Infertility Treatment

Couples experiencing infertility suffer with disappointment and frustration.

Drugs or surgery are common treatments, and happily, two-thirds of couples treated for infertility go on to have children.

Orange Coast Urology provides extensive treatment for infertility and related conditions.
Infertility describes the biological inability of a person to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term. There are many biological causes of infertility, some which may be bypassed with medical intervention.

Women who are fertile experience a natural period of fertility before and during ovulation, and they are naturally infertile during the rest of the menstrual cycle. Fertility awareness methods are used to discern when these changes occur by tracking changes in cervical mucus or basal body temperature.

There are similar terms, e.g. subfertility for a more benign condition and fecundity for the natural improbability to conceive. Infertility in a couple can be due to either the woman or the man, not necessarily both.

INFERTILITY
Reproductive endocrinologists, the doctors specializing in infertility, consider a couple to be infertile if:

  • The couple has not conceived after 12 months of contraceptive-free intercourse if the female is under the age of 34
  • The couple has not conceived after 6 months of contraceptive-free intercourse if the female is over the age of 35 (declining egg quality of females over the age of 35 account for the age-based discrepancy as when to seek medical intervention)
  • The female is incapable of carrying a pregnancy to term.

SUBFERTILITY
A couple that has tried unsuccessfully to have a child for a year or more is said to be subfertile meaning less fertile than a typical couple. The couple's fecundability rate is approximately 3-5%. Many of its causes are the same as those of infertility. Such causes could be endometriosis, or polycystic ovarian syndrome.

PRIMARY VS. SECONDARY INFERTILITY
Couples with primary infertility have never been able to conceive, while, on the other hand, secondary infertility is difficulty conceiving after already having conceived (and either carried the pregnancy to term, or had a miscarriage). Technically, secondary infertility is not present if there has been a change of partners.

PREVALENCE

  • Generally, worldwide it is estimated that one in seven couples have problems conceiving, with the incidence similar in most countries independent of the level of the country's development.
  • Fertility problems affect one in seven couples in the UK. Most couples (about 84 out of every 100) who have regular sexual intercourse (that is, every 2 to 3 days) and who do not use contraception will get pregnant within a year. About 92 out of 100 couples who are trying to get pregnant do so within 2 years.
  • Women become less fertile as they get older. For women aged 35, about 94 out of every 100 who have regular unprotected sexual intercourse will get pregnant after 3 years of trying. For women aged 38, however, only 77 out of every 100 will do so. The effect of age upon men's fertility is less clear.

CAUSES
This section deals with unintentional causes of sterility. For more information about surgical techniques for preventing procreation, see sterilization. Common causes of infertility include:

  • Ovulation problems
  • Tubal blockage
  • Male associated infertility
  • Age-related factors
  • Uterine problems
  • Previous tubal ligation
  • Previous vasectomy
  • Unexplained infertility

ASSESSMENT
If both partners are young and healthy, and have been trying for a baby for 12 months to two years without success, a visit to the family doctor could help to highlight potential medical problems earlier rather than later. He or she may also be able to suggest lifestyle changes you can make to increase your chances of conceiving. Women over the age of 35 should see their family doctor after six months as fertility tests can take some time to complete, and your age may affect the treatment options that are open in that case.

Our doctors will take a medical history and give you a physical examination. They can run basic tests on both partners to see if there is an identifiable reason for not having achieved a pregnancy yet.

TREATMENT

Treatment methods for infertility may be grouped as medical or complementary and alternative treatments. Some methods may be used in concert with other methods. Medical treatment of infertility generally involves the use of medication, medical device, surgery, or a combination of the following. If the sperm are of good quality, and the mechanics of the woman's reproductive structures are good (patent fallopian tubes, no adhesions or scarring) physicians may start by prescribing a course of ovarian stimulating medication.

Treatments recommended by our doctors include the use of a conception cap cervical cap which the patient uses at home by placing the sperm inside the cap and putting the conception device on the cervix, intrauterine insemination (IUI), in which the doctor introduces sperm into the uterus during ovulation, via a catheter. If this does not work, our doctors often recommend the patient undergo in vitro fertilization (IVF). IVF and related techniques (ICSI, ZIFT, GIFT) are called assisted reproductive technology (ART) techniques.

Additional treatments combine a hormone-antioxidant combination to improve sperm count and motility in infertile men.

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