couple struggling with infertility

What is infertility? Your questions answered.

Infertility is a complex and often misunderstood issue that affects millions of individuals and couples worldwide. Despite its prevalence, many people are unaware of the various types and causes of infertility, as well as the treatment options available. In this comprehensive guide, we will explore the different aspects of infertility, debunk common misconceptions, and shed light on the diagnostic process and treatment options for both men and women.

From understanding the risk factors to navigating the emotional and financial challenges, our goal is to provide a valuable resource for those facing infertility or seeking to learn more about this sensitive topic.

What are the types of infertility?

The definition of infertility is the inability to conceive after trying for at least one year without success. It may be you or your partner that are infertile or it could be both of you. There are two main types of infertility: primary and secondary. Let’s have a look at what they mean.

Primary Infertility

Primary infertility refers to couples who have never fallen pregnant, despite having regular, unprotected intercourse for at least one year. This type of infertility can be attributed to various factors, such as medical conditions, lifestyle choices, genetic issues, or a combination of these elements.

Secondary Infertility

Secondary infertility occurs when a couple has previously conceived a child but is unable to conceive again after trying for at least one year. Secondary infertility can result from changes in either partner’s health, age-related fertility decline, or the development of new medical conditions or complications.

Both primary and secondary infertility can be further classified into male or female factor infertility, or unexplained infertility.

Male Factor Infertility

In this case, the infertility issue lies with the male partner. Causes can include low sperm count, poor sperm motility or morphology, or issues with sperm production due to genetic, health related, hormonal, or environmental factors.

Sperm morphology is the shape and structure of the sperm, and motility is the sperm’s ability to move.

Female Factor Infertility

Female factor infertility results from issues related to the woman’s reproductive system. Common causes include ovulation disorders, fallopian tube blockages, endometriosis, uterine abnormalities, or hormonal imbalances.

Unexplained Infertility

In some cases, despite thorough medical evaluation, no specific cause for infertility can be identified in either partner. This is referred to as unexplained infertility, which accounts for approximately 10-15% of all infertility cases.

Understanding the different types of infertility is crucial for couples seeking appropriate medical interventions and support to help them achieve their dream of parenthood.

Is infertility a common problem?

Infertility is a more common problem than many people realize. According to the World Health Organization (WHO), about 15% of couples worldwide experience infertility. In Australia, 1 in 6 couples in the reproductive age struggle with difficulty getting pregnant or carrying a pregnancy to term.

Infertility affects both men and women:

  • 40-50% of cases is male infertility
  • 40-50% of cases is female infertility
  • 10-15% cases is unexplained fertility

The high prevalence of infertility highlights the importance of raising awareness about this issue. Not only awareness and education of factors contributing to infertility, but also awareness and education on the impact of nutrition, lifestyle and environmental factors on infertility as well as treatment options available.

The stigma of infertility

Many people may feel embarrassed or ashamed they are struggling with infertility. For this reason, couples may want to hide this from their circle of friends, work colleagues and even family. They often struggle alone with the effects of infertility in their life. Infertility is a common problem, those struggling to conceive can feel less isolated and more empowered by seeking help by talking about it in their social circles as well as from fertility professionals.

Is infertility just a woman’s problem?

Infertility is not just a woman’s problem, as mentioned earlier, male infertility accounts for about 40-50% of infertility cases.

population study looking at men’s fertility found that those men that succeeded in fathering a child had:

  • greater than 48 million sperm per ml
  • a motility of more than 63%
  • a normal morphology of 12%

These are different parameters from what you will see on the sperm analysis results. Morphology, the shape of the sperm, is normal at 4% which is what is needed for a chance of IVF success. However, if you are trying to conceive naturally, research shows that sperm morphology needs to be over 12% normal. This is why the burden of fertility treatment often falls on the women. Their partners are told their sperm morphology is ok at 4%, whereas in actual fact, they need 12% or more.

The difference in these values is one of the reason why there is a misconception that infertility is solely a woman’s problem. It can lead to unnecessary blame and guilt, as well as delay proper diagnosis and treatment for both partners. It is essential for couples facing infertility to understand that it is a shared issue and seek appropriate medical evaluation and support for both individuals. Early intervention and a cooperative approach can significantly improve the chances of successful conception and a healthy pregnancy.

