Infertility

Infertility is defined as not being able to get pregnant despite having frequent, unprotected sex for at least a year for most couples.

Infertility may result from an issue with either you or your partner, or a combination of factors that prevent pregnancy. Fortunately, there are many safe and effective therapies that significantly improve your chances of getting pregnant.

Symptoms

The main symptom of infertility is not getting pregnant. There may be no other obvious symptoms. Sometimes, women with infertility may have irregular or absent menstrual periods. In some cases, men with infertility may have some signs of hormonal problems, such as changes in hair growth or sexual function.

Most couples will eventually conceive, with or without treatment.

When to see a doctor or healthcare provider

You probably don’t need to see your health care provider about infertility unless you have been trying regularly to get pregnant for at least one year. Women should talk with a care provider earlier, however, if they:

• Are age 35 or older and have been trying to conceive for six months or longer
• Are over age 40
• Have irregular or absent periods
• Have very painful periods
• Have known fertility problems
• Have been diagnosed with endometriosis or pelvic inflammatory disease Have had multiple miscarriages
• Have undergone treatment for cancer

Men should talk to a health care provider if they have:

• A low sperm count or other problems with sperm
• A history of testicular, prostate or sexual problems
• Undergone treatment for cancer
• Small testicles or swelling in the scrotum
• Others in your family with infertility problems

Causes

Infertility causes can affect one or both partners. Sometimes, no cause can be found.

Causes of male infertility

These may include:

• Abnormal sperm production or function due to undescended testicles, genetic defects, health problems such as diabetes, or infections such as chlamydia, gonorrhea, mumps or HIV. Enlarged veins in the testes (varicocele) also can affect the quality of sperm.
• Problems with the delivery of sperm due to sexual problems, such as premature ejaculation; certain genetic diseases, such as cystic fibrosis; structural problems, such as a blockage in the testicle; or damage or injury to the reproductive organs.
• Overexposure to certain environmental factors, such as pesticides and other chemicals, and radiation. Cigarette smoking, alcohol, marijuana, anabolic steroids, and taking medications to treat bacterial infections, high blood pressure and depression also can affect fertility. Frequent exposure to heat, such as in saunas or hot tubs, can raise body temperature and may affect sperm production.
• Damage related to cancer and its treatment, including radiation or chemotherapy. Treatment for cancer can impair sperm production, sometimes severely.

Causes of female infertility

Causes of female infertility may include:

• Ovulation disorders, which affect the release of eggs from the ovaries. These include hormonal disorders such as polycystic ovary syndrome. Hyperprolactinemia, a condition in which you have too much prolactin — the hormone that stimulates breast milk production — also may interfere with ovulation. Either too much thyroid hormone (hyperthyroidism) or too little (hypothyroidism) can affect the menstrual cycle or cause infertility. Other underlying causes may include too much exercise, eating disorders or tumours.
• Uterine or cervical abnormalities, including abnormalities with the cervix, polyps in the uterus or the shape of the uterus. Noncancerous (benign) tumors in the uterine wall (uterine fibroids) may cause infertility by blocking the fallopian tubes or stopping a fertilised egg from implanting in the uterus.
• Fallopian tube damage or blockage, often caused by inflammation of the fallopian tube (salpingitis). This can result from pelvic inflammatory disease, which is usually caused by a sexually transmitted infection, endometriosis or adhesions.
• Endometriosis, which occurs when endometrial tissue grows outside of the uterus, may affect the function of the ovaries, uterus and fallopian tubes.
• Primary ovarian insufficiency (early menopause), when the ovaries stop working and menstruation ends before age 40. Although the cause is often unknown, certain factors are associated with early menopause, including immune system diseases, certain genetic conditions such as Turner syndrome or carriers of Fragile X syndrome, and radiation or chemotherapy treatment.
• Pelvic adhesions, bands of scar tissue that bind organs that can form after pelvic infection, appendicitis, endometriosis or abdominal or pelvic surgery.
• Cancer and its treatment. Certain cancers — particularly reproductive cancers — often impair female fertility. Both radiation and chemotherapy may affect fertility.

