Infertility is the inability of a couple to achieve pregnancy after 12 months of regular unprotected sexual intercourse. Regular sexual intercourse refers to three or more days of sexual intercourse in one week.
Infertility is a distressing condition to the affected family. It has both psychological and social implications for the couples.
Classification - Infertility can be classified into primary and secondary.
This can be divided into male, female and combined causes (involving both male and female). Adequate sexual exposure is very important to achieve conception. Without adequate sexual intercourse, it is difficult to determine the reproductive potentials of both husband and wife.
This is because, to define infertility, adequate sexual exposure, defined as at least three days of sexual intercourse in a week, is taken into consideration.
For a couple engaging in sexual activities less than three times in a week, it may be difficult to ascertain the fertility potential of the couple. Sometimes, this is due to husband and wife living several miles apart, due to whatever reason.
Sometimes the couple live together but, due to other engagements of the day, may find it difficult to meet up with this demand. In such cases, achieving pregnancy may be difficult even without any identifiable abnormality in both of them.
Couples experiencing infertility should seek medical advice from qualified medical practitioners. Early presentation will afford them early diagnosis of the probable cause(s) and what solutions are available for them. It is unfortunate that many couples seek alternatives to medical solution to their infertility problems thereby wasting quality time while doing so.
Knowing that age is of essence in fertility treatment, couples should seek quality medical advice early. Though evaluation for infertility is done after one year, provided there is regular unprotected intercourse according to the definition, for women up to 35 years and above, evaluation may commence after six months, knowing the woman has no much time on her side in terms of reproduction.
In evaluating for infertility, both male and female are evaluated as the contribution of either is about 50%. Males are usually investigated first as this is easier and takes shorter time than investigating women. Investigation of male infertility mainly revolves around evaluation of semen.
After investigating the man, it is usually necessary to also investigate the woman, especially if the man is found to be normal. Investigations for female infertility revolve round ovulation and patency of the reproductive tract. Sometimes, both the man and woman are investigated concurrently to save time, especially if clinical evaluation suggests involvement of both.
Treatment is directed at the specific cause. Lifestyle modification such as stopping smoking or alcohol intake may improve the quality of semen and help improve erectile dysfunction. Weight reduction for obese women, weight gain for underweight women etc may be necessary to correct ovulatory dysfunction.
Treatment of certain medical conditions such as hypertension, diabetes as well as treatment of genital tract infection may also be necessary. In some cases, the causes may not be amenable to medical treatment and therefore assisted reproduction may be necessary or even adoption in certain cases.
This involves knowing the risk factors and avoiding them. Late marriage should be avoided as reproductive capabilities have been known to decline with age both in women and men. Smoking and alcohol intake should be avoided or stopped as they have been noted to have significant impact on reproductive potentials of both genders.
Sexually transmitted infection, known to have effects on reproductive tract of both male and female, should be avoided by practicing safe sex (use of condom) if abstinence is not feasible. Expert medical advice should be sought before a woman or man, who is still desirous of future reproductive life, chooses any form of contraception.