What causes infertility in women? (or people assigned female at birth)

There are several factors that can cause infertility in women, ranging from issues with the reproductive system to hormonal imbalances and lifestyle choices. Some of the common causes of female infertility include:

Lifestyle factors:

Lifestyle choices can make a dramatic impact to health and to infertility. Unhealthy habits like smoking, excessive alcohol consumption, drug use will affect fertility negatively. Other lifestyle factors poor nutrition can negatively impact fertility. Additionally, being significantly undernourished and over exercising can also affect hormone levels and the regularity of ovulation.

You will often read that being overweight is a factor in infertility. Many overweight women are shamed into believing their weight is preventing them from becoming pregnant. Women are being told their weight is the problem and to go and lose weight, rather than being investigated into why they are struggling with infertility, thus being denied care. It is this lack of care that is more of a factor than their weight.

High levels of stress and chronic stress can interfere with hormones required for ovulation and may contribute to irregular menstrual cycles or other fertility issues.

Ovulation disorders:

Problems with ovulation account for a significant portion of female infertility cases. Conditions such as Polycystic Ovary Syndrome (PCOS), hypothalamic dysfunction, and premature ovarian failure can disrupt or halt the release of eggs from the ovaries.

Fallopian tube blockages:

Blocked or damaged fallopian tubes can prevent sperm from reaching the egg or hinder the fertilized egg from traveling to the uterus. Causes of fallopian tube blockages can include pelvic inflammatory disease, endometriosis, or a history of abdominal surgeries.

Endometriosis:

Endometriosis is a condition where the tissue lining the uterus (endometrium) grows outside the uterus, often affecting the ovaries, fallopian tubes, and the pelvic cavity. This can cause scarring, adhesions, and inflammation, which can interfere with ovulation, fertilization, and implantation of the fertilized egg.

Uterine abnormalities:

Structural abnormalities in the uterus, such as fibroids, polyps, or a septate uterus, can affect implantation and the ability to carry a pregnancy to term.

Hormonal imbalances:

Disorders affecting hormone levels, such as thyroid dysfunction or hyperprolactinemia, can disrupt the menstrual cycle and impact fertility.

Age:

A woman’s fertility naturally declines with age, particularly after the age of 35. The quantity and quality of eggs decrease over time, which can make it more challenging to conceive and increasing the risk of miscarriage or chromosomal abnormalities. However women are fertile until menopause and while age does matter, women can still get pregnant after 40 years of age, naturally or with assisted reproductive technology.

Medical history:

Certain medical treatments, such as chemotherapy or radiation therapy, can cause damage to the reproductive system and impact fertility. A history of sexually transmitted infections (STIs) can also lead to complications like pelvic inflammatory disease, which may result in infertility.

Identifying and addressing the specific cause of infertility in women is crucial for determining the appropriate treatment options and improving the chances of successful conception and a healthy pregnancy.

How does age affect a woman’s ability to have children?

A woman’s age can significantly impact her ability to have children. As women age, the quantity and quality of eggs decrease, making it more challenging to conceive and increasing the risk of complications during pregnancy. Here are some notable ways that age affects a woman’s reproductive abilities:

Fertility: A woman’s fertility begins to decline naturally in her late 20s and early 30s and significantly accelerates in her mid-to-late 30s. By age 40, a woman’s fertility may be less than half of what it was in her 20s, which can make it more challenging to conceive naturally. There are herbal traditions that can improve the chances of pregnancy by improving the blood supply and nutrition to the ovaries. Women can fall pregnant in their forties and all the way up to menopause though statistically it does decline.

Miscarriage risk: Older women have a higher risk of miscarriage due to chromosomal abnormalities in the fetus, which become more common in older eggs. The risk of miscarriage increases dramatically after age 40.

Pregnancy complications: Advanced maternal age is a significant risk factor for pregnancy complications, including gestational diabetes, hypertension, premature birth, and complications during delivery.

Birth defects: The risk of chromosomal abnormalities such as Down syndrome increases as a woman’s age increases.

Infertility treatment success: Older women may also have a reduced chance of success with infertility treatments such as IVF, as the quality and quantity of eggs decrease over time.

