From Frustration to Hope: Understanding Infertility

Clary and Jace had always dreamed of starting a family. One year went by without being able to conceive, and the excitement started giving way to frustration with each passing month showing a pregnancy test negative. Like any other couple, they just assumed it would take time, but deep inside, they started worrying if something was wrong. Without making any phone call, they finally booked an online appointment with a doctor through Cellmaflex. After consulting their doctor, they found out that both suffer from fertility problems. The news was saddening, but it marked the beginning of their journey to understanding, treatment, and finally, hope.

For millions of couples across the globe, the quest to have children has become an issue. However, it does not necessarily have to end in despair and helplessness. Read the blog to know about the infertility, age of occurrence, types, causes of infertility and treatments available.

What are the Infertility Issues?

Infertility issues, in general, are the failure to conceive, following one year of uninterrupted, unprotected intercourse. These problems can occur among both men and women. Causes could be hormonal imbalances, physical irregularities, lifestyle factors, or even health problems. Infertility in most cases of women is caused by a problem with ovulation, blocked fallopian tubes, uterine abnormalities, whereas in men, poor quality sperm or low count of sperm is considered an impediment to fertility.

If you are younger than 35, your healthcare provider may diagnose infertility after one year (12 months) of trying to conceive. Trying to conceive is defined as having regular, unprotected sex. If you are 35 or older, your provider may diagnose infertility after six months of regular, unprotected sex.

According to WHO, in 2023, around 17.5% of the adult population – roughly 1 in 6 worldwide – experience infertility.

What Are the Types of Infertility?

Types of infertility include:

Primary infertility: You have never been pregnant and cannot conceive after one year (or six months if you are 35 or older) of regular, unprotected sexual intercourse.

Secondary infertility: You cannot get pregnant again after having at least one successful pregnancy.

Unexplained infertility: Fertility testing has not found a reason why a person or couple is unable to get pregnant.

Infertility Causes for Women

Ovulation disorders are the leading cause of infertility in people with ovaries. Ovulation is the process when an ovary releases an egg for fertilization. Ovulation disorders can contribute to female infertility and are caused by a variety of factors.

The following factors can contribute to female infertility:

• Endometriosis
• PCOS
• Infrequent or absent menstrual periods
• Primary ovarian insufficiency or poor egg quality
• Genetic or chromosomal disorders
• Sexual dysfunction
• Uterine fibroids or uterine polyps
• Thyroid disease
• Structural abnormalities of the vagina, uterus or fallopian tubes
• Autoimmune conditions like lupus
• Hypothalamic and pituitary gland disorders
• Surgical or congenital absence of ovaries

Infertility Causes for Men

The leading cause of male infertility includes any issues with the shape, movement (motility), or number of sperm (low sperm count). Other causes of male infertility are:

• Low testosterone
• Enlarged veins (varicocele) in the scrotum – the sac that contains testicles
• Sexual dysfunction, such as erectile dysfunction, anejaculation i.e. no ejaculation, premature ejaculation or retrograde ejaculation i.e. ejaculation may go into the bladder instead
• Genetic disorders, such as cystic fibrosis
• Chromosomal disorders such as Klinefelter syndrome
• High heat exposure to the testicles from tight clothing, frequent use of hot tubs and saunas, and holding laptops or heating pads on or near the testes
• Injury to the scrotum or testicles
• Misuse of anabolic steroids
• Undescended testicles
• Previous chemotherapy or radiation therapy
• Surgical or congenital absence of testes
• Prior surgical sterilisation (vasectomy)

How is Female Infertility Diagnosed?

As the initial step, the healthcare provider will gather the full medical and sexual history. Fertility for people with a uterus involves ovulating healthy eggs. In order for this to happen, the brain needs to send out signals through hormones to the ovary so that it releases an egg(s) to go through the fallopian tube on its way to the uterine lining. Fertility testing will consist of looking for an issue with any of these steps.

These tests may be carried out by the healthcare provider to help diagnose or rule out problems:

Pelvic exam: The healthcare provider performs a pelvic exam and will assess for any structural issues or signs of diseases. 

