What is Infertility?

Infertility, is defined as the inability of a couple to conceive after one year of unprotected sex. It affects as many as 1 in 6 couples or 10% to 15% of reproductive-age couples.

The monthly conception rate of couples at peak fertility is 20% to 25%. 60% of couples conceive within 6 months, 80% within 12 months, and 90% within 18 months.

Why is infertility on the rise?

The prevalence of infertility is on the rise as women are postponing childbearing for social, economical, professional, or psychological reasons. Stress, smoking, alcohol, toxic chemicals and drugs exposure, and nutritional deficiencies or excesses can all negatively affect fertility.

What are the causes of infertility?

  • One Third of infertility cases can be attributed to male factors.
  • One Third of infertility cases can be attributed to female factors.
  • One Third of infertility cases are caused by a combination of factors in both partners.

Treatment is individualized to each patient after assessing them thoroughly in terms of history, examination and the previous treatment taken. Unnecessary investigations and unindicated procedures are avoided.

When do you evaluate the couple for infertility?

We evaluate the couple normally after one year of unprotected intercourse. However, early evaluation and treatment is indicated in women with:

  • Age > 35 yrs
  • Hypo/oligomenorrhea and amenorrhoea
  • Known or suspected uterine / tubal disease, endometriosis or diminished ovarian reserve
  • Suspected or infertile partner
  • One third of women who delay pregnancy until after age 35 and at least half of the women who delay until after 40 will have some difficulty in conceiving

Infertility Testing & Evaluation

Evaluation begins with a detailed documentation of the history and physical examination of both the partners. Adequate counselling is an integral part of the management.

As a routine it is suggested to do:

  • Haemogram with HPLC (to rule out thalasemia or other hemoglobinopathies)
  • Blood sugar (fasting )
  • Rubella IgG
  • Endocrinology profile including S.TSH and S.Prolactin (These are the treatable causes of infertility)
  • Mountoux and Chest X ray in suspected cases of tuberculosis.

Treatment is individualized to each patient after assessing them thoroughly in terms of history, examination and the previous treatment taken. Unnecessary investigations and unindicated procedures are avoided.