Trying for baby? David Robertson, Medical Director of Bourn Hall Clinic answers your questions on fertility and pregnancy.
Q. I’ve been told I am infertile, but what is the cause?
Infertility is a disease, so no-one can be blamed for it any more than anyone is to blame for diabetes or leukemia. About one-third of infertility cases can be attributed to male factors, and about one-third to factors that affect women. For the remaining one-third of infertile couples, infertility is caused by a combination of problems in both partners or, in about 20 per cent of cases, is unexplained. In the Gulf region, among the local population, male factor problems are more common, probably accounting for more than half of cases that are seen. The reasons for this are not entirely clear but are probably largely genetic.
Q. What are the most common factors of infertility?
In men it’s azoospermia (no sperm cells are produced) and oligospermia (few sperm cells are produced). In females it’s an ovulation disorder, where eggs are not released from the ovaries on a regular basis. In the Gulf Region, this is common, and usually secondary to Polycystic Ovary Syndrome (PCOS), which has a number of effects on the body as a whole. Again, this is probably genetic.
Q. How is Infertility diagnosed?
Couples should seek medical help if they are unable to achieve pregnancy after a year of unprotected intercourse. The doctor will take a detailed history from both partners, and conduct a physical examination, to determine their general state of health and to evaluate physical disorders that may be causing infertility.
Q. My husband and I are struggling to have a baby, can infertility be treated?
In many cases it’s fairly simple – some couples might just need advice on timing, for example. Where there is a problem with ovulation, medication can usually correct this. This may need to be combined with attention to lifestyle factors. For example, infertility is certainly aggravated by obesity, particularly in women with polycystic ovaries, so attention to this will bring benefits.
Male factor infertility is less amenable to treatment. Unless there’s a hormone deficiency, drug treatment will not usually bring about any significant improvement. In this case, assisted reproduction treatment, such as in-vitro fertilization (IVF/ICSI) is necessary.
Q. I’m considering IVF, but what are the chances of success?
The likelihood of IVF working depends on a variety of factors, in particular, the woman’s age. The latest complete figures for the USA (2010) show that 47.6 per cent of women aged 35 and under, who had a full cycle of IVF treatment, got pregnant, and 41.5 per cent gave birth to a live baby. At age 40-44, those figures fall to 15.2 per cent and 8.7 per cent respectively. IVF treatment is more likely to be cancelled in older women, as they may not respond to the drugs given to stimulate egg production.
Q My doctor suggested IUI (artificial insemination) is this more or less effective than IVF?
If you want to try and speed the process, without too much intervention, IUI is a reasonable approach. It is only useful if the sperm is more or less normal (minor sperm problems are OK) and the woman’s tubes are open, so those things should be checked. You should also have blood taken for FSH,LH and AMH to make sure those are normal.
Q Is there anything I can do diet-wise to become more fertile?
Fertility is certainly linked to general health and well-being so anyone trying to conceive should pay attention to their diet and ensure that it is healthy – a balanced intake. Fresh fruit and vegetables are always a good source of vitamins and essential elements, and red meat is a source of iron. Smoking impairs both male and female fertility, as does alcohol: both should be avoided completely if at all possible. The effect of caffeine is less clear but some studies have shown that it can increase the length of time taken to conceive, so I normally advise couples to moderate their intake.
For more information on Bourn Hall Clinic, visit www.bournhall-clinic.ae