Infertility Is Not Rare Part 2 (continued)

11 September 2013

Investigation and Treatment Options

The investigation of infertility basically involves a couple. Both partners should attend the interview. In the history of the infertile couple questions relating to general health, medications, lifestyle and reproductive health are asked. Both partners are examined.

The investigations involve semen analysis for the male, perhaps an ultrasound and blood tests for things such as hormonal levels and infectious diseases. Apart from just counting and looking at sperm, other tests of sperm function may be done - such as determining the presence or absence of anti-sperm anti-bodies and trying to ascertain their fertilizing potential.

In women the female menstrual history is important. Investigations include evaluating the hormonal profile and testing if cycling is occurring. A tracking cycle may be carried out to see how good the cycle is. An ultrasound is often performed and the gold standard for tubal function and pelvic health is a diagnostic laparoscopy where they look into the pelvis with a camera and make sure no adhesions, endometriosis, or other abnormality is present.

Assisted Reproductive Techniques

Causes for the infertility can be found in a high proportion of couples. If there is a cervical problem or an ovulatory problem, or if the sperm do not swim well, an intra-uterine insemination can be performed. If ovulation is a problem, tablets or injections to induce ovulation may accompany this. Stimulation of the ovaries may also be combined simply with timed intercourse. If this is not successful after a variable number of tries the couple may proceed to more sophisticated and invasive techniques.

If there are problems such as tubal blockage and poor sperm numbers this treatment may be the first line. Injectable drugs stimulate multiple ovulation and the ova are collected through the vaginal wall by a needle connected to a suction device. The embryologist does some interesting things with the eggs and then sperm is added in a variety of ways. Later the resulting embryos are returned to the uterus. Embryos that have been produced over those required for the transfer can be frozen and then thawed and used for future cycles as required. The number of embryos to be transferred will vary according to the clinic and the age of the patient. The success rates of each treatment option will vary with the age of the woman, the clinic and the reason for the infertility.

In Summary...

Infertility is a common, devastating condition. It causes enormous heartache to those so effected. Treatment is often invasive and frequently stressful, time consuming and expensive. Time away from work is often considerable and there is a lot to be learnt in a short time frame for those going through investigation and treatment. If you are going through it, be gentle on yourself, have frequent breaks away from the clinic, and don't get caught on the merry-go-round of treatment. There is life, and a good one, away from the clinic.

Pace yourself, seek help if you need it. There is a time to seek treatment and equally there comes a time to stop it. This is a very personal issue but there are people who can discuss this with you and help you decide when this might be appropriate. Ask questions but remember they are sometimes unanswerable.

Dr Paul Stokes and his Sunshine Coast fertility specialist team consult with you to find the right solution dependent on your age, fertility needs and desired outcome.