Infertility FAQ

1. Infertility is a women only issue, true or false?
2. What are the different causes that lead to infertility?
3. What tests are suggested for Infertility?
4. What is the cost of tests for infertility in India?
5. What are the common signs and symptoms of infertility?
6. What are the preventive measures to adopt for avoiding infertility?
7. What are the different treatments for infertility?
8. What do you mean by the concept of artificial insemination?
9. What is IVF or In Vitro Fertilization?
10. How is infertility linked to psychological issues?

1. Infertility is a women only issue, true or false?

   False. Infertility is not a women only issue. It is a medical condition concerned with reproductive system and is diagnosed when couples have unprotected and timely intercourse for an year and yet the women fails to conceive.
   35% of times the cause of infertility is a female while 35% of times it is related to the male. The remaining percentage is due to issues in both partners.

2. What are the different causes that lead to infertility?

   With regards to women, the factors responsible for infertility are:
   • Damaged fallopian tubes
   • Ovulatory issues
   • Conditions that affect the uterus
   • Endometriosis
   • Unidentified reasons

   Some other factors include:

   • Fertility of women usually declines significantly post 35 years of age
   • Gynecology related issues such as miscarriage
   • Medical ailments such as epilepsy, bowel diseases, thyroid and diabetes
   • Lifestyle concerns such as smoking, being over or below normal weight and stress
   • PCOS (Polycystic Ovary Syndrome)

   With regards to men, the factors responsible for infertility are:

   • Low quality and count of sperm
   • Issues with tubes that carry sperm
   • Erection problems
   • Ejaculating issues

   Some other factors include:

   • Having orchitis (Inflamed testes)
   • Bacterial infection in past leading to blocked tubes and scarring
   • Medical treatments like radiotherapy, hernia surgery, twisted testicles, undescended testes or drug treatments
   • Genetic issues
   • Diabetes
   • Lifestyle concerns such as the person being overweight or working for jobs involving contact with radiation or chemicals

3. What tests are suggested for Infertility?

   Tests suggested for women are:
   • Progesterone Hormone test
   • Chlamydia test
   • Hysterosalpingo-contrast-ultrasonography
   • Laparoscopy

   Tests suggested for men are:

   • Physical examination of penis and testicles
   • Semen analysis
   • Chlamydia test

4. What is the cost of tests for infertility in India?

   Based on the diagnostic center or hospital you choose for tests along with the city you reside, the cost of tests for infertility in India may vary. You can check a comprehensive list of costs for infertility tests across Indian cities here.

5. What are the common signs and symptoms of infertility?

   Symptoms of women infertility are:
   • Abnormality in periods wherein bleeding is either heavy or light than normal
   • Irregularity in periods wherein gap between periods always varies
   • Sudden stop in periods
   • Pain during periods such as cramping, pelvic and back pain
   • Acne
   • Changes in skin
   • Changes in desire and sex drive
   • Thinning or hair loss
   • Gain in weight
   • White colored milky discharge seen from nipples which is not due to breastfeeding
   • Pain experienced during sexual activity

   Symptoms of men infertility are:

   • Alterations in growth of hair
   • Changed sexual desire
   • Swelling, lump or pain in testicles
   • Ejaculating and erection problems
   • Small or firm testicles

6. What are the preventive measures to adopt for avoiding infertility?

   Preventive measures to avoid infertility for women are:
   • Avoid alcohol, smoking and drugs
   • Trying for pregnancy at the right age (Post 35 years of age fertility declines)
   • Maintaining healthy weight and correct lifestyle
   • Safe sex

   Preventive measures to avoid infertility for men are:

   • Avoid alcohol, smoking and drugs
   • Safe sex
   • Avoiding exposure to environmental toxins
   • Monitoring diet and following an exercise regime

7. What are the different treatments for infertility?

   Treatments will be dependent on various factors such as patient's age, duration of infertility, general health and personal preferences. Couples are sometimes advised to engage in sexual intercourse for 2-3 times every week as this may result in improving fertility if the frequency was lesser than this before.
   Treatments for women include:
   • Ovulation disorder: Fertility drugs are prescribed for regulating or inducing ovulation. These drugs include:
   • Clomifene (Serophene, Clomid): Prescribed to women who don't ovulate or ovulate sometimes.
   • Metformin: Females who do not respond positively to Clomifene are prescribed this medication.
   • Repronex: Prescribed to women with fault in pituitary gland that prevents ovulation.
   • Follicle-stimulating hormone: This stimulates ovaries for maturing egg follicles.
   • Pregnyl, Ovidrel: Used for stimulating follicle for ovulation.
   • Gonadotropin releasing hormone: Proscribed for women ovulating prematurely.

   Treatments for men include:

   • Premature ejaculation or erectile dysfunction: Behavioral approaches or medications are prescribed for correcting such conditions.
   • Ejaculatory duct blockage: Extraction of sperm directly from testicles for injecting into eggs.
   • Varicocele: Surgical removal of varicose vein if present inside scrotum.
   • Retrograde ejaculation: Directly taking sperm from bladder and then injecting it inside an egg.
   • Epididymal blockage surgery: Surgically repairing blockage in epididymis.

8. What do you mean by the concept of artificial insemination?

   Commonly referred as intrauterine insemination (IUI), artificial insemination is a process wherein couples experiencing unexplained infertility are treated. The process utilizes donor's sperm or the husband's sperm if fertile. The sperm is then injected into women's vagina during ovulation. The sperm is first washed and treated before insertion. Some factors that may affect success rate of this process are:
   • Old age of women
   • Poor quality of egg
   • Poor quality of sperm
   • Endometriosis is severe state
   • Damaged fallopian tubes
   • Blockage in fallopian tubes

9. What is IVF or In Vitro Fertilization?

   IVF has been given this name as fertilization in this case occurs outside the body of a women. This fertilization takes place in lab dishes and not inside fallopian tubes of women. Drugs for ovulation stimulation are given to the woman for production of excess eggs. Theses eggs will then be removed surgically and fertilization will be done in lab dishes with the sperms. If fertilization occurs, embryos are transferred into uterus of the woman.

10. How is infertility linked to psychological issues?

    Infertility can have bad effects in married life and is distressing for the couple concerned. The very thought about not being able to conceive for long duration evokes feelings of significant loss. Moreover, coping with various medical decisions along with uncertainties associated with infertility, lead to emotional upheaval and trauma for couples. Couples are bound to experience depression, anxiety and feeling of isolation.