the scrotum (varicocele), an endocrine imbalance, or problems with other male reproductive organs (such as the testicles, prostate gland, or seminal vesicles).

If a low sperm count is the problem, it's possible to restore fertility by:

• treating underlying infections
• timing sex to coincide with the time the woman is ovulating, which means that the egg is released from the ovary and is beginning to travel down the fallopian tube (the site of fertilization)
• having sex less often to build up the number of sperm in the semen
• treating any endocrine imbalance with drugs
• having a surgical procedure to remove a varicocele (varicocelectomy)

Fertility drugs

If infertility is due to a woman's failure to release eggs from the ovary (ovulate), fertility drugs can help bring hormone levels into balance, stimulating the ovaries and triggering egg production.

Surgical repair

In some women, infertility is due to blocked fallopian tubes. The egg is released from the ovary, but the sperm is prevented from reaching it because of a physical obstruction in the fallopian tube. If this is the case, surgery may help repair the damage. Microsurgery can sometimes repair the damage to scarred fallopian tubes if it is not too severe. Not all tube damage can be repaired, however, and most tubal problems are more successfully treated with in vitro fertilization.

Fibroid tumors in the uterus also may cause infertility, and they can be surgically treated. Endometriosis,a condition in which parts of the lining of the uterus become imbedded in other internal organs (such as the ovaries or fallopian tubes) may contribute to infertility. It may be necessary to surgically remove the endometrial tissue to improve fertility.

Artificial insemination

Artificial insemination may be tried if sperm count is low, the man is impotent, or the woman's vagina creates a hostile environment for the sperm. The procedure is not always successful. In this procedure, the semen is collected and placed into the woman's cervix with a small syringe at the time of ovulation. From the cervix, it can travel to the fallopian tube where fertilization takes place. If the partner's sperm count is low, it can be mixed with donor sperm before being transferred into the uterus.

If there is no sperm in the male partner's semen, then artificial insemination can be performed using a donor's sperm obtained from a sperm bank.