Couples are considered infertile if they have not been able to conceive after 6 to 12 months of regular sexual intercourse without the use of any form of birth control. About 15 to 20% of all couples are infertile.
Infertility may be temporary and it may be due to many different problems. More than one problem may be present in a couple. Many of these problems can be corrected. Both the man and woman should be tested. In 15 to 20% of all couples who are infertile, both the man and the woman have problems that cause the infertility. In 35 to 40 %, problems occur in the man. In another 35 to 40%, problems occur in the woman. The remaining cases have no known cause.
A man may be infertile because he does not have enough sperm, because the sperm do not move or function properly, or because he has blocked passageways. Disease, fevers or infections, and congenital abnormalities can contribute to these problems in men.
A woman may be infertile because some parts of her reproductive system are not functioning properly due to disease, infections, problems with hormone production or congenital abnormalities. These factors may interfere with reproduction in a number of ways: ovulation may not occur, the uterus may not be properly prepared to receive the developing embryo, the tubes may be blocked, diseased, or bound by scar tissue, or there may not be adequate cervical mucus for the sperm's survival.
In both the male and female, poor general health may contribute to the causes of infertility. Obesity, poor eating habits, too much stress, smoking or alcohol can make infertility problems worse. Another possible cause may be the development of antibodies to sperm, either in the male or female. Such antibodies may attack and impair sperm and thus prevent conception.
If the couple is infertile and wants to conceive a child, the first step is to have a complete infertility evaluation. This is done by our doctors in order to determine the cause of their infertility and what can be done to correct it. Medical work‐ups for infertility begin with a consultation with the IGO physician. A medical history and physical exam is usually included. The couple is also asked about their sexual relations to find out if their infertility may be related to such factors as the timing or frequency of intercourse.
In some cases, patients may simply need more information on the timing of intercourse most favorable to conception. In other cases, drugs may be prescribed to treat an underlying disease, infection or hormone deficiency found in the man or the woman. In the last ten years, there have been tremendous advances with other types of treatment for more difficult infertility problems, including:
In some cases, the husband's semen may be enhanced by treating the sperm in such a way that removes unhealthy sperm cells, antisperm antibodies and seminal fluid which may be irritating or rejected by the uterus. The healthy sperm are then placed directly into the uterus during an insemination procedure at a simple office visit.
Using these new techniques, some types of infertility may be permanently cured. These procedures are especially useful to correct conditions which cause the fallopian tubes to be blocked, displaced or scarred. The use of a surgical microscope to magnify the small tubes and tissues has greatly increased the success of this type of reconstructive procedure. In appropriate cases, this can be done through laparoscopic surgery, requiring no overnight hospitalization.
Therapeutic insemination using donor semen is a simple process. Donors are carefully screened to comply with the American Society of Reproductive Medicine standards and to match for characteristics similar to those of the husband or whatever other characteristics the patient desires. The procedure is completely confidential and the husband has sole rights to fatherhood under California law.
Many couples may benefit from "test tube baby" procedures. In these procedures (In Vitro Fertilization, Intracytoplasmic Sperm Injection, Assisted Hatching, Blastocyst Culture), eggs are removed from the woman and mixed in the laboratory with the man's sperm. They are later transferred back into the woman in the hopes of achieving a pregnancy. Such treatments are performed in the office setting. No hospitalization is required.
Donor eggs can be used for In Vitro Fertilization and Embryo Transfer in situations of increased maternal age, hormonal irregularities which impair normal egg production or genetic problems which render a woman's eggs unsuitable for Assisted Reproductive Technologies. The donated eggs are mixed in the laboratory with the husband's sperm and then later transferred to the wife's uterus in the hopes of achieving a pregnancy.
Infertility can lead to severe stress and tension in a relationship. Couples may find this very discouraging. It is a time when a couple needs to be especially supportive of each other and may need to turn to professional counseling. Your IGO physician can recommend an experienced and caring counselor or, if appropriate, refer you to an adoption advisor. Many insurance companies now provide financial assistance for the diagnosis and treatment of infertility. Be sure to check your policy or call your agent. The IGO Patient Account Representative at (858) 455‐1248x153 will be glad to assist you.
The first test for male infertility is an analysis of his semen. Usually the man is asked to bring a sample of his semen into the laboratory for examination and analysis. Semen analysis includes a check of the sperm morphology (shape and appearance), a measurement of the volume and pH, a computerized analysis of the sperm count and movement characteristics, and semen cultures (to detect bacterial and mycoplasma infections). If there is any question about the findings, additional tests may be conducted or the husband may be referred to a urologist (a doctor who specializes in matters involving the urinary tract, testes, and related reproductive organs).
The first step in testing the woman is to discover whether or not she is ovulating (producing an egg) each month. This can be done in several ways by using a home ovulation test kit, ultrasound, or by simple blood tests in the physician's office. The results determine whether additional tests are needed. In many cases, it is also necessary to determine whether or not the fallopian tubes are open. This may be done with a special X‐ray examination (hysterosalpingogram) of the tubes. This test can show whether the tubes are open as well as define the shape of the uterus. The tubes can also be examined by laparoscopy, one of the most useful diagnostic tests for infertility. This technique permits the doctor to use a miniature light transmitting telescope called a laparoscope to look into the abdomen and inspect the female organs for disease.
Talk to the physicians at IGO Medical Group. They can help you take the first step in finding answers to your questions. Success in achieving a pregnancy is much more likely if you seek help early. If you are concerned that you might have an infertility problem and you wish to have a child, call IGO Medical Group for more specific information or to schedule an appointment. Remember, we are here to help you reach your goal of becoming parents. Your inquiries are treated confidentially and promptly.