Infertility Testing

Causes of Infertility – Info from a Top Dubai Clinic

Infertility is a condition where couples are unable to conceive after six months or one year of unprotected and regular intercourse. Infertility affects about 6% of married women 15-44 years of age. Contrary to popular belief, infertility affects both men and women. Studies found that 7.5% of sexually active men reported seeing a fertility doctor during their lifetime, this equals 3.3-4.7million men.Infertility Sign

Infertility in men can be caused by multiple factors and can be evaluated using a semen analysis. The semen from the individual is evaluated for the concentration (amount), motility (movement), and morphology (shape). If the semen analysis is slightly abnormal, it does not always mean that the patient is infertile. Conditions that may contribute to an abnormal semen analysis includes:

  1. Varicoceles: the veins in the testicle is enlarged causing it to overheat which affects the number or shape of the sperm.
  2. Other medical conditions: Diabetes, trauma, infection or previous history of chemotherapy or radiation may affect the sperm.
  3. Habits: use of alcohol, smoking, steroid use or drug use can also affect the sperm
  4. Environmental toxins and exposure

For women, Infertility can be caused by any interruption to the process below:

  1. Ovulation: the process where the woman releases an egg from one of the ovaries. Some women do not ovulate due to:
    1. Polycystic ovarian syndrome (PCOS): a hormone imbalance interfering with ovulation
    2. Functional hypothalamic amenorrhea (FHA): absent period due to no physical or emotional stress
    3. Diminished ovarian reserve (DOR): ovary is unable to produce eggs due to surgical, medical or unexplained reasons. Number of eggs also decrease with age.
    4. Menopause: ovarian function declines due to age and eventually stops producing eggs.

2. Fertilization: A man’s sperm must meet the egg along the way. If the woman’s tube is blocked, fertilization cannot happen.

3. Travel: the fertilized egg must be able to go through the tube towards the uterus (womb).canstockphoto27582301

4. Implantation: after travelling to the womb, the fertilized egg must be able to attach to the inside of the uterus.

For women, age is one of the factors that contribute to infertility. In today’s world, many women are waiting until they are successful and stable enough in life to have a baby. This usually occurs in their 30s or 40s. 20% of women in the United States have their first child after the age of 35 years old.

Aging not only decreases fertility but also increases the chance of miscarriage and having a child with a genetic anomaly. With age, a woman’s ovaries are less able to release eggs. They also have less eggs (decreased reserve), less healthy eggs, more health conditions that may cause fertility problems and more likely to have a miscarriage. Coupled with today’s lifestyle, many women smoke, drink alcohol excessively, are either obese or underweight, and have stress that can contribute to infertility.

It is recommended that women below the age of 35 can try to conceive for 1 year and women above the age of 35 years old should see a doctor after 6 months of trying to conceive unsuccessfully. A woman’s chance of conceiving declines after the age of 30.

 

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Basics of Infertility Testing at a Top Dubai Fertility Clinic

Infertility tests at our Dubai fertility center are used to help find why a woman cannot get pregnant. These tests help the fertility specialist determine whether the problem is related to a male factor or female factor or both.

 

Should I be tested?

 

Many women use fertility awareness methods to find the best time to get pregnant. A woman is most fertile during ovulation and 1-2 days before ovulation occurs. A woman should keep a record of her menstrual cycle, including ovulation. Consider having testing for you or your partner if:

 

  • You are in your mid 30s or older, have not been using birth control for 6 months, and are not able to get pregnant.
  • There is a physical problem, such as no ovulation, not being able to ejaculate, or having irregular menstrual cycles.
  • You are in your 20s or early 30s, have not used birth control for 12 months or more, and cannot conceive.

 

Do fertility tests cost a lot?

 

Infertility tests are quite expensive, and they can be stressful. Before undergoing testing, talk with your partner about how much testing you are willing to do, and make a decision together regarding what you wish to spend.

 

What are the benefits of fertility tests?

 

Fertility tests can find exactly what is causing the problem, and you may be able to be treated during the tests. A blocked fallopian tube can be opened during a hysterosalpingogram. When tests do not uncover the cause of infertility, the fertility specialist may recommend assisted reproductive therapies that can help.

 

What tests are done first?

 

Both partners will undergo a comprehensive medical history, which involves questions about your sex life, history of sexually transmitted infections, medication use, substance/drug use, and birth control methods. The doctor will check the woman’s menstrual cycle also. The woman must also undergo a Pap test and pelvic examination. For men, the physical includes a testicular examination.

 

Both partners have certain hormonal tests including luteinizing hormone (LH) and progesterone levels. For women, LH is evaluated to see if a woman is ovulating, and for men it could show a pituitary problem. Thyroid function tests assess for gland dysfunction, and prolactin levels are checked. Prolactin is a hormone that helps regulate the woman’s menstrual cycle. For men, a semen analysis checks for the number of sperm (sperm count), the number of sperm that move normally (motility), and if the shape appears normal.

 

What tests are done if the initial testing does not find a cause?

 

For the woman, a pelvic ultrasound is used to check the structure and size of the uterus and ovaries. It is also used to check ovarian reserve, which is a woman’s egg supply. This involves counting the number of follicles in both ovaries during a certain time of the cycle. A hysterosalpingogram is a special x-ray that looks inside the uterus and fallopian tubes. This is used to assess for blockages and growths. Another procedure used for female infertility is the laparoscopy, which involves making a small incision so a scope can be inserted into the pelvic region.

 

For the man, a transrectal and scrotal ultrasound is used to assess for certain medical conditions, including retrograde ejaculation and ejaculatory duct obstruction. A testicular biopsy involves surgical removal of samples from the testicle using a needle. The result of this biopsy will tell if sperm production is normal. If it is, the man’s problem could be related to a blockage or other problem with sperm transport.

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