A woman’s age is a critical factor in fertility and pregnancy outcomes. It is essential to talk to a healthcare provider about family planning and fertility options to maximize the chances of successful conception and a healthy pregnancy.

How is female infertility diagnosed?

How long should women try to get pregnant before calling their doctors?

In general, a woman under the age of 35 should try to conceive for a year before seeking medical attention if she is not able to become pregnant. However, women over the age of 35 should see a doctor after six months of trying without success. If the woman has any known risk factors for infertility, such as a history of sexually transmitted infections or endometriosis, it is recommended to consult a doctor earlier.

Furthermore, even if a couple is able to conceive, if they have three or more miscarriages, they should speak to their doctor about possible causes and interventions. It’s important to remember that infertility is a common problem affecting many couples, and seeking early medical intervention can increase the chances of successful conception.

Infertility treatment for women

Infertility treatment for women can vary based on the underlying cause of infertility, the age of the woman, and personal preferences. Some of the most common treatments are discussed below:

Ovulation Induction: Ovulation induction involves the use of fertility medications to regulate or stimulate ovulation. These medications work by encouraging the growth and release of eggs from the ovaries. Ovulation induction is typically recommended for women who are not ovulating regularly or have irregular menstrual cycles.

Intrauterine Insemination(IUI): IUI, also known as artificial insemination, involves the placement of concentrated, healthy sperm directly into the woman’s uterus around the time of ovulation. IUI is often used for women with ovulatory disorders, including those with unexplained infertility.

Assisted Reproductive Technology(ART): ART is a collective term used to describe various fertility treatments that involve handling eggs and sperm outside the body. The most commonly used ART procedure is in vitro fertilization(IVF). During IVF, eggs are removed from the woman’s ovaries, fertilized with sperm in a laboratory, and then transferred back into the uterus.

Surgery: In some cases, surgery may be necessary to correct structural issues in the reproductive system that are preventing pregnancy. Common surgeries for women include laparoscopic surgery to remove endometriosis, uterine fibroids, or tubal ligation reversal.

Donor Eggs or Sperm: Women with low ovarian reserve or other conditions that adversely affect the quality of their eggs, may benefit from using donor eggs during IVF. Similarly, couples with male factor infertility may benefit from using donor sperm.

Gestational Carrier: Women who are unable to carry a pregnancy to term due to various medical reasons, such as a hysterectomy or uterine abnormalities, may benefit from working with a gestational carrier. A gestational carrier is a woman who carries a pregnancy for someone else.

The best approach to infertility treatment for women depends on many factors, including the cause of infertility, age, and personal preferences. It is essential to work closely with a fertility specialist to determine the most appropriate treatment that maximizes the chances of successful conception and a healthy pregnancy.

Male infertility

What causes infertility in men?

Infertility in men can be caused by various factors that affect sperm production, function, and delivery. Some of the common causes of male infertility include:

Sperm production issues: Problems with sperm production can result from genetic factors, hormonal imbalances, or medical conditions such as varicocele (an enlargement of the veins within the scrotum), undescended testicles, or infections that affect the reproductive system.

Sperm quality: Even if sperm production is normal, issues with sperm quality, such as low sperm count (oligospermia), poor sperm motility (asthenospermia), or abnormal sperm morphology (teratospermia), can hinder the ability to fertilize an egg.

Obstruction or blockages: Blockages in the male reproductive tract, such as those caused by congenital abnormalities, infections, or previous surgeries, can prevent sperm from being effectively delivered during ejaculation.

Erectile dysfunction and ejaculation issues: Conditions like erectile dysfunction, premature ejaculation, or retrograde ejaculation (where semen enters the bladder instead of exiting through the penis) can negatively impact fertility by interfering with the successful delivery of sperm.

Hormonal imbalances: Imbalances in hormones, such as testosterone, luteinizing hormone (LH), or follicle-stimulating hormone (FSH), can disrupt sperm production and contribute to infertility.

Lifestyle factors: Unhealthy habits like smoking, excessive alcohol consumption, drug use, high levels of stress, and poor nutrition can negatively impact sperm quality and overall fertility. Obesity has also been linked to reduced sperm quality and an increased risk of infertility.

Environmental factors: Exposure to environmental toxins, such as pesticides, heavy metals, and radiation, can adversely affect sperm production and quality. Prolonged exposure to heat, like that experienced by frequent users of hot tubs or saunas, can also temporarily reduce sperm count.

