I have seen many cases in my career as an IVF Expert
where over 10% of reproductive-age
What to do if
unsuccessful?
The first step is to identify the possible causes
contributing to a couple’s inability to conceive. Both partners should undergo
a physical exam depending on the risks identified; further testing is done to
specifically identify the limiting conditions. This may include testing to
examine the male’s sperm (amount, motility, etc.), evaluation of the female’s
anatomy (for example a hysterosalpingogram, ultrasound, and/or other tests) and
evaluation of the women’s ability to ovulate (possibly including hormonal
testing and/or other tests). In fact out of 100%
nearly 30% of all infertility cases,
the cause is attributed to a problem in the male, 30% of cases, the cause is
attributed in female and 30% to both male and female factors and rest 10% is
unknown.
The main cause of
infertility could be:
Abnormalities in sperm of males which includes low sperm
production or immobile sperm.
tubal issues in the woman account for another third,
ovulation issues for about 15 percent, and
other issues or no explanation identified in the rest.
What treatment to
go for when the cause is identified?
Once a cause is identified, a specific care plan can be
developed. This may include treatment for the male partner (or even
consideration of using sperm donation), medical treatment of the woman to help
increase ovulation (including weight change – loss or gain if that is a
contributing factor, as well as medications to stimulate ovulation), surgery to
address anatomical issues, use of intra-uterine insemination (where sperm is
injected into the woman’s uterus), and possibly use of assisted reproductive
technology (ART, which is taking eggs from the women, typically by a minimally
invasive surgical procedure, and combining them with sperm in the laboratory).
In India nowadays the most common approach to ART is in
vitro fertilization or IVF, where a sperm is directly injected into the egg
with subsequent transfer of the embryo (after the fertilized egg has been
incubated in a special culture medium for several days to increase the chance
that is will be viable). The first IVF was done in 1976, and since then it has
led to over 5 million successful pregnancies worldwide.
Couples having difficulty conceiving should see a
fertility specialist so they can have the workup appropriate for them and then
discuss their best options.
