Infertility

Couples who have not conceived after twelve months of trying are considered to be subfertile. The reason for subfertility is found to be due to the male inn 40 percent of cases, 40 percent to the female, and in 20 percent in cases subfertility is found in both. In men, subfertility may be due to absence or insufficiency of sperm in the semen. Blockage of the ejaculatory ducts or inability to ejaculate. In women, the problem may be failure to ovulate, blockage of the tubes or a defect of the uterus. Also, there may be factors in the seminal fluid or in the cervical mucus which cause the sperm to lose their motility, and thus prevent them from reaching the ovum in the tube.

Investigations and treatments for subfertility are:

·        Analysis of the semen. If the sperm count is less than 20 million per milliliter, the cause may be sought and treated if possible.

·        Tests to see whether the woman is ovulating. These usually include keeping a basal body temperature chart, observing the cervical mucus, and measuring blood hormones.

·        Post-coital test. Some mucus is taken from a woman’s cervix within 2 hours of intercourse. If moving sperm are found in this mucus it is certain that there are healthy sperm in the semen, that the semen is being deposited in the right place, and that there is no incompatibility between the seminal fluid and the cervical mucus.

·        Tests to see whether or not the tubes are blocked. This may be done by X-Ray (hysterosalpingogram), or by laparoscopy or laparotomy. If a blockage is found it may be able to be corrected by surgery.

·        Sperm migration tests. The man’s semen is tested with the woman’s cervical mucus and donor cervical mucus to measure the progress of sperm through the mucus. If sperm movement is impeded in the partner’s mucus, the cause (such as antibodies, infection) can be sought and treated.

·        About 10-12 percent of couples are subfertile. For half of these couples the cause can be remedied. For those who remain infertile, possible options may be adoption, artificial insemination or in-vitro fertilization.