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Many women and men believe because they previously conceived
as a teen or early 20 something by accident getting pregnant
(or getting her pregnant) when you’re ready to start a family
will be easy. Obviously you’re fertile. Unfortunately from
the mid to late thirties and early forties for a woman or for
a man in his forties, fifties and sixties, easy may no longer
be the operative word. Suddenly being blessed with a family is
no longer a certainty and each day that passes, your chances
to conceive and carry to term diminish. Pregnancy becomes a
scientific experience of monitoring, temperatures, cycles and
schedules. For many couples, that act of making a baby
becomes work, not love. Fortunately, science has enabled many
to still conceive, at times too many at once. Other options
also exist which are not as costly or medical. If you are a
couple trying to conceive and having trouble, you have two
primary courses of action: Fertility specialist or an
alternative medical practitioner.
What is defined as infertility?
Infertility is the
inability to conceive on the part of either the female or male
after one year of unprotected sexual activity.
The optimum age for a
woman is twenty-seven. At twenty-seven she has a one in four
chance of conceiving each month. By age forty-two, her
chances drop to just seven percent. Most of the celebrity
births we read about after age forty were conceived using a
donor egg from a teen or twenty-something female. There is no
conclusive evidence to suggest that a woman taking birth
control pills for ten or more years decreases her chances of
becoming pregnant upon cessation of the monthly therapy.
What are the causes of infertility?
The initial diagnostic
evaluation of infertility routinely examines identifiable
causes by utilizing a routine sexual, health and menstrual
histories, blood tests, diagnostic tests and hormonal assays.
Tubal blockage, ovarian cysts and other problems originating
in the delivery of the egg to the uterus are the top reason
women have trouble conceiving. In older women, thirty-five
plus with no outstanding problems the main cause is simply old
eggs. Each woman is born with a specific number of eggs.
Unlike sperm, these are not regenerated. When they are gone,
they are gone. For men the most common problem is varicocoele
or the wrapping of the veins around the testicles. This
inhibits the production of sperm and prevents it from leaving
his body and entering hers.
SEE GRAPH OF
MOST COMMON CAUSES
BIOMEDICAL and
SURGICAL Approaches:
There are several different
treatment strategies in both Western biomedical/surgical
medicine and in the Eastern Energy-focused systems. It is
important to keep in mind that the problems they are fixing
may coincide.
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The causes of infertility in
women and men are diverse. A comprehensive workup by the team
of physicians (including the primary care doctor and fertility
specialists) is required to pinpoint the specific problem of a
given person. Rather than go into the individual details of
each test used to diagnose each condition, this article
focuses on the premise that there are a host of medical
conditions contributing to infertility that may be diagnosed
and subsequently treated.
Tests for infertility range
from hormone analysis studies, which determines problems with
sperm production or ovulatory (egg-tube-uterus) disorders, to
invasive diagnostic exams to visualize problems with sperm
structure or anomalies that block transport of the sperm
through the female reproductive tract. Common diseases such as
endometriosis, uterine fibroids, pelvic adhesions from surgery
or prior infections can all cause structural abnormalities
that can be treated once diagnosed. Once treated fertility is
generally restored.
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What are some of the current
treatments
available for restoring fertility?
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Medications:
Depending on the cause, the most popular medications are
hormone-inducing drugs that aid in ovulation such as Clomid.
These are the medications responsible for the release of
multiple eggs. This is what causes multiple gestations and
ultimately multiple births. Medications such as hormonal
suppressant or stimulating drugs can often be utilized to
suppress medical conditions (such as Polycystic Ovarian
Disease or thyroid deficiencies) that may affect ovulation
or optimal fertilizing conditions.
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Hysterosalpingogram:
Try not to choke on this word. Hyster—comes from uterus,
salpingo—comes from fallopian tube, and gram—is a
radiographic test that injects a contrasting fluid into the
woman’s reproductive organs for easy visualization under an
x-ray. This is frequently used as a non-surgical method to
see the reproductive tract. Obstructions can be seen through
this system that may prevent normal sperm penetration or egg
release.
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Laparoscopy:
If there is evidence of endometriosis or a suspicion past
surgical adhesions are blocking the reproductive pathway,
this surgical procedure is able to remove cysts and fibroids
thus opening the channels with a simple incision under the
belly button. Through this incision, the doctor inserts a
tiny video camera. Frequently the laparoscopic procedure is
utilized for both diagnosis and treatment. One of the most
frequent causes for infertility is a complication arising
from a prior pelvic infection.
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ART: (Assisted Reproductive
Technologies)
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IUIS:
(intra-uterine insemination): This is an in-office procedure
that allows cleansed sperm to be collected and injected into
the uterus through a small tube inserted through cervix at
the time of ovulation.
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IVF (in-vitro
fertilization): This is the famous “test-tube baby” where
the egg and sperm are fertilized “in-vitro” or outside of
the body in a test tube or dish and placed back into the
uterus. It is usually reserved the 5% of couples where
problems include endometriosis, immunologic complications,
fallopian tube problems, low sperm count, cervical mucous
problems, and other unknown complications.
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GIFT and ZIFT
(Gamete, Zygote-intrafallopian transfer):
These are
different from IVF because the egg and sperm are
allowed to fertilize in-vitro, yet they are placed
immediate (GIFT) or after pre-embryonal development
(ZIFT) into the fallopian tubes rather than the
uterus. This is usually done via a laparoscopic
procedure after intrauterine insemination has been
attempted.
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ICIS
(intra-cytoplasmic
insemination): This is the form of treatment for
male-factor problems, when the sperm has motility
disorders (picture a sperm doing donuts in a parking
lot with no direction). A single viable sperm is
injected via a pipette into the cytoplasm (the outer
layer of the female egg) inducing a forced
fertilization.
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