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When a couple cannot conceive even after regular, unprotected sex, it is known as infertility. It might be so that only one of the partners cannot contribute to conception. The couple would generally be advised to have 12 months of regular sexual intercourse without birth control before any step is undertaken.

What are the causes of infertility in women?

1. Ovulation disorders are among the most common causes of infertility in women. In such cases, the eggs might never be released or released only in some of the monthly cycles. The ovulation disorders could result from:
premature ovarian failure - where the ovaries stop working before 40 years of age
polycystic ovary syndrome - where the ovaries function normally and there might not be any ovulation
poor egg quality - the eggs might have genetic abnormalities or be damaged
hyperprolactinemia - if prolactin levels are high even when the woman is not breastfeeding or pregnant, fertility and ovulation might be hampered
thyroid dysfunction – Abnornally low (hypothyroidism) or high (hyperthyroidisn) levels of the thyroid hormones in the blood could lead to irregularities in ovulation, due to the resulting high levels of oestrogen



2. The problems in the fallopian tubes and the uterus would prevent the egg from reaching the uterus. It could be due to:
Previous surgery - There might be damage or scarring from pelvic surgery. The surgery could even scar or shorten the cervix, the neck of the uterus.
Endometriosis - The lining of the uterus has cells which start to grow in the other parts
Sterilization treatment - Some women might have chosen to have their fallopian tubes blocked. However, there are low chances of becoming fertile.

3. Medications and treatments could also cause infertility.
Chemotherapy - Such treatments often result in ovarian failure and this could be permanent.
NSAIDs - Chronic usage of such drugs would make it hard to conceive.
Radiation Therapy - It could increase the risk of fertility problems if aimed near the reproductive organs

What are the causes of infertility in men?

The problems would generally include the following:
Low sperm count - A low number of sperms would be ejaculated. Many couples have infertility problems due to this reason.
Abnormal sperm - The sperms might have an unusual shape, which would make it harder to move and hence fertility is affected.
Low sperm mobility - The sperms would not be able to swim well to reach the egg.
Overheated testicles - A varicocele, undescended testicle, varicose veins in the scrotum, use of saunas and tight clothes could be reasons for infertility as well.
Ejaculation disorders - The ejaculatory ducts might be blocked and the semen might be ejaculated into the bladder.
Hormonal disorders - A testosterone deficiency could also be a problem.

What are the available treatments?

The treatments depend on many factors, including the age of the couple, personal preferences and how long infertility has lasted.
1. Frequency of intercourse - The couple is generally advised to have sexual intercourse more often during the time when ovulation takes place. The sperms would survive for about 5 days within the women and the egg can be fertilized for a day. This offers a window of 6 days when conception is possible.
2. Fertility treatments for men would include identifying the underlying cause of infertility and treating it. Medicines, surgery and other treatment procedures are available depending on the condition.
3. The fertility treatments for women would also include the diagnosis of the problems. There are surgical procedures as well as methods of assisted conception that could help.

If the women are aged above 35, the couples should act fast as the fertility in women start to drop as they proceed in their 30s.

Authored by "Dr.Saravanan Lakshmanan" and "Dr.Mahalakshmi Saravanan"

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