Medical history and treatments: Certain medical treatments, such as chemotherapy or radiation therapy, can cause damage to the reproductive system and impact fertility. A history of sexually transmitted infections (STIs) can also lead to complications that affect sperm production or delivery.

Identifying and addressing the specific cause of male infertility is crucial for determining the appropriate treatment options and improving the chances of successful conception.

What increases a man’s risk of infertility?

Several factors can increase a man’s risk of infertility by affecting sperm production, quality, or delivery. Some common risk factors include:

Age: While men can remain fertile for a more extended period than women, fertility in men gradually declines with age, particularly after the age of 40. This decline is attributed to reduced sperm quality and motility, as well as an increased risk of genetic abnormalities.

Lifestyle factors: Unhealthy habits like smoking, excessive alcohol consumption, drug use, and poor nutrition can negatively impact sperm quality and overall fertility. In particular, tobacco use has been linked to lower sperm count and motility, while excessive alcohol consumption can lead to hormonal imbalances that affect sperm production.

Obesity: Being significantly overweight can impact male fertility by altering hormone levels, reducing sperm count and motility, and increasing the risk of erectile dysfunction.

Stress: Chronic stress can interfere with hormones required for sperm production and may contribute to erectile dysfunction or premature ejaculation.

Environmental factors: Exposure to environmental toxins, such as pesticides, heavy metals, and radiation, can adversely affect sperm production and quality. Prolonged exposure to heat, like that experienced by frequent users of hot tubs or saunas, can also temporarily reduce sperm count.

Medical history: A history of infections, such as sexually transmitted infections (STIs) or mumps, can lead to complications that affect sperm production or delivery. Previous surgeries on the male reproductive tract, such as vasectomy reversal or hernia repair, can also increase the risk of infertility.

Hormonal imbalances: Conditions that affect hormone levels, such as hypogonadism (low testosterone) or hyperprolactinemia (high prolactin), can disrupt sperm production and contribute to infertility.

Genetic factors: Certain genetic conditions, such as Klinefelter syndrome, Y chromosome microdeletions, or cystic fibrosis, can impact sperm production and increase the risk of infertility.

Understanding and addressing these risk factors can help men improve their fertility and increase the chances of successful conception. In some cases, lifestyle changes or medical interventions may be necessary to mitigate the impact of these factors on fertility.

How is male infertility diagnosed?

Diagnosing male infertility involves a thorough evaluation of medical history, physical examination, and various tests to identify the underlying cause of fertility issues. The diagnostic process typically includes the following steps:

Medical history: The doctor will begin by discussing the patient’s medical history, including any pre-existing health conditions, surgeries, medications, family history of genetic disorders, and lifestyle habits that may impact fertility.

Physical examination: A comprehensive physical examination will be conducted to check for any visible abnormalities, such as varicoceles or undescended testicles, which could affect fertility. The doctor will also look for signs of hormonal imbalances, infection, or other health issues.

Semen analysis: This is the primary test for evaluating male fertility. The patient will be asked to provide a semen sample, which will be analyzed to assess sperm count, motility, morphology, and overall semen quality. In some cases, multiple samples may be required to obtain accurate results.

Hormone testing: Blood tests to measure hormone levels, such as testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin, can help determine if hormonal imbalances are contributing to infertility.

Genetic testing: If there is a suspected genetic cause for infertility, such as Klinefelter syndrome or Y chromosome microdeletions, genetic testing may be recommended to confirm the diagnosis.

Imaging studies: In some cases, imaging tests like ultrasound, magnetic resonance imaging (MRI), or a transrectal ultrasound may be performed to assess the reproductive tract’s structure and identify any blockages or abnormalities.

Testicular biopsy: In rare cases, a small tissue sample may be taken from the testicles to evaluate sperm production directly. This test is typically reserved for situations where the semen analysis shows no sperm (azoospermia) or when other tests have not identified a clear cause for infertility.

Specialized sperm function tests: Additional tests, such as sperm penetration assay, anti-sperm antibody testing, or reactive oxygen species (ROS) assessment, may be conducted in specific situations to further evaluate sperm function and fertility potential.