Blood test: A blood test interrogates hormone levels to see if hormones are imbalanced or if you are ovulating. Various types of blood tests are carried out for different interrogations for determining any other conditions.

Transvaginal ultrasound: The healthcare provider puts a ultrasound wand into the vagina to assess for problems in the reproductive system.

Hysteroscopy: The healthcare provider puts a small tubular instrument (hysteroscope) into the vagina and assesses the uterus.

Saline sonohysterogram (SIS): The healthcare provider will inject the sterile solution of salt water into the uterus and use the transvaginal ultrasound technology to see the uterine lining.

Sono hysterosalpingogram (HSG): The healthcare provider will inject saline solution and air bubbles into the fallopian tubes during the SIS process to identify tubal blockage.

X-ray hysterosalpingogram (HSG): This diagnostic tool utilises X-rays to visualise an injectable dye that travels through the fallopian tubes. This diagnostic tool is utilised to identify tubal blockage.

Laparoscopy: The healthcare provider will insert a laparoscope (thin tube with camera) through a small incision in the abdomen to identify problems such as endometriosis, uterine fibroids, and scar tissue.

How is Male Infertility Diagnosed?

Diagnosing male infertility usually involves ruling out or diagnosing whether or not a person is ejecting healthy sperm. Most fertility testing is focused on the sperm. Therefore, the following tests may be carried out by the healthcare provider to determine or rule out issues.

Semen Analysis: Tests for low sperm count and poor mobility. In some cases, a needle biopsy of the testicle would be needed to collect sperm for testing.

Blood Test: A blood test can be done that will test levels of thyroid and other hormones. Genetic blood testing can also be done to check for chromosomal abnormalities.

Scrotal Ultrasound: An ultrasound of the scrotum can assess for varicoceles or any other testicular pathology.

How is Infertility Treated?

Lifestyle Adjustments: Changes in lifestyle that promote weight management, stress reduction, smoking cessation, moderation of alcohol intake and nutritional improvements promote fertility for men and women.

Medication: As advised by the healthcare professional, in women, specific medications, may be prescribed to induce and facilitate ovulation. Men may undergo hormone therapy to stimulate sperm production.

Assisted Reproductive Technology (ART):

Intrauterine insemination (IUI): Fertility treatment that introduces a sperm sample directly into the uterus with the intention of improving fertility.
In Vitro Fertilization (IVF): One of the most utilised treatments for infertility. IVF is the process of removing eggs, fertilizing them in a lab and transferring fertilised eggs into the uterus.

Intracytoplasmic sperm injection (ICSI): A process used with IVF where a single sperm is injected into an egg to facilitate fertilisation.

Surgical Treatment: Infertility may be managed surgically. Women may go through surgical procedures to address tubal obstructions. Men may need to be treated surgically for the repair of varicoceles. The healthcare professional will decide the treatments.

Counselling and support: Counselling or support groups for couples will help mitigate the emotional stress of the infertility journey.

How Cellmaflex Helps Patients

Cellmaflex is an all-in-one digital healthcare hub for patients. Patients can sign up on Cellmaflex for free. Through Cellmaflex, they can search the directory to find the right specialist in a few clicks. Patients can easily view the doctors’ calendars and check their availability. With Cellmaflex, patients can directly book doctor appointments online without any phone calls. Patients can book online appointments with desired doctors with ease and receive appointment reminders.   

Patients can receive their test results directly, access the test results and health records anytime, anywhere. Patients can order prescriptions by finding pharmacies on Cellmaflex.   

Infertility is an intimate and challenging experience, but there are many ways for parenthoods. With early diagnosis, appropriate treatment, and the right support, couples can vastly improve their chances of achieving pregnancy and start their family journey. Register on Cellmaflex for free and take charge of your health.

Disclaimer: Please note that the information is strictly for informative purposes. It is not intended to be used in lieu of professional medical advice, inclusive of diagnosis or treatment. It is strongly advised that you seek a doctor’s medical advice on any treatment or medical condition that you learn about.