Primary Infertility – Causes & Treatment
If you or your partner have been trying to conceive for over a year without success, then one of you might be suffering from infertility. Due to our fast-paced, stressful life, many couples suffer from infertility or experience difficulty in conceiving a baby. Read on to know more about primary infertility.
What is Primary Infertility?
When a couple is unable to conceive in spite of having unprotected sex for 12 months or more then it is termed as primary infertility.
Primary Infertility and Conception
Primary infertility happens when a couple has never conceived earlier and has been unsuccessful in making a baby. If a couple has conceived in the past but are currently unable to conceive again, then it is termed as secondary infertility.
Causes of Primary Infertility
Causes of infertility in a couple can be broadly classified as:
1. In Men
Causes of primary infertility in men can be due to the following reasons
- Low sperm count.
- Sperm mobility issues.
- Abnormal functioning of the sperm.
- Excessive alcohol consumption.
- Chain smoking.
- Infection in the testicles.
2. In Women
Causes of primary infertility in female can be due to the following reasons
- Lack of ovulation or difficulty in ovulation
- Hormonal imbalance
- Cysts in the ovaries or PCOS
- Excessive alcohol consumption
- Unable to produce a mature egg
- When a mature egg fails to get attached to the lining of the uterus.
Primary Infertility Treatment
Primary infertility treatment differs on a case to case basis. Many factors affect the line of treatment used for primary infertility like the age of both the partners, primary infertility tests, the exact cause of infertility, and how long the couple has been trying to conceive. The primary infertility treatments include:
1. Assisted Reproductive Technology (ART)
ART can be considered as an option when a woman is unable to get pregnant naturally and with the help of fertility drugs. ART helps in artificial implantation in women through the following methods:
- In Vitro Fertilization (IVF): IVF is a procedure wherein a woman’s egg is externally fertilized with a man’s sperms, and then the embryo is transferred to the woman’s womb within 3-5 days of fertilization.
- Vibratory stimulation or electric ejaculation: Vibratory stimulation is a painless and non-sedative procedure adapted to collect the sperms of men with spinal cord injuries who cannot experience natural ejaculation. Electric ejaculation is used for men who do not respond to vibratory stimulation process. The collected sperm is then transferred to the woman’s uterus for fertilization.
- Assisted hatching: Assisted hatching is the latest technology adopted by fertility specialists for couples who have failed the IVF cycles once or twice, and with poor embryo quality. This procedure provides advanced assistance to the embryo to attach itself to the outer lining of the uterus by piercing the outer layer of the embryo.
- Intracytoplasmic sperm injection (ICSI): This procedure involves direct injection of a single sperm of the male partner into the eggs of the female for fertilization. Just like IVF procedure, in ICSI, the sperm and egg are collected from both the partners. The only difference is the fertilization process as in IVF the sperms and egg are mixed naturally, and in ICSI the sperms are injected into the egg using a needle.
The success rate of ART procedure depends on factors like age, and overall medical health of both the partners. Women under the age of 35 have high chances of success rate through ART as compared to those above 35 years of age.
2. Fertility Drugs
Fertility drugs help women with ovulation disorders to by stimulating the ovaries to produce a good quality egg. The following drugs are most commonly used to treat infertility:
- Clomiphene Citrate: Commonly known as Clomid this drug is used to induce ovulation in women who do not ovulate due to a medical condition like PCOS.
- Metformin Hydrochloride: This tablet is generally accompanied with Clomid to induce ovulation in women with PCOS and insulin resistance.
- Follistim: This medication is used to stimulate the ovaries to produce more follicles which thereby results in more production of eggs. It is also available under the brand names of Gonal, Bravelle, Puregon, etc.
Side Effects of Primary Infertility Treatments
The major side effects caused by primary infertility treatments include:
1. Stress and Mental Fatigue
Infertility treatments can be really taxing on our mental health and causes a lot of stress, mood swings, headaches, restlessness and depression. This might be caused due to the hormonal imbalance or the medication involved.
2. Multiple Births
Every infertility treatment carries a risk of multiple births, i.e. twins or in rare cases triplets.
3. Birth Defects
Infertility treatments can cause premature delivery accompanied by major birth defects in the babies like cerebral palsy, nervous disorder or heart or gastrointestinal defects.
4. Ovarian Hyper Stimulation Syndrome
Infertility treatments like IVF can cause OHSS in women which results in enlarged ovaries. OHSS causes bloating, pelvic discomfort, dehydration, difficulty in urinating, etc. depending upon its severity.
5. Low Birth Weight
Many times the treatment results in premature births and very low birth weight of the baby.
Why is it Important to Talk Openly with Your Doctor?
Each case of infertility is different from the other. Hence it is extremely crucial, to be honest with your doctor about all your symptoms and problems. The doctor needs to know all the details regarding your reproductive health including any previous miscarriages, or abortions if any. This helps in diagnosis and formulating a correct treatment for infertility.
As a couple, you need to be patient and supportive of each other. Stress and depression will only worsen the matter. Meditation, yoga and breathing exercises are considered to be highly effective when fighting against infertility as well as a great measure to combat stress.
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