Once the diagnostic process is complete, the doctor will discuss the results and recommend appropriate treatment options based on the identified cause of infertility. Early diagnosis and intervention can significantly improve the chances of successful conception and a healthy pregnancy.

Infertility treatment for men

Infertility treatment for men depends on the underlying cause of the fertility issue and may involve a combination of medical interventions, lifestyle changes, and assisted reproductive technology (ART). Some common treatment options for male infertility include:

Medications: Hormonal imbalances or certain infections can be treated with medications to normalize hormone levels or clear the infection, potentially improving sperm production and overall fertility.

Varicocele repair: Varicoceles, which are enlarged veins in the scrotum, can negatively impact sperm quality and production. Surgical repair of varicoceles can improve blood flow, reduce swelling, and enhance fertility.

Lifestyle modifications: Addressing unhealthy habits like smoking, excessive alcohol consumption, drug use, and poor nutrition can significantly improve sperm quality and overall fertility. Maintaining a healthy weight, managing stress, and staying physically active can also contribute to better reproductive health.

Assisted reproductive technology (ART): In cases where natural conception is not possible or has been unsuccessful, ART can offer alternative methods for achieving pregnancy. Some common ART options for male infertility include:

Intrauterine insemination (IUI): Sperm is collected, washed, and directly inserted into the woman’s uterus during ovulation. This procedure bypasses the cervix, making it easier for sperm to reach and fertilize the egg.

In vitro fertilization (IVF): Eggs are retrieved from the female partner, fertilized with sperm in a laboratory, and the resulting embryos are transferred back into the woman’s uterus. IVF can be particularly helpful when there are issues with sperm function or delivery.

Intracytoplasmic sperm injection (ICSI): During this IVF variation, a single sperm is directly injected into an egg to achieve fertilization. ICSI is often used when sperm count, motility, or morphology are significantly impaired.

Surgical sperm retrieval: In cases of azoospermia (absence of sperm in the ejaculate) due to blockages or issues with sperm production, surgical methods such as testicular sperm extraction (TESE) or microsurgical epididymal sperm aspiration (MESA) can be used to obtain sperm directly from the testicles or epididymis. The retrieved sperm can then be used in ART procedures like IVF or ICSI.

Treatment for erectile dysfunction or ejaculation issues: Medications, therapy, or assistive devices may be recommended to address erectile dysfunction or premature ejaculation, improving the chances of natural conception.

Counselling and emotional support: Fertility struggles can take a significant emotional toll on individuals and couples. Seeking counseling or joining support groups can provide valuable coping strategies and help navigate the psychological challenges associated with infertility.

It is essential to work closely with a healthcare professional to determine the most appropriate treatment options based on the specific cause of male infertility. With the right approach and timely intervention, many men can improve their fertility and achieve successful conception.

How will doctors find out if a woman and her partner have fertility problems?

Doctors typically begin by conducting a thorough medical history and physical exam of both partners. They may ask about menstrual cycles, sexual history, lifestyle factors, and any previous pregnancies. For men, a semen analysis will be performed to assess sperm count, motility, and morphology.

Women may undergo a series of tests to evaluate ovulation, including basal body temperature monitoring, ovulation predictor kits, and hormonal blood tests. A transvaginal ultrasound may also be performed to evaluate the ovaries and uterus.

Additional tests may be ordered based on the initial evaluation’s findings, such as:

Hysterosalpingogram (HSG) – An X-ray test that evaluates the uterus and fallopian tubes for blockages or abnormalities.

Laparoscopy – A surgical procedure in which a small camera is inserted through the belly button to evaluate the reproductive organs for signs of infection, scarring, or other abnormalities.

Blood tests – To assess hormone levels, including thyroid function, prolactin levels, and anti-Mullerian hormone (AMH).

Genetic testing – To assess for genetic conditions that may be impacting fertility.

The diagnostic process may differ depending on the individual case, but a combination of tests can typically help doctors identify the cause or causes of infertility and develop an appropriate treatment plan.

How do doctors treat infertility?

Infertility treatment depends on the underlying cause, the duration of infertility, and the age and preferences of the couple. Treatment options can range from lifestyle changes and medications to surgical interventions and assisted reproductive technology (ART). Here is an overview of common infertility treatments:

Lifestyle modifications: Adopting healthier habits, such as maintaining a balanced diet, exercising regularly, quitting smoking, reducing alcohol consumption, and managing stress, can improve fertility for both men and women.

