Understanding Infertility

Infertility is a common medical condition that affects almost one in six adults at some point in their lives.

Infertility is commonly diagnosed by a failure to achieve pregnancy after 12 months of regular, unprotected sexual intercourse. Infertility can be caused by both male and female factors, and the rate of infertility for women increases with age.

What kinds of testing are recommended for infertility?
In general, doctors recommend initiating a workup for infertility after a failure to conceive after 12 months (if under the age of 35) or 6 months (if over the age of 35). Your doctor may begin this workup even earlier if you are over the age of 40. The workup of infertility is individualized based on each patient’s history, but some common diagnostic testing includes:

• Analysis of semen for male partners.
• Bloodwork for female partners to examine hormone levels at different times in the menstrual cycle, test for ovarian reserves, and rule out other medical conditions.
• A special x-ray of the uterus and fallopian tubes to determine if there are any structural abnormalities with the tubes and uterine cavity.
• Some patients may undergo further testing with pelvic ultrasounds or laparoscopy to rule out endometriosis, fibroids, ovarian cysts or other gynecological conditions.

What are the possible treatment options for infertility?
The treatment of infertility also requires an individualized approach and will differ based on the cause of the underlying infertility. Most interventions begin with lifestyle adjustments, but more advanced reproductive technologies are available if these are not successful. Although this list does not include all possible treatment options for infertility, some common interventions include:

• Medications: When infertility is caused by ovulation problems, there are medications available that can help women ovulate more regularly. Clomid and letrozole are two common medications used to induce ovulation. For those with infertility due to PCOS and insulin resistance, metformin is another medication that may help improve
  ovulation.
• Intrauterine insemination (IUI): In this technique, the sperm is inserted directly into the uterine cavity and fallopian tubes, closer to the egg. This increases the chances of the sperm fertilizing the egg.
• In vitro fertilization (IVF): The IVF procedure begins with harvesting eggs directly from the ovary. Medications are used to increase the number of available eggs during one menstrual cycle, and they are removed from the ovary in a procedure called an egg retrieval. The eggs are then fertilized with a sperm and can either be implanted directly into the uterus, grown for 3-5 days and then implanted, or frozen and stored for implantation at another time.
• Donor sperm or egg: When viable sperm or eggs are not available, a sperm or egg from a donor may be considered.

What else should I consider when trying to conceive?
Regardless of how you are trying to conceive, lifestyle habits are very important for everyone attempting pregnancy. To improve your overall health and increase the chances of a successful pregnancy, you may consider the following:

• Cut down on excessive caffeine and alcohol consumption, and quit smoking.
• Maintain a healthy weight and engage in regular exercise.
• Take a prenatal vitamin to ensure you’re getting essential nutrients required for a healthy pregnancy.
• For optimal chances of conception, engage in sexual intercourse every 1–2 days around the expected time of ovulation. If you are unsure, you can purchase an ovulation predictor kit over the counter.

Where can I turn for help?
Your gynecologist can help begin a workup for infertility. If you are planning on pursuing any advanced reproductive technologies, your gynecologist may refer you to a reproductive endocrinologist for further management. Infertility may also cause significant emotional distress, so counseling and mental health services may also be helpful.

If you have any questions or need assistance, feel free to reach out to us anytime via your Summus Dashboard at www.summusglobal.com/dashboard.