Thousands of couples seek infertility treatment to resolve conceiving issues or achieve the childbearing capacity. The conventional treatment options have complex procedures and country-specific infertility treatment guidelines should be referred to before initiating treatment. However, there is no specific medical recommendation related to treatment commencement, definite diagnostic test or termination of treatment etc. The infertility treatment is completely individualized depending upon the requirement of the patient.
In Vitro Fertilization (IVF) and gestational surrogacy(infertility treatment alternative) are common conventional infertility treatments. But these procedures are quite expensive and the expenses are generally not covered under medical insurances.
Definition and causes of Infertility
Difficulty to become pregnant after conducting unrestricted, frequent intercourse for a certain period of time or complications related to completion of gestation period is considered as infertility. Usually, 15-20% of couples are experiencing conceiving difficulty even after regular intercourse without using birth control for almost one year. But this does not indicate that a couple is infertile, as within two years of period almost 90% of couples conceive without treatment. Therefore, reproductive experts consider that two years without conception require infertility treatments.
Either male and female or both can be responsible for infertility problem. Research data found 40% of infertility involves a female reproductive problem, whereas, another 40% of involves male infertility issues. Both female and male fertility problem involves 10% infertility cases and remaining 10% of infertility cases are medically unexplainable.
Hormonal abnormality or infection or scar tissue can cause the following pathophysiology and hamper or negatively affect the fertility:
• Irregular or poor quality eggs produced in women’s ovary
• Low sperm count or unable to pass through a sufficient amount of sperm from male reproductive organ to the female uterus during intercourse
• Blockage of the cervix can also restrict the entrance of sperm to female uterus
• Fallopian tube blockage can obstruct the egg or embryo travelling at the initial phase
• The uterus lining incapable to have the embryo implant and sustain the pregnancy.
Factors responsible for infertility
There are two primary factors responsible for infertility, i.e. ageing and stress. Ageing declines female fertility. A gradual decline starts after 30 years of age and a steep decline starts after 35 years of age. Similarly, stressful lifestyle or excessive psychological stress can limit egg and sperm production in the female and male reproductive system.
Conventional Infertility Treatment
Following are different conventional infertility treatments for men:
There are many medications invented by pharmaceutical research and development sector to enhance testicular functioning and improve sperm production and quality. These medications are found to be helping in improving the pregnancy rate.
Surgical intervention is conducted for reversing the blockage and improves sperm passage. Varicocele repairing through surgical intervention may also improve pregnancy rate.
Sperm retrieval is a clinical intervention applied when sperm is absent in ejaculated fluid. This technique is also included in assisted reproductive techniques in case of a male partner has an abnormally low sperm count.
Following are different conventional infertility treatments for women:
There are fertility medications for female stimulate ovulation or induce ovulation. However, these medications also have some risk factors, so consultation with a medical expert is necessary before administering these medications.
Intrauterine insemination (IUI)
In IUI the healthy sperms are inserted to the female uterus during the egg release from the ovary for fertilization. The timing of IUI should be matched with normal ovulation cycle or with fertility medication administration in case of abnormality of the cycle.
Surgical intervention helps to restore fertility in case of uterine problems. Hysteroscopic surgery is recommended for treating endometrial polyp development in the uterine wall or development of intrauterine scar tissue.
Assisted reproductive technology (ART)
There are many advanced assisted reproductive technologies discovered with the advancement of reproductive medical technology. Experts recommend specific ART depending based on his/her findings from the patient’s condition.
• In vitro fertilization (IVF) is one of the most common ART(Assisted reproductive technology) involving stimulation of egg and retrieving mature healthy eggs form female partner. In a laboratory, these eggs are fertilized in a Petri dish by introducing sperm. The formed embryo is implanted after 3-5 days of fertilization.
• In Intracytoplasmic sperm injection (ICSI) process, a healthy single sperm is directly injected into a mature egg in case of poor semen quality or prior failure of the IVF process.
• Assisted hatching is a process in which the outer covering of embryo is released and then implanting it into the embryo lining.
• Donor egg and sperm is also an option for couples who have healthy egg or sperm-related problems. The collection and use of donor’s egg or sperm can be successfully conducted under the IVF process.
• A gestational carrier is also an option for females who unable to bear and carry a pregnancy due to some serious health issue.
Alternative Options for Infertility Treatment
Infertility treatment is not always based on above mentioned conventional treatments or ART. But some alternative treatment approaches are also effective in case of mild to moderate reproductive disorders.
Healthy lifestyle and improving behavioural factors can increase the scope of pregnancy. Avoidance of certain medication quit smoking, reduction of alcohol consumption, regular exercise, and weight management can naturally improve the possibility of conceiving.
Research results have found that acupuncture improves fertility through distressing and relaxing without any harmful effect. A research study conducted in 2010 reported that acupuncture improves the fertility rate in patients who were undergoing IVF treatment. This study also concluded the improvement of fertility through acupuncture due to the placebo effect. Research experts recommended that patients may choose acupuncture along with recommended fertility treatment after consulting with a physician to get a better outcome of fertility treatment.
There are some supplements like chaste berry extract, DHEA supplements, and CoQ10 supplements that claim to improve fertility rate, but scientific research do not support these claims and some of these supplements even have negatively impact. Therefore, proper selection of supplement is very crucial.
The Robinson Research Institute conducted a research in 2017 on 1,100 infertile women and the study result reported that flushing of infertile women’s fallopian tubes with iodized poppy seeds oil gives a 40% positive outcome. This procedure is simple, but the patient may feel uncomfortable during the procedure.