Infertility means that a couple is unable to become pregnant after at least one year of regular sexual intercourse without contraception.

Infertility may be caused by factors related to the man or the woman or both of them.
Frequently Found Factors in Women
  • Problems with hormones that affect ovulation.
  • Fallopian tube blockage or damage caused by pelvic inflammatory disease, endometriosis, or surgery of the pelvis.
  • Problems with the uterus.
  • Problems with the cervix, preventing sperm from traveling into the uterus.
  • Premature menopause.
Frequently Found Factors in Men
  • Problems with sperm production and/or motility.
  • Blockage of the vas deferens.
  • Impotence, decreased libido, or inability to ejaculate.
  • Genetic disorders that affect sperm production.
  • Varicoceles, affecting sperm quality.
  • Diseases that affect reproduction, such as liver disease or infection of the reproductive system (prostate infection).
  • Problems with hormones.
Both the man and woman must be tested at the same time. The process begins with a thorough medical history and a general health screening.
  • Hormone levels and genetic screening.
  • Ultrasound of the uterus and ovaries.
  • Endoscopy of the uterine cavity.
  • Hysterosalpingography (x-ray of the uterus and Fallopian tubes after dye is administered).
  • Sperm quality analysis.
  • Ultrasound of the testicles and blood vessels.
  • Endoscopy of abdomen and testicles.
Treatment for infertility depends on its cause. The doctor’s goal will be to restore fertility and/or help achieve pregnancy as naturally as possible. This may mean medication to stimulate function of the testicles, tests to discover any hormonal issues that might affect the function of the ovaries, or even surgery to remove uterine growths/fibroids. However, even after the cause of infertility is treated, some couples may still struggle to conceive and may require technology to become pregnant. Currently, the two main techniques are:
  1. Intrauterine insemination (IUI), which involves stimulating the ovaries to produce more eggs than usual and then inserting a sperm sample (that has been processed in the laboratory) directly into the uterus. This is an option for couples with fairly uncomplicated issues and the procedure takes approximately two weeks from start to finish.
  2. In vitro fertilization (IVF) involves an egg being fertilized by sperm outside a woman’s body in a laboratory. The fertilized egg (embryo) is then implanted into a woman’s uterus to cause pregnancy. It is an option in the case of blocked Fallopian tubes, a large number of uterine fibroids, chronic anovulation, and problems with sperm production and function.  The process takes approximately four weeks.
        In the case that no sperm is found in semen, the doctor may recommend extracting sperm directly from the testicles for treatment or diagnosis. The semen sample will be frozen to be used for infertility treatment later on.
  1. Testicular epididymal sperm extraction (TESE) involves surgically removing testicular tissue and cutting it down to remove sperm from the tissue.
  2. Percutaneous epididymal sperm aspiration (PESA) involves administering a needle into the vas deferens through the testicle to extract sperm directly.
  3. Microsurgical epididymal sperm aspiration (MESA) involves passing a needle through the scrotum and into the epididymis and epididymal fluid, along with sperm, is aspirated.

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