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Let's Talk about Infertility

Author:Dr.Irena Mehandjiska Shumanska

Infertility is defined as an inability to conceive despite frequent and unprotected intercourse for at least a year. This is a disease of the male and female reproductive system, and the reasons for it can be different. For many couples with this problem, being open about it is crucial for understanding its nature and finding a possible solution.


Understanding the process of conception

Before I start with the causes and the reasons for infertility, let’s first explain the process of conception. Understanding how pregnancy occurs can help couples control the whole process and accept it more easily. Conception includes three steps. The first one is ovulation, when the mature egg is released from the ovary for possible fertilization. It happens about 14 days before the next period in the fallopian tube, and usually, it lasts for 12-24h. Next is fertilization, when the sperm and egg union is happening and is called conception. It happens during 12-24 hours since ovulation in the fallopian tube, and it lasts for 24 h. The last step is implantation, which is the process of attachment of a fertilized egg in the uterine wall, and it happens in 6 to 11 days from fertilization. All of these steps need to happen correctly to get pregnant.


Causes of infertility

Infertility occurs because of health issues in one of the partners or both, and there are cases when the cause cannot be identified clearly. There are many causes of infertility, such as sperm disorders (35% of couples), ovulatory dysfunction (20%), tubal dysfunction (30%), abnormal cervical mucus (5%), and unknown factors (10%). Many risk factors can trigger infertility like age, smoking tobacco and marijuana, alcohol consumption, being overweight or underweight. Specific diagnoses like endometriosis (polyps in the womb), PCOS (polycystic ovary syndrome), and epididymal blockage (blocked pathway of the sperm) are becoming common reasons nowadays for not being able to conceive.

Possible treatments

There are three main types of fertility treatments: a prescription of medicine, surgical procedures, and assisted conception like IUI (intrauterine insemination) and IVF (in vitro fertilization). The medication is usually prescribed for women who have ovulatory dysfunction that will encourage the monthly release of an egg (ovulation). Other types are prescribed for women with PCOS (polycystic ovary syndrome). Conditions like endometriosis, PCOS, can be treated with surgical procedures. The IUI (intrauterine insemination) is a procedure when sperm is inserted into the womb via a thin plastic tube passed through the cervix. IVF (in vitro fertilization) is a procedure when an egg is fertilized outside the body in a laboratory. The fertilized egg is, after that, returned to the womb to grow and develop.


When to visit a doctor

You probably don't need to see a doctor about infertility unless you have been trying regularly to get pregnant for at least one year. Couples who have a problem having a baby longer than one year should consult a doctor to help them diagnose the problem and find a proper solution.