Subfertility

What is subfertility?

The inability of a couple to get pregnant after a minimum period of one year of unprotected(without using any form of contraception) regular sexual intercourse,(minimum ¾ times per week) with due attention to the fertile period.

Causes of subfertility?

Male factors 40% and rising

Female factors 30%

No cause in either male or female 30-40%

Both male and female factors 40-60%

Conditions of male genital tract

Varicocele,undescended testes,vasectomy,reduced sperm quality and quantity(caused by smoking,alcohol,drugs),ejaculatory dysfunction.

Diseases of the female genital tract

Polycystic ovariandiseases,tubal diseases,endometriosis.

Coital problems

Pain(Dyspareunia) or muscle spasm(Vaginismus)during intercourse

Impotence(no erection or cannot sustain erection)

What can you do?

  • Maintain body weight within normal range.
  • Stop bad habits-smoking,heavy alcohol consumption,consuming other drugs.
  • Attention to hygiene specially around genital area.
  • Learn to mange stress-in family ,social and at work place.
  • Regular unprotected intercourse(without contraception)at least ¾ times per week,with attention to fertile period.

Things to remember when planning a pregnancy

  • The pregnancy should be wanted by both partners.
  • Make sure to take Rubella vaccination prior to getting pregnant.
  • Have regular unprotected sexual intercourse.
  • Awareness about the fertile period.
  • Control other diseases as much as possible.eg; diabetes,hypertension etc.
  • If there are any doubts talk to a health care professional(public health midwife,nurse,doctor).
  • Start folic acid.

 

What age is best to get pregnant?

Optimum age for a pregnancy is between 22-24 yhears.

Better complete the family befor 35 years.

When to seek help?

If there is no pregnancy after regular  intercourse.

For a woman less than 35years-seek help after  a 1 year.

For a woman over  35years-seek help after  a  period  of 6 months.

Management options for the couple?

First,both you and your partner will be examined by the doctor for possible abnormalities of the genital tract.

Then you and your partner will undergo a basic sets of investigations which includes,

Tests for male

Tests for female

01)Seminal fluid analysis-tests your semen quality and quantity.

01)Temperature chart-to check the ovulation.

02)Ultra sound scan of the genital tract.

02)Ulta sound scan of genital tract-check whether you have mature ova(egg cells),abnormality in the uterus.

03)Hormones tests-eg:testosterone.

03)Check patency of tube

        -HSG

        -Laparoscopy dye test

 

Management options

  • Medicines to induce ovulation-for women those who have defect in egg cell maturation.
  • IUI-intra uterine insemination(processed sperm will be deposited in your womb).
  • In vitro fertilization-(artificial fertilization of you partner/donors’ sperm with your/donors’ egg cells.
  • ICSI-intra cytoplasmic sperm injection(injection of sperms into an ovum/egg cell)
  • Egg donation.
  • Deposition of a fertilized egg in a womb of a willing women.
  • Sperm donation.

Where and by whom can you get help?

Subfertility clinics at Goverment Hospitals.

Subfertility clinics at the family health bureau(FHB).

Center for Family Health clinic at FPA Sri Lanka.

Specialist at a private hospitals.

Family doctor.