Infertility
One in six Cypriot couples will experience infertility.
Infertility is defined as the inability to achieve conception after a year of unprotected intercourse, or the inability to carry pregnancies to a live birth.
Infertility is shared equally among men and women, and in many cases a physical problem can be diagnosed. It is vitally important that infertility is viewed as a condition affecting the couple and the couple should always be consulted, investigated and managed together.
Most common causes of infertility
Lifestyle Factors
Obesity, cigarette smoking and marijuana consumption all have significant negative effects on both male and female fertility.
Advanced Age
Fertility decreases with age for both the female and male. The effect of increasing age is more dramatic for females with the average woman becoming unable to conceive using her own eggs after age 41.
Ovulation Problems
Related to hormone imbalance – eg polycystic ovary syndrome (PCOS), thyroid conditions, being under or over-weight.
Endometriosis
Severe endometriosis may distort the normal anatomy or block the tubes. Mild or moderate endometriosis may also reduce female fertility by affecting egg quality.
Tubal Factors
Blocked or damaged tubes. May be related to past pelvic infection, pelvic surgery or endometriosis.
Reduced numbers of normal sperm or reduced motility can be picked up on a semen test. Cigarette smoking and other lifestyle factors can damage the DNA inside the sperm.
In 10-20% of couples no cause will be found.
Investigations
Female Infertility Tests
- Blood tests – various tests to check your hormone levels etc.
- Ovulation test – You will need a blood test to check whether or not you are ovulating, or producing an egg every month.
- Ultrasound scan – An ultrasound scan checks the lining of your uterus (endometrium) and diagnoses any conditions that may be distorting the lining such as fibroids or polyps. Also assessment of your ovaries.
- Checking your fallopian tubes and uterus – Hysterosalpingogram – may be required to confirm the fallopian tubes are open
- Diagnostic – Laparoscopy and Hysteroscopy may be required
Male Infertility Tests
- Semen analysis – Semen analysis is the most important male infertility test. It is a simple test to undertake. It accurately measures the number of sperm, their motility (ability to move), their morphology (size and shape), and the volume and consistency of the ejaculated sample.
- Blood tests – various tests to check your hormone levels.
- At least 30% of infertility is due to a combination of male and female factors and up to 10% of infertility remains unexplained.
- Many couples suffering fertility problems can be successfully treated with medical or surgical techniques or by addressing lifestyle issues.
- The initial work-up for subfertility should be undertaken by a general gynaecologist who can investigate and manage many of the common problems.
- If initial treatments are not successful some couples may require more advanced fertility treatments such as IVF.