Medications: Fertility drugs can be prescribed to help stimulate ovulation in women or regulate hormone levels in both men and women, depending on the specific cause of infertility.

Surgery: In some cases, surgical intervention may be necessary to address issues like blocked fallopian tubes, endometriosis, uterine abnormalities, or varicoceles in men. Surgery can improve the chances of natural conception by correcting anatomical problems or removing obstructions.

Intrauterine insemination (IUI): IUI involves collecting sperm, washing and concentrating it, and then directly inserting it into the woman’s uterus during ovulation. This procedure can be especially helpful for couples with mild male factor infertility or unexplained infertility.

Assisted reproductive technology (ART): ART refers to advanced fertility treatments that involve handling both eggs and sperm outside the body. The most common form of ART is in vitro fertilization (IVF), where eggs are retrieved from a woman’s ovaries, fertilized with sperm in a laboratory, and then transferred back into the uterus. Other ART techniques include intracytoplasmic sperm injection (ICSI), preimplantation genetic testing (PGT), and the use of donor eggs or sperm.

Donor sperm, eggs, or embryos: In cases where a couple is unable to conceive using their own gametes due to severe male or female factor infertility, they may choose to use donor sperm, eggs, or embryos to achieve pregnancy through IUI or IVF.

Gestational carrier or surrogacy: If a woman is unable to carry a pregnancy to term due to uterine issues or other medical conditions, a couple may choose to work with a gestational carrier, who will carry the pregnancy on their behalf.

Adoption or foster care: For some couples, adoption or foster care may be a preferred option for building their family when fertility treatments are unsuccessful or not desired.

The most appropriate infertility treatment depends on the unique circumstances of each individual or couple. It is essential to work closely with fertility specialists to determine the best course of action based on the specific cause of infertility and personal preferences.

What are common fertility treatments?

Common fertility treatments aim to address the underlying causes of infertility and improve the chances of conception. These treatments can range from medications and lifestyle changes to surgical interventions and assisted reproductive technology (ART). Some common fertility treatments include:

Fertility medications: These drugs help stimulate ovulation in women or regulate hormone levels in both men and women, depending on the specific cause of infertility. Common medications include clomiphene citrate, letrozole, gonadotropins, and metformin.

Intrauterine insemination (IUI): IUI involves collecting sperm, washing and concentrating it, and then directly inserting it into the woman’s uterus during ovulation. This procedure can be helpful for couples with mild male factor infertility, unexplained infertility, or when using donor sperm.

Surgery: Surgical intervention may be necessary to address issues like blocked fallopian tubes, endometriosis, uterine abnormalities, or varicoceles in men. Surgery can improve the chances of natural conception by correcting anatomical problems or removing obstructions.

In vitro fertilization (IVF): IVF is the most common form of assisted reproductive technology (ART). Eggs are retrieved from a woman’s ovaries, fertilized with sperm in a laboratory, and then transferred back into the uterus. IVF can be particularly helpful when there are issues with sperm function or delivery, tubal factor infertility, or severe endometriosis.

Intracytoplasmic sperm injection (ICSI): During this IVF variation, a single sperm is directly injected into an egg to achieve fertilization. ICSI is often used when sperm count, motility, or morphology are significantly impaired.

Preimplantation genetic testing (PGT): PGT involves screening embryos created through IVF for genetic abnormalities before transferring them to the uterus. This treatment can be beneficial for couples with a history of genetic disorders or recurrent miscarriages.

Donor sperm, eggs, or embryos: For couples unable to conceive using their own gametes due to severe male or female factor infertility, donor sperm, eggs, or embryos can be used to achieve pregnancy through IUI or IVF.

Gestational carrier or surrogacy: If a woman is unable to carry a pregnancy to term due to uterine issues or other medical conditions, a couple may choose to work with a gestational carrier, who will carry the pregnancy on their behalf.

The most appropriate fertility treatment depends on the unique circumstances of each individual or couple. It is essential to work closely with fertility specialists to determine the best course of action based on the specific cause of infertility and personal preferences.

What medicines are used to treat infertility in women?