Risk factors

Many of the risk factors for both male and female infertility are the same. They include:

• Age. Women’s fertility gradually declines with age, especially in the mid-30s, and it drops rapidly after age 37. Infertility in older women is likely due to the lower number and quality of eggs, and can also be due to health problems that affect fertility. Men over age 40 may be less fertile than younger men.
• Tobacco use. Smoking tobacco or marijuana by either partner may reduce the likelihood of pregnancy. Smoking also reduces the possible effectiveness of fertility treatment. Miscarriages are more frequent in women who smoke. Smoking can increase the risk of erectile dysfunction and a low sperm count in men.
• Alcohol use. For women, there’s no safe level of alcohol use during conception or pregnancy. Alcohol use may contribute to infertility. For men, heavy alcohol use can decrease sperm count and motility.
• Being overweight. Among American women, an inactive lifestyle and being overweight may increase the risk of infertility. For men, sperm count also may be affected by being overweight.
• Being underweight. Women at risk of fertility problems include those with eating disorders, such as anorexia or bulimia, and those who follow a very low-calorie or restrictive diet.
• Exercise issues. A lack of exercise contributes to obesity, which increases the risk of infertility. Less often, ovulation problems may be associated with frequent strenuous, intense exercise in women who are not overweight.

Prevention

Some types of infertility aren’t preventable. But several strategies may increase your chances of pregnancy.

Couples

Have regular intercourse several times around the time of ovulation for the highest pregnancy rate. Intercourse beginning at least five days before and until a day after ovulation improves your chances of getting pregnant. Ovulation usually occurs in the middle of the cycle — halfway between menstrual periods — for most women with menstrual cycles about 28 days apart.

Men

Although most types of infertility aren’t preventable in men, these strategies may help:

• Avoid drug and tobacco use and drinking too much alcohol, which may contribute to male infertility.
• Avoid high temperatures found in hot tubs and hot baths, as they can temporarily affect sperm production and motility.
• Avoid exposure to industrial or environmental toxins, which can affect sperm production.
• Limit medications that may impact fertility, both prescription and nonprescription drugs. Talk with your doctor about any medications you take regularly, but don’t stop taking prescription medications without medical advice.
• Exercise moderately. Regular exercise may improve sperm quality and increase the chances for achieving a pregnancy.

Women

For women, a number of strategies may increase the chances of becoming pregnant:

• Quit smoking. Tobacco has many negative effects on fertility, not to mention your general health and the health of a fetus. If you smoke and are considering pregnancy, quit now.
• Avoid alcohol and street drugs. These substances may impair your ability to conceive and have a healthy pregnancy. Don’t drink alcohol or use recreational drugs, such as marijuana, if you’re trying to get pregnant.
• Limit caffeine. Women trying to get pregnant may want to limit caffeine intake. Ask your doctor for guidance on the safe use of caffeine.
• Exercise moderately. Regular exercise is important, but exercising so intensely that your periods are infrequent or absent can affect fertility.
• Avoid weight extremes. Being overweight or underweight can affect your hormone production and cause infertility.

Treatment

In cases where spontaneous pregnancy doesn’t happen, couples can often still achieve a pregnancy through use of assisted reproductive technology. Infertility treatment may involve significant financial, physical, psychological and time commitments.

Treatment for men

Men’s treatment for general sexual problems or lack of healthy sperm may include:

• Changing lifestyle factors. Improving lifestyle and certain behaviours can improve chances for pregnancy, including discontinuing select medications, reducing or eliminating harmful substances, improving frequency and timing of intercourse, exercising regularly, and optimising other factors that may otherwise impair fertility.
• Medications. Certain medications may improve sperm count and likelihood for achieving a successful pregnancy. These medicines may increase testicular function, including sperm production and quality.
• Surgery. For some conditions, surgery may be able to reverse a sperm blockage and restore fertility. In other cases, surgically repairing a varicocele may improve overall chances for pregnancy.
• Sperm retrieval. These techniques obtain sperm when ejaculation is a problem or when no sperm are present in the ejaculated fluid. They may also be used in cases in which assisted reproductive techniques are planned and sperm counts are low or otherwise abnormal.

Treatment for women

Some women need only one or two therapies to improve fertility. Other women may need several different types of treatment to achieve pregnancy.

