You’re trying for a baby. But for some reason, it’s just not happening… Here are five things you should get your specialist to check (plus four for the mister) before considering IVF and other treatment.
Make sure your ob-gyn has cleared you of the following before you contemplate getting fertility treatment:
1. Egg (ovum) production issues
Problems in producing the eggs (also known as female ova) can lead to infertility. Ovulation is primarily controlled by the various female hormones from the brain and the ovaries, and there are many potential disruptive factors affecting the balance of these hormones, such as PCOS, excessive exercise, chronic poor health and so on.
2. Fallopian tubes — are they clear?
These account for approximately 15 per cent of the causes of subfertility in women. The fallopian tubes are crucial for the transport of the egg and the male sperm (which swim up the tube to meet the egg). Any blockage can interfere with this, including endometriosis, pelvic infections, a woman having had a previous ectopic pregnancy (when the fertilised egg starts developing in the tubes rather than going to the uterus) or previous pelvic surgery.
When you end up with endometrial (uterus lining) tissues outside the uterus but within the pelvis — it’s endometriosis. This is a chronic inflammatory process that can potentially damage the fallopian tubes, ovaries and even the uterus.
4. Uterine factors
There are several abnormalities of the uterus (or “womb”) that can contribute to fertility problems such as malformations of the uterus from your own birth, septae (when tissue divides the uterus), certain fibroids and so on.
5. Genetic problems
Genetic abnormalities affecting the female reproductive system are uncommon. But they can influence an affected woman’s fertility potential through different mechanisms including those mentioned above.
Things to make sure your husband doesn’t have (he’ll need to check with a urologist)…
A. Problems of the testicles
Failure of sperm production in men's testes can be due to many causes such as infection, testicular torsion (twisting of the spermatic cord suspending a testicle leading to very sudden, sharp pain to start with), trauma, cancer, previous treatments (such as surgery, chemotherapy, radiotherapy) and anomalies at birth. Often, there may be no obvious reasons behind testicular dysfunction.
Obstruction of the vas deferens (sending the sperm to the penis) can be a result of prior surgery or it can be congenital.
Some medications can potentially affect male fertility. Medications for high blood pressure, anti-depressants and sedatives can cause ejaculatory dysfunction (these problems could be summed up as “too fast, too slow or not at all” by Boston University web site). Others can have an impact on the sperm production and quality of the sperm. Chronic smoking can also affect the quality of the sperm produced.
D. Ejaculatory factors
Retrograde ejaculation (semen goes “back” into the bladder) and ejaculatory dysfunction (again) play important roles in infertility. These can be congenital in nature or they can be caused by medications, smoking and even some medical conditions such as diabetes mellitus.
This story was written with the help of Dr Jason Lim Shau Khng, a consultant at the Department of Obstetrics & Gynaecology, Singapore General Hospital.
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