Times of Oman
Oman wellness: Coping with infertility
August 19, 2017 | 7:11 PM
by Dr Batoul Dalati
Infertility can be treated with medicine, surgery, artificial insemination, or assisted reproductive technology.
 
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Most experts define infertility as not being able to get pregnant after at least one year of trying.

In order to get pregnant:

• A woman must release an egg from one of her ovaries (ovulation).

• The egg must go through the fallopian tube towards the uterus (womb).



• A man’s sperm must join with (fertilise) the egg in the fallopian tube.

• The fertilised egg must move along the fallopian tube and attach to the inside of the uterus (implantation).

Is infertility just a woman’s problem?

No, in about one-third of cases, infertility is due to the woman (female factors). In another third of cases, infertility is due to the man (male factors). The remaining cases are caused by a mixture of male and female factors or by unknown factors.

What causes infertility in men?

• Problems in making sperm: Producing too few sperm or none at all.

• Problems with the sperm’s ability to reach the egg and fertilise it: Abnormal sperm shape or structure prevents it from moving correctly.

Sometimes a man is born with the problems that affect his sperm. Other times problems start later in life due to illness or injury. For example cystic fibrosis.

What increases a man’s risk of infertility?

• Alcohol

• Drugs

• Environmental toxins, including pesticides and lead

• Smoking cigarettes

• Health problems

• Medicines

• Radiation treatment and chemotherapy for cancer

• Age

What causes infertility in women?

Problems with ovulation account for most cases of infertility in women. Some signs suggest that a woman is not ovulating normally include irregular or absent menstrual periods.

Other causes of fertility problems in women include:

• Blocked fallopian tubes due to pelvic inflammatory disease, endometriosis, or surgery for an ectopic pregnancy.

• Endocrinal and Hormonal problems like hyperprolactinaemia.

• Uterine fibroids and uterine anomalies.

How long should women try to get pregnant before calling their doctors?

Most healthy women under the age of 30 shouldn’t worry about infertility unless they’ve been trying to get pregnant for at least a year. Men should also talk to their doctors if this much time has passed.

In some cases, women should talk to their doctor’s earlier like:

• Women in their 30s who’ve been trying to get pregnant for six months should speak to their doctors as a woman’s chances of having a baby decreases rapidly every year after the age of 30.

• Women with irregular periods, very painful periods or no menstrual periods.

• Endometriosis.

• Pelvic inflammatory disease

• More than one miscarriage.

No matter how old you are, it’s always a good idea to talk to a doctor before you start trying to get pregnant. Doctors can help you prepare your body for a healthy baby. They can also answer questions on fertility and give tips on conceiving.

How will doctors find out if a woman and her partner have fertility problems?

By doing a complete fertility evaluation. This process usually begins with physical exams, health and conjugal histories. If there are no obvious problems, like poorly timed copulation or absence of ovulation, tests will be needed. Finding the cause of infertility is often a long, complex, and emotional process. It can take months for you and your doctor to complete all the needed exams and tests. So don’t be alarmed if the problem is not found right away. For a man, doctors usually begin by testing his semen. They look at the number, shape, and movement of the sperm. Sometimes doctors also suggest testing the level of a man’s hormones.

For a woman, the first step in testing is to find out if she is ovulating each month. There are several ways to do this like:

•Follicular study by ultrasound

•Blood tests

•Recording changes in morning body temperature (basal body temperature) for several months

•Recording the texture of cervical mucus for several months

•Using a home ovulation test kit (available at drug or grocery stores)

If the woman is ovulating normally, more tests are needed including:

•Hysterosalpingography: To check for physical problems of the uterus and fallopian tubes. They start by injecting a special dye through the vagina into the uterus. With these X-rays doctors can find blockages that may be causing infertility. Blockages can prevent the egg from moving from the fallopian tube to the uterus and can also keep the sperm from reaching the egg.

•Laparoscopy: Using the laparoscope, doctors check the ovaries, fallopian tubes, and uterus for disease and physical problems. Doctors can usually find scarring and endometriosis by laparoscopy.

How do doctors treat infertility?

Infertility can be treated with medicine, surgery, artificial insemination, or assisted reproductive technology. Many times these treatments are combined. About two-thirds of couples who are treated for infertility are able to have a baby.

The treatment will be based on:

•Test results

•How long the couple has been trying to get pregnant

•The age of both the man and woman

•The overall health of the partners

•Preference of the partners

- lifestyle@timesofoman.com

Dr Batoul Dalati MD, MRCOG is a specialist Gynaecologist at Burjeel Hospital

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