• Stimulating ovulation with fertility drugs. Fertility drugs are the main treatment for women who are infertile due to ovulation disorders. These medications regulate or induce ovulation. Talk with your doctor about fertility drug options — including the benefits and risks of each type.
• Intrauterine insemination (IUI). During IUI, healthy sperm are placed directly in the uterus around the time the ovary releases one or more eggs to be fertilized. Depending on the reasons for infertility, the timing of IUI can be coordinated with your normal cycle or with fertility medications.
• Surgery to restore fertility. Uterine problems such as endometrial polyps, a uterine septum, intrauterine scar tissue and some fibroids can be treated with hysteroscopic surgery. Endometriosis, pelvic adhesions, and larger fibroids may require laparoscopic surgery or surgery with a larger incision of the abdomen.
• Assisted reproductive technology: Assisted reproductive technology (ART) is any fertility treatment in which the egg and sperm are handled. There are several types of ART.

In vitro fertilization (IVF) is the most common ART technique. IVF involves stimulating and retrieving multiple mature eggs, fertilizing them with sperm in a dish in a lab, and implanting the embryos in the uterus several days after fertilization.

Other techniques are sometimes used in an IVF cycle, such as:

Intracytoplasmic sperm injection (ICSI). A single healthy sperm is injected directly into a mature egg. ICSI is often used when there is poor semen quality or quantity, or if fertilization attempts during prior IVF cycles failed.

Assisted hatching. This technique assists the implantation of the embryo into the lining of the uterus by opening the outer covering of the embryo (hatching).

Donor eggs or sperm. Most ART is done using a couple’s own eggs and sperm. However, if there are severe problems with either the eggs or the sperm, you may choose to use eggs, sperm or embryos from a known or anonymous donor.

Gestational carrier. Women who don’t have a functional uterus or for whom pregnancy poses a serious health risk might choose IVF using a gestational carrier.

In this case, the couple’s embryo is placed in the uterus of the carrier for pregnancy.

Complications of treatment

Complications of infertility treatment may include:

• Multiple pregnancy. The most common complication of infertility treatment is a multiple pregnancy — twins, triplets or more. Generally, the greater the number of fetuses, the higher the risk of premature labor and delivery, as well as problems during pregnancy such as gestational diabetes. Babies born prematurely are at increased risk of health and developmental problems. Talk to your doctor about any concerns you have about a multiple pregnancy before starting treatment.
• Ovarian hyperstimulation syndrome (OHSS). Fertility medications to induce ovulation can cause OHSS, particularly with ART, in which the ovaries become swollen and painful. Symptoms may include mild abdominal pain, bloating, and nausea that lasts about a week, or longer if you become pregnant. Rarely, a more severe form causes rapid weight gain and shortness of breath requiring emergency treatment.
• Bleeding or infection. As with any invasive procedure, there is a rare risk of bleeding or infection with assisted reproductive technology or reproductive surgery.

The Best Ways for Boosting Fertility Naturally

Besides consulting a specialist, you can also opt for holistic fertility treatments and take care of your fertility problem in a natural way. Some of the things you can do at home to boost your fertility and increase the chances of getting pregnant include the following:

• Eat a Big Breakfast

Eating a big and healthy breakfast has been found to help women improve fertility problems. A few studies have been conducted on this topic showing that indeed having a larger breakfast, instead of a substantial dinner, can help boost ovulation

for 30%. Thanks to this, the levels of insulin can be reduced by 8% and the levels of testosterone by 50% which ultimately leads to higher chances of becoming pregnant.

• Eat Antioxidant-rich Foods

Antioxidant-rich foods can also help in improving fertility in both men and women. Thanks to antioxidants, you can naturally reduce the number of free radicals that are known to damage egg cells and sperm in your body. If you want to boost your fertility, try to include more fruits, vegetables, grains, and nuts that are naturally packed full of good antioxidants such as vitamins E and C, beta-carotene, lutein, and folate.

• Avoid Eating Trans Fats

Consuming healthy fats is the basis of every balanced diet, and if you’re trying to get pregnant you should avoid trans fats altogether. Trans fats are known to negatively impact ovulation levels. For a natural conception, it would be best if you avoided trans fast altogether and had a healthy diet.

• Choose Your Carbs Wisely

There are two important things you should be aware of when it comes to carbs – you should pay attention to the number of carbs you eat on the overall and the type of carbs you consume every day. Having a low-carb diet can help improve hormone levels in women with PCOS while avoiding refined carbs can increase your chances to get pregnant.