There are various types of medication that may be used to treat infertility in women, depending on the underlying cause of infertility. Here are some of the most commonly used fertility medications:

1. Clomiphene Citrate: Clomiphene Citrate is one of the most popular medications for treating infertility in women. It works by stimulating the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland, which in turn stimulates ovulation.

2. Gonadotropins: Gonadotropins are hormone medications that stimulate the ovaries to produce eggs. They are often used in combination with other medications to enhance the chances of pregnancy. Common Gonadotropins include follicle-stimulating hormone (FSH) and luteinizing hormone (LH).

3. Metformin: Metformin is a medication that is commonly used to treat polycystic ovary syndrome (PCOS). It helps to regulate insulin levels, which can improve ovulation and enhance the chances of pregnancy.

4. Letrozole: Letrozole is another medication that is commonly used to induce ovulation in women with ovulation disorders. It works by inhibiting estrogen production, which stimulates the release of FSH and LH hormones, leading to ovulation.

5. Bromocriptine: Bromocriptine is a medication that is used to treat high levels of prolactin in the blood. Prolactin is a hormone that stimulates milk production, but elevated levels can suppress ovulation.

6. Human Chorionic Gonadotropin (HCG): HCG is a hormone that is produced by the developing placenta during pregnancy. It is commonly used in combination with other fertility medications to trigger ovulation and enhance the chances of pregnancy.

It’s important to note that fertility medication should only be used under the guidance of a fertility specialist, who can tailor the medication regimen to the individual needs of the patient.

What are the different types of assisted reproductive technology (ART)?

Assisted reproductive technology (ART) refers to fertility treatments that involve handling eggs, sperm, and embryos outside of the body. There are several types of ART, including:

1. In vitro fertilization (IVF): IVF is the most common type of ART. It involves fertilizing an egg with sperm in a laboratory dish, then transferring the resulting embryo to the uterus. IVF is often used in cases of male factor infertility, tubal factor infertility, or endometriosis.

2. Intracytoplasmic sperm injection (ICSI): ICSI is a variant of IVF, in which a single sperm is injected directly into an egg. ICSI is typically used in cases of male factor infertility, where the sperm may have difficulty penetrating the egg.

3. Blastocyst transfer: Blastocyst transfer involves transferring embryos that have been cultured longer in the laboratory to a woman’s uterus. This allows the selection of embryos with better-developed blastocysts for transfer.

4. Preimplantation genetic testing (PGT): PGT involves screening embryos for genetic abnormalities before transferring them to the uterus. This can help identify embryos that may have chromosomal abnormalities, which may increase the chances of having a healthy pregnancy.

5. Frozen embryo transfer (FET): FET involves thawing and transferring previously frozen embryos to the uterus. The embryos may have been created during a previous IVF cycle, allowing couples to try again without going through the entire IVF process.

6. Donor eggs or sperm: In cases of severe male or female infertility where pregnancy may not be possible with the individual’s own gametes, donor eggs or sperm can be used in conjunction with IVF.

7. Surrogacy or gestational carrier: Surrogacy or gestational carrier involves using a third party to carry a pregnancy on behalf of the intended parents. In gestational surrogacy, the embryo is created using IVF, and the surrogate or carrier has no genetic relation to the child.

ART can be an effective treatment for infertility in many cases. However, it’s important to discuss all options and potential risks with a fertility specialist before deciding on a course of action.

Can birth control cause infertility?

No, using birth control does not cause infertility. Birth control methods such as the pill, patch, or IUD work by preventing pregnancy, but they do not damage your reproductive system or negatively impact your fertility in the long run. In fact, birth control can actually help preserve fertility by regulating menstrual cycles and preventing conditions such as endometriosis or uterine fibroids, which can negatively impact fertility. However, it’s important to note that it may take some time for fertility to return to normal after discontinuing birth control methods, as it can take some time for ovulation to resume. In most cases, fertility returns within a few months to a year after stopping birth control.

What can you do?

While you can often feel a sense of disempowerment and lack of control with fertility treatment, there is actually a lot you can do.

This article covers the conventional view of infertility, what is not covered here is the holistic approach to fertility, which includes Chinese medicine, yoga, and self care that has gained popularity in recent years due to its success in helping both natural conception and assisted reproductive conception. A great place to start is in our fertility courses.

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