Three Main Causes of Infertility
A lack of fertility or concerns about a lack of fertility is something that worries a larger number of couples.
It has been shown that if a couple are having regular unprotected sexual intercourse, then there is an 80% chance of conception after 12 months and a 90% chance of conception after 18 months. It is therefore very common to wait for a year or more before investigating the couple who are trying to conceive.
Gynecology Department of Elaj Medical Centre in supervision of The Best Gynecologist in Ajman provides comprehensive services to help couples overcome the infertility problems.
There are three main causes of infertility. A woman needs to produce eggs regularly and at the right time of her menstrual cycle, the man needs to produce sperm of the right quality and quantity, and the two need to be able to meet and therefore the women’s Fallopian tubes need to be open and undamaged.
About 25% of infertility is due to a lack of eggs, about 25% is due to a problem with the sperm, about 25% is due to tubal problems and in the final 25% the reason for infertility is never discovered (so called unexplained infertility.
Ovulation
The vast majority of healthy women between the ages of 15 and 40 will ovulate regularly. A regular menstrual cycle, especially if it is approximately 28 days, gives a strong indication that the women is ovulating.
In addition, the mucus produced by the cervix is often very thin and runny at the time of ovulation and some women can detect this. Some women experience short but sharp pains in the pelvis at the time of ovulation, which is normal. Ovulation usually occurs 14 days before the first day of a period (therefore in a 28 day cycle it occurs 14 days after the first day of the period as well). A simple blood test measuring the progesterone level one week before a period is due is usually sufficient to confirm ovulation.
Alternatively, a series of ultrasound scans starting at the beginning of the cycle can show the progress of an egg being produced.
Male Factor
A man is expected to produce at least 20 million sperm per millilitre of semen. Those sperm need to be of good quality. A past history of surgery on the testes or certain infections such as mumps or orchiditis can cause a decrease in sperm production. A semen analysis involves collecting a sample of the ejaculate and analyzing it under the microscope.
Tubal Factors
A patient who has had previous surgery in the pelvis or previous infection in the pelvis, may be at risk of having damage to the Fallopian tubes. Damage to the Fallopian tubes can also be caused by endometriosis. There are two commonly used tests to investigate the patency of the Fallopian tubes. A hysterosalpingogram is an investigation done in the X-Ray department where a dye is inserted through the cervix and X-Rays are taken showing the progress of the dye up through the uterus and out through the Fallopian tubes.
An alternative investigation is to perform a laparoscopy, which is a minor operation done under general anaesthetic (see laparoscopy). Dye can be inserted through the cervix and into the uterus and tubes and can been seen spilling out of the ends of the tubes under direct vision through the laparoscopy.