Sex may permeate our popular culture, but conversations about it are still associated with stigma and shame in Indian households. As a result, most individuals dealing with sexual health issues or trying to find information about sex often resort to unverified online sources or follow the unscientific advice of their friends.
To address the widespread misinformation about sex, News18.com is running this weekly sex column, titled ‘Let’s Talk Sex’, every Friday. We hope to initiate conversations about sex through this column and address sexual health issues with scientific insight and nuance.
The column is being written by Sexologist Prof (Dr) Saransh Jain. In today’s column, Dr Jain addresses all questions related to infertility.
Infertility is a condition during which a couple has trouble getting pregnant or staying pregnant. People of all genders can experience fertility problems, and there are several causes for this.
A person is generally diagnosed with infertility if the pregnancy doesn’t happen after one year or more of trying or if she has multiple miscarriages. However, there are treatments for different kinds of infertility, and many people go on to have a healthy pregnancy and a child following such treatments.
Fertility isn’t just a “woman’s problem” or an age issue. Lots of things can lead to infertility, and it can affect people of all sexes and ages. When a couple has a hard time getting pregnant, either person (or both people) is equally likely to cause the problem. That’s why both people are usually tested for infertility if a couple is having trouble getting pregnant.
What causes infertility?
There are lots of possible causes of infertility. However, some common reasons for infertility in women include painful or heavy periods, irregular periods, pain during sex, hormonal fluctuations, not ovulating (not releasing eggs from the ovaries), the fallopian tubes are blocked so sperm can’t get to the egg, poor egg quality, the shape of your uterus makes it hard for a fertilized egg to implant, endometriosis, and uterine fibroids.
For men, the most common causes of infertility include changes in sexual desire, testicle pain or swelling, problems maintaining an erection, small and firm testicles, low sperm count (not having enough sperm in the semen), poor sperm motility (when sperm doesn’t swim well enough to reach an egg), sperm that aren’t formed correctly, semen that’s too thick for sperm to move around in it quickly and no sperm in the semen.
Having too much or too little of some hormones that help your body make sperm can also lead to sperm-related problems that cause infertility. In addition, a problem with ejaculation can also cause infertility in men. If the tubes inside your penis or testicles are blocked, you may have difficulty ejaculating. Sometimes, ejaculation can send semen backward from your prostate into your bladder instead of out of your penis.
However, in some cases, there’s no known reason for infertility; that’s known as unexplained infertility. Unexplained infertility can be frustrating, but there are still usually treatment options that you can try.
What might increase the risk of infertility?
There are certain health and lifestyle factors that can increase your chances of having fertility problems in men and women. They include being older than 35 (for women), being overweight or underweight, chemotherapy or radiation, excessive drug or alcohol use, smoking cigarette, injury to the scrotum and testes, overheated testicles, and having an undescended testicle.
What are tests Involved in the Fertility Evaluation?
History and physical examination: First and foremost, your fertility physician will take a very thorough medical and fertility history. Secondly, a transvaginal ultrasound will be conducted to evaluate the structure of the uterus, tubes, and ovaries.
The most common tests include measurements of blood levels of certain hormones such as estradiol and FSH, which are related to ovarian function and overall egg numbers. Hysterosalpingogram (HSG) is a test that is essential for evaluating fallopian tubal potency.
Many uterine and tubal abnormalities are detected by the HSG and can be surgically corrected. The semen analysis is the primary test to evaluate males.
What are the treatments for infertility?
Education: We strongly believe that educating our patients about the normal process of fertility, problems that affect fertility, and treatment options will empower our patients to make the best choices.
Medications to induce egg development: The medications that help stimulate the ovary to develop mature eggs for ovulation come in two forms: pills taken by mouth and injections.
Insemination: Intrauterine insemination, also known as IUI, is a process by which sperm is washed and prepared for placement into the uterine cavity, bypassing the cervix and bringing a higher concentration of motile sperm closer to the tubes and ovulated egg.
In Vitro Fertilization (IVF): In vitro means “outside the body.” IVF is a process whereby eggs are collected and fertilized by sperm outside the body in an embryology laboratory. IVF with intracytoplasmic sperm injection (ICSI) is an advanced laboratory procedure that involves injecting a single healthy sperm into an egg to create an embryo, which is implanted into a woman’s uterus.
Third-Party Reproduction: This is a general reference to a general process where another person provides sperm or eggs or where another woman acts as a gestational surrogate, with the purpose of helping another person or couple have a child.
Surgery: After a thorough history, physical examination, and ultrasound is performed, your doctor may recommend surgery to correct an abnormality. The most common surgical procedures in reproductive medicine are laparoscopy, hysteroscopy, and abdominal myomectomy (removal of uterine fibroids).
Sperm Retrieval: For men who cannot ejaculate or produce semen involves retrieval of semen from the testicles using a small needle.
Vasectomy Reversal: It enables a man to produce healthy sperm in his semen once again.
Sperm Donation: It is the use of another male’s sperm to fertilize a woman’s egg.
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