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How common is infertility?

At least one quarter of couples experience a period of infertility (inability to get pregnant) at some stage during their relationship. Some of these couples continue to be unable to conceive, leading to at least 1 in 6 couples being referred to a Gynaecologist for further investigations.

Psychosexual Problems
It is important to remember that you must have regular sexual intercourse to increase your chances of getting pregnant. Some couples have ‘psychosexual’ problems (inability to have penetrative sex due to a psychological condition). This may manifest for women as pain during intercourse or loss of interest in sex. In men it may cause problems with erection or ejaculation. These problems don’t just cause problems with fertility but can also have a major impact on your day to day relationship. Dr Orla Conlon, at Marble Arch Private Healthcare, holds a Diploma in Psychosexual Medicine & is a specialist in this field. Please contact us for further information and counselling as this needs to be rectified before further investigations for infertility are carried out.

At Marble Arch Private Healthcare we acknowledge the emotional anxiety infertility brings to both of you and strive to provide a sympathetic yet informative service in a private, confidential setting.
Causes of Infertility
For a baby to be conceived there needs to be an egg produced from the ovary, sperm produced to fertilise the egg and the ability for the sperm and egg to meet. Infertility is caused by several different factors. The loosely break down to female, male and unexplained each responsible for approximately one third of causes.

Female Factor Infertility
Again there are several reasons for this:
  • Endometriosis
  • Pelvic Inflammatory Disease, this can cause damage to the fallopian tubes to prevent the egg meeting the sperm
  • Polycystic Ovarian Syndrome (PCOS) affects egg production
  • Psychological stress, anxiety, bereavement may affect egg production
  • Extremes of weight: anorexia & obesity may also affect egg production
  • Fibroids
  • Premature menopause
  • Age
Male Factor Infertility
If you have a low sperm count this does not mean that you cannot father a child it may mean though that it will take a slightly longer time or you may need further investigations or treatment. The causes of male factor infertility include:
  • Genetic / medical conditions.
  • Previous trauma or surgery to the scrotum; this can cause anti sperm antibodies that can damage the sperm.
  • Wearing tight clothing to the scrotum or working in high temperatures.
  • Working with chemicals or dyes to affect the development of sperm.
  • Caffeine; lots of coffee, coke, other high caffeine drinks can affect sperm count.
  • Alcohol: binge drinking can also reduce sperm count.
  • Premature menopause.
  • Smoking.
Unexplained Infertility
  • This is when all investigations do not find a reason. It may be due to factors which as yet have not been discovered
At Marble Arch Private Healthcare we acknowledge the emotional anxiety infertility brings to both of you and strive to provide a sympathetic yet informative service in a private, confidential setting.

What should we do if we have been trying to get pregnant for more than one year?
A year is the average time it takes for a couple to conceive. If however you have been trying for longer, you need to see your GP or you can attend Marble Arch Private Healthcare for further investigation

What questions will I be asked when I see the Doctor?

Female
  • Age.
  • Your menstrual cycle, if it comes every month.
  • Previous pregnancies, miscarriages or ectopic pregnancies.
  • If this is the same partner as with your last pregnancy.
  • Are you taking any medication.
  • Do you suffer from any gynaecological conditions; endometriosis, polycystic ovaries, fibroids.
  • Have you had any pelvic infections in the past, particularly Chlamydia.
  • Have you lost a lot of weight recently or are you under a lot of stress.
Male
  • Do you suffer from any genetic or chronic diseases, particularly lung disease (cystic fibrosis)
  • Have you had a vasectomy (male sterilisation), surgery or trauma to the scrotum
  • Do you work in very high temperatures
  • Do you work with chemicals or dyes
  • Do you drink a lot of caffeine drinks / alcohol
  • Do you smoke
Investigations
Female
Tubal Patency Test
This is where dye is injected through the neck of the womb, it then goes into the womb and should spill out the ends of the tubes. If the tubes are blocked the dye will not spill out the ends of the tubes. This test can be done by a Gynaecologist in the X-ray Department without anaesthetic and is no more uncomfortable than having a smear test done. It can also be done by a Gynaecologist at Laparoscopy (keyhole surgery) under general anaesthetic if you need further investigation of your pelvis for example if you suffer a lot of pelvic pain. It is best to do this procedure during the first few days of your period, so that afterwards you can still try to get pregnant that month.
Tubes can just be a little bit sticky and this test alone by flushing the tubes can be enough to help you get pregnant.

Ovulation Tests
This is a blood test to determine whether you have produced an egg. It is usually done 7 days after the middle of your cycle i.e. Day 21 of a 28 Day cycle. It has been used in the past, the value of this test is now questionable, but it may be offered in some centres.

Male
You will be asked to give a sample of your sperm for a test called ‘semen analysis’. After producing the sperm test by ejaculation, you will be asked to bring this to the lab as soon as possible as a time delay can affect the result. You will also be asked to keep the sample at a constant temperature as this too can change the result. A semen analysis looks at several aspects of the sperm. These include the sperm count; actual number of sperm, the percentage of sperm that is ‘normal’ , the percentage of mobile sperm i.e. those that can ‘swim’ up the tubes to meet the egg, and whether there are any anti sperm antibodies that can damage the sperm, this can be due to trauma or surgery to the scrotum.

Treatment

Female
If you have endometriosis you may require medication or surgery. (See Endometriosis)
If you have tubal problems or have had your tubes removed e.g. due to ectopic pregnancy you will probably need Invitrofertilisation (IVF).
If you have Polycystic Ovarian Syndrome you may need to take medication to help stimulate your ovaries to produce and egg. This is called Ovulation Induction. (See Polycystic Ovarian Syndrome)

Male
If you have an abnormality of your sperm you may need to have Intracytoplasmic Sperm Injection (ICSI). This is where the sperm is surgically collected from your testes and injected directly into the centre your partners egg. This will form an embryo which will then be placed into your partner’s womb in the same was as in IVF treatment.

What is IVF?

This is a procedure where the sperm fertilises the egg outside of the womb. The woman is given medication to stimulate her ovaries to produce eggs (Ovulation Induction). These eggs are removed while the woman is given some medication to make her feel more comfortable. The male partner then produces a semen sample which is processed and placed in an incubator with the eggs. If the sperm fertilises the egg and embryo is formed. This embryo is then placed back in the womb.

What happens if I have ‘Unexplained Infertility'?

There is another treatment available to you. This is called Intrauterine Insemination (IUI). This is when the woman is given medication to stimulate her ovaries to produce an egg (Ovulation Induction). Her male partner is then asked to produce a semen sample which is processed. The semen sample is then placed through the neck of the womb via a narrow tube into the womb. This brings the sperm closer to the egg to increase the chances of fertilisation. This procedure should not be any more painful than having a cervical smear test done.

Tips for Planning a Pregnancy

There are several steps you should take to increase your chances of becoming pregnant and to reduce the risks of your baby.
  • Eat a healthy diet & take plenty of exercise; women who are overweight find it more difficult to conceive and have increased health risks during pregnancy.
  • Stop smoking and reduce your alcohol intake.
  • Take folic acid tablets while you are trying to get pregnant: 400mcg per day, if you suffer from epilepsy 5mg per day throughout pregnancy.
  • If you are due a cervical smear, have this done first as it is best to treat abnormal cells before you get pregnant.
  • Have your rubella status checked: this is to make sure you are immune to German measles (Rubella). This is in the form of a simple blood test. This can be done by your GP or at Marble Arch Private Healthcare.
If you have any queries do not hesitate to contact us:

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