• Consume High-fat Dairy Products

More than one study has been conducted that shows the connection between high- fat dairy and fertility. Studies showed that women who consumed one or two servings of high-fat dairy products have higher chances of getting pregnant than those who consumed low-fat dairy. If you’re looking for natural remedies for ovulation and infertility, replacing at least one low-fat dairy serving with a high-fat dairy one can help you achieve that.

• Use Diverse Protein Sources in Your Diet

Protein is an integral part of your diet, but you should try to consume protein sources other than meat to reduce the risk of infertility. Vegetable protein sources such as beans, seeds, and nuts have been found to improve women’s chances of becoming pregnant faster. Try to use different protein sources in your diet to help boost your fertility.

• Increase Your Fiber Intake

Fiber is generally good for everyone’s diet, but increasing your fiber intake while you’re trying to conceive may significantly improve your chances of it. The great thing about fiber is that it can help your body remove excess hormones while keeping your blood sugar levels in control.

Food that has high levels of fiber includes fruit and veggies, whole grains, and beans, so you might want to base your diet around them. Of course, try to not go overboard with fiber intake as it can have a negative effect on your ovulation and fertility.

• Try Some Multivitamin

If you think you’re not getting enough nutrients from your everyday diet, opting for some multivitamins is a good idea. Being persistent in taking your fertility and ovulation supplements can significantly improve your fertility and ovulation.

One of the most important vitamins for women who are trying to get pregnant is folate, so you can start taking it once you start planning your pregnancy, but try to include other vitamins and minerals as well to make sure you’re getting all the necessary nutrients.

• Get Physically Active

Being obese or overweight can really impact your possibilities to conceive. Besides being good for your overall health, regular and moderate exercising can help you achieve a normal weight and increase chances for pregnancy.

Try to avoid a sedentary lifestyle and include some walking or light physical activity

to get your body in shape and ready for pregnancy. It’s important that you don’t exaggerate since too much exercising can have a negative impact on holistic fertility and conception.

• Maintain a Healthy Weight

Weight is one of the most relevant factors that affect fertility in both men and women. Maintaining a healthy weight is one of the best ways to help you with boosting fertility and conception.

Unhealthy weight is connected with irregular menstrual cycles which can significantly reduce the chances of becoming pregnant. Women who are either underweight or overweight will have problems conceiving so the first step towards getting pregnant should be to keep your weight under control.

• Cut Down on Caffeine Sources

One of the well-known home remedies for ovulation includes cutting down on caffeine sources on a daily level. Women who drink a lot of coffee have fewer chances of conceiving and caffeine has been shown to increase the chances of miscarriage. If you’re a coffee-lover, you don’t have to completely avoid coffee, but simply try to be moderate with your caffeine consumption.

• Avoid Drinking Alcohol

Although it’s not determined how much alcohol can affect fertility, if you and your partner are trying to have a baby, you should really try to cut down on your alcohol intake. Several studies have been conducted trying to make a connection between alcohol and infertility, however, the results are mixed. The only certain thing is that excessive alcohol consumption is bad for fertility and decreases the chances of pregnancy.

• Reduce Stress Levels

If you have been trying to conceive for some time now, it’s possible that you feel under pressure because of it. However, stress is one of the most relevant factors for conception. Try to relax and reduce any stressors from your environment to

help boost your fertility. By learning how to cope with everyday stress and anxiety you can improve your chances of getting pregnant.

• Increase Your Iron Intake

Iron intake is very important for everyone, but especially for women who are in their reproductive years. It’s paramount that you try to eat iron-rich foods such as plant-based iron food if you want to improve your ovulation and fertility. If your diet doesn’t include enough iron sources, try to find an adequate supplement as a substitute.

• Natural Fertility Supplements

Some of the best natural fertility supplements include the following: Bee pollen – helps improve immunity, nutrition, and fertility in men.

Bee propolis – women who used bee propolis twice a day had higher chances of getting pregnant.

Maca – a plant that grows in Peru has been shown to positively affect sperm levels.

Royal jelly – packed full of lipids, vitamins, amino acids, iron, fatty acids, and calcium, it can help boost fertility.