Causes of Infertility
On 26th April, 2018, Cloudnine hosted a live Tweetinar on Understanding Your Fertility Quotient on its Twitter handle @CloudnineCare. It was conducted by Dr. Vaishali Chaudhary, Fertility Specialist at Cloudnine Hospitals, Shivajinagar and Kalyaninagar, Pune. The Tweetinar earned wholehearted participation from Twitter users across the country and spotlighted a host of issues that commonly plague those affected by infertility.
Specialist Details: Dr. Vaishali Chaudhary
Clinical Focus and Expertise: In vitro fertilisation (IVF), intrauterine insemination (IUI), infertility evaluation, intracytoplasmic sperm injection (ICSI), preimplantation genetic diagnosis (PGD), egg donor programme, embryo donor programme, sperm donor programme, colonoscopy, unilateral salpingo-oophorectomy, dilation & curettage, fertility treatment, cosmetic labiaplasty, gynaecological problems
1. What is ‘fertility quotient’?
‘Fertility quotient’ refers to your chances of becoming pregnant naturally without any treatment.
2. Is there a link between stress and infertility?
Yes, there’s definitely a link between the two. Infertility is usually triggered by hormonal disturbances and stress is a big influencer.
3. Apart from low sperm count, what are the other possible causes of infertility in men?
Apart from count, the motility, morphology and quality of sperm also matter.
4. What tests are performed to determine one’s fertility quotient?
For women, a transvaginal ultrasound is performed to examine the number of eggs available. In addition, blood is drawn to evaluate the level of anti-mullerian hormone, a critical marker for ovarian reserve.
For men, a semen analysis is performed to help highlight the quality and motility of sperm.
5. What factors increase a woman’s risk of infertility?
Factors like irregular menstrual cycles and obesity affect fertility, especially in women 35 years or older. For those below 35, fertility issues are more likely to be resolved by following a healthy diet plan and a regular exercise regime.
6. Can being overweight influence infertility?
Being overweight can lead to polycystic ovarian syndrome (PCOS). In men, however, it can cause diabetes and lead to lower sperm count.
7. Is infertility treatable?
In 90% of cases, infertility is treatable. In the remaining 10% of cases, the underlying reasons for infertility remain unexplained.
8. How long should one attempt to conceive before turning to a fertility specialist?
At least 1 year if you’re less than 35 years of age. If you’re over 35, you should consult a specialist after 6 months of trying.
9. What factors should one consider in evaluating a fertility clinic?
The qualification of the doctor and the training they have received is of prime importance when choosing a fertility clinic. The clinic should have an in-house embryologist and counsellor. In addition, you should have a view of their success rates.
10. How does one determine which fertility treatment is most appropriate?
The right fertility treatment would depend on the results of your fertility tests. Your doctor would need to find out where the problem lies and accordingly identify the appropriate treatment option.
11. Does the concept of ‘fertility quotient’ apply to both men and women?
Yes, both men and women should keep their fertility quotient in mind while planning a pregnancy.
12. From what age should one’s fertility quotient be considered seriously?
Once you’re married, the sooner you seek your fertility quotient, the better. This will give you valuable insight into when you should start planning your family.
13. Should one’s fertility quotient be evaluated at the time of planning a family or after one year of unsuccessful conception?
It should be determined the moment you get married as it will help you decide when to start trying.
14. Infertility causes a huge psychological impact, especially on women. Should women seek professional therapy or counselling in such situations?
It’s extremely important to seek counselling through infertility. The in-house counselor at your fertility clinic would be the best person to consult in such a case.
15. Is it possible for a couple with a positive fertility quotient to still face fertility issues?
There are multiple tests that a couple must undergo before it is confirmed that the man or woman has fertility issues. It’s difficult to present a definitive diagnosis without comprehensive testing.
16. If one’s menstrual flow becomes lighter after the first pregnancy, is it an indicator of declining fertility for subsequent pregnancies?
If the flow is significantly lighter than before, a uterine infection may be the cause. However, a small decrease in menstrual flow shouldn’t be a concern.
17. What are the chances that my first IVF cycle will be successful? Is there a proven success rate?
IVF has a success rate of about 50%, but it is important to note that the chances of a positive outcome are dependent on a host of individual factors, most often tied to the specific problem at hand. Your doctor can make a suitable prediction of success based on your reports.
18. Many of my friends have faced fertility issues but I do not recall them using the term ‘fertility quotient’. Is this the first test patients are usually asked to take?
‘Fertility quotient’ is not a universal term used in fertility. On Cloudnine, it refers to a bouquet of basic tests performed to evaluate one’s fertility.
19. Do the chances of conceiving twins increase with IVF and age? Is there no way to control the number of embryos selected and transferred to reduce the odds of multiples?
The odds of twins increase during a fertility treatment because often, two embryos are transferred to increase the chances of conception. This can be controlled by waiting to transfer an embryo at the 5-day mark, when it has reached the blastocyst stage. To reduce the chances of twins, a single high-quality blastocyst is transferred.
20. Are there any specific vegetarian foods that can help promote fertility in men? Are these any different from those recommended for women?
There is no particular food that can promote fertility, but a healthy lifestyle can help enhance it to a certain extent.
21. Is it possible for a couple with a child to face fertility issues the second time around?
Secondary infertility is not very common but women over 35 are more susceptible to it.
22. On an average, what percentage of infertility cases are attributed to the male partner?
About 40% of infertility cases are attributed to the male partner.
23. What is a semen analysis?
It pertains to the examination of semen under a microscope, to determine the quality, motility and count of sperm.
24. What age is considered the upper threshold to conceive a child?
Fertility sees a sharp fall in women at 35. In men, on the other hand, there is no particular age that marks the decline of fertility, but sperm quality is known to reduce after 45.
25. Does the fertility quotient also consider one’s body weight?
No, it is composed of a single test each for men and women: a semen analysis and a transvaginal ultrasound respectively.
26. Does a previous case of miscarriage affect one’s fertility quotient?
A past miscarriage may shed light on the quality of your eggs. Most often however, a miscarriage happens due to some fault in the embryo.
27. Between smoking and alcohol, in your opinion, which is more harmful for the child and which of the two affects fertility in men and women more?
Smoking is harmful for both men and women. Even passive smoking can lead to complications during pregnancy.
28. With age, do the quality of eggs or frequency of ovulation decline?
The quality of eggs decreases with age.
Authored By: Dr. Vaishali Chaudhary Fertility Specialist, Cloudnine Hospitals