Infertility: General concepts
Infertility by definition means failure to conceive after one year of unprotected sexual intercourse. Nearly 60% of women conceive by six months of regular sexual intercourse and this figure raises to 85% by one year of time.
Of the couples who are not able to conceive even after one year of sexual intercourse, more than half will conceive with just advice and few precautions. The other half will require some form of assisted reproduction.
The single most important factor in determining fertility is the age of the female partner, with fertility reducing rapidly in women over 35 years of age. Factors that reduce the chance of a spontaneous conception include more than 3 years of trying to conceive,
low coital frequency and inappropriate timing of intercourse to ovulation, no previous pregnancy, smoking and a body mass index (BMI) outside the range 20-30 (weight (kg)/height (m)2) in the woman.Causes of Infertility are divided into male and female causes. Both the male and female partners are responsible for 1/3rd of the infertility and in the rest third both male and female causes are implicated.
Investigations for infertility are commenced after one year but it can be started early at six months if the women is over 35 yrs of age.
Now some general pre-conception advice:
If you or your partner smoke then quit smoking, smoking reduces the life and quantity of sperms. Smoking also impairs with the transport of ova through the fallopian tubes. Quitting smoking has been proven to enhance your chances of a pregnancy.
The same applies for alcohol and recreational drugs. Both depress the production and motility of sperms and affect the motility of fallopian tubes and uterine lining.
Men would be advised against wearing tight trousers and working in hot environments. Men should also avoid keeping their laptops for prolonged periods over their laps. This greatly increases the scrotal temperature and reduces sperm count.Apart from these measures you must also have frequent sexual intercourse, at least 2-3 times a week.
You should also start taking folic acid supplements and if you have not been vaccinated to German measles you should get yourself immunised.
Weight reduction also helps conceive by inducing ovulation. So if you are overweight then this should be an added motivation for you to lose weight.
With the help of pre-conception counselling and lifestyle measures nearly 50% of the couples presenting for infertility will conceive. Only about 4% of couples remain childless in spite of all efforts.
Do not be bogged down by the fact that you are unable to conceive. Maintain a positive attitude and remain cheerful. With hope and perseverance you can defeat infertility.
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