Sishu Fertility Clinic

Doctor explaining about infertility to a girls

What is Infertility? Causes Of Infertility and Treatments

Infertility is the failure to have offspring/child despite having regular, unprotected sexual intercourse for more than a year. 

Ovarian dysfunction in women, uterine or fallopian tube problems, low sperm count in men, or sexually transmitted infections are the causes of infertility.

There are various medical options to treat infertility, such as medications, surgery, sex-related treatments such as injections, or assisted reproductive technology (ART) to conceive.

Is Infertility a Common Problem?

Yes, infertility is a common problem. One in every six couples worldwide experiences infertility. It means millions of people struggle to conceive. 

If you’re concerned about infertility, then talk to Urology or gynecology doctor nearby. They can help you determine the cause of your infertility and recommend treatment options.

What are the causes of infertility?

There are different causes factor of infertility in men and women.

The most common causes are:

What are the Causes of Female Infertility?

  • Ovulation Disorders

Ovulation is the release of an egg from the ovary each month. Ovulation disorders are a common cause of female infertility. The causes of ovulation disorders are polycystic ovary syndrome (PCOS), thyroid problems, and premature ovarian failure.

  • Endometriosis

Endometriosis is a condition in which tissues grow outside of the uterus that can cause inflammation, scarring, and blockage in the fallopian tubes. The blockage in the fallopian tube makes it difficult for sperm to reach the egg. 

  • Blocked Fallopian Tubes

Blocked fallopian tubes can prevent sperm from reaching the egg or a fertilized egg from implanting in the uterus. The scar tissue from pelvic surgery, endometriosis, or pelvic inflammatory disease (PID) is the reason for tube blockage.

  • Uterine Fibroids

Uterine fibroids are tiny tumors in the uterus. They might sometimes block the fallopian tubes or interfere with implantation.

  • Cervical Problems

Cervical mucus can sometimes be thick or hostile to sperm, making it difficult for sperm to reach the egg.

What are the Causes of Male Infertility?

  • Low Sperm Count

 A low sperm count is when a man has fewer than 15 million sperm per milliliter of semen.

  • Abnormal Sperm Morphology 

Sperm morphology defines the size and structure of sperm. Sperm that are not the right shape may have difficulty reaching or fertilizing an egg.

  • Poor Sperm Motility

Sperm motility is the capability of sperm to move. Sperm that do not move well will have difficulty reaching the egg.

  • Varicocele

 A varicocele is a swollen vein in the scrotum. It can raise the temperature in the scrotum, which can impair sperm production.

  • Hormonal Imbalances

 Hormonal imbalances can affect sperm production.

Other Causes of Infertility

  • Age

 A woman’s fertility naturally declines after age 35, and fertility starts to decline after age 40 for men.

  • Lifestyle Factors 

Smoking, heavy alcohol consumption, and obesity can all cause infertility.

  • Environmental Factors

Exposure to certain environmental toxins can also cause infertility.

What are the Signs or Symptoms of Infertility?

Here’s a breakdown of potential symptoms by gender:

Symptoms of Infertility In Women:

      • Irregular or absent menstrual periods: This could indicate issues with ovulation.
      • Painful period: This can be a sign of endometriosis or pelvic inflammatory disease.
      • Heavy or light bleeding: This may suggest hormonal imbalances.
      • Pelvic pain: This could be a sign of endometriosis or pelvic inflammatory disease.

Symptoms of Infertility in Men:

      • Problem with ejaculation: This may suggest hormonal issues or underlying health conditions.
      • Small or swollen testicles: Sign of hormonal imbalances or testicular problems.
      • Reduced sex drive: This may indicate hormonal issues or other health problems.

(Note: These are just some possible infertility symptoms, and it’s important to talk to an infertility expert if you’re facing the above infertility symptoms. Doctors perform tests to determine the cause of your infertility and recommend appropriate treatment options.)

Diagnosing and Testing Infertility

Diagnosing Female Infertility

Diagnosing female infertility involves a multi-step process conducted by a healthcare professional (gynecologist or fertility specialist). 

Here’s a breakdown of the general approach:

Initial consultation:

    • Medical history review: Doctors will discuss your medical history, including past pregnancies, surgeries, pelvic inflammatory disease, and menstrual cycles. They may also inquire about your partner’s health history.
    • Physical exam: A pelvic exam to check the overall health of your reproductive organs and identify any abnormalities.

Diagnostic tests:

    • Ovulation testing: This can be done at home using ovulation predictor kits that detect surges in luteinizing hormone (LH) or through blood tests measuring progesterone levels post-ovulation.
    • Hormonal testing: Blood tests can assess levels of hormones like estrogen, progesterone, prolactin, and thyroid hormones, as hormonal imbalances can affect ovulation.
    • Imaging tests:
        • Hysterosalpingography (HSG):  Hysterosalpingography (HSG) is a medical imaging procedure used to evaluate the shape of the uterine cavity and the patency (openness) of the fallopian tubes. It is for women who are experiencing infertility or recurrent miscarriages.
        • Transvaginal ultrasound (TVS): A painless internal ultrasound providing detailed images of the uterus and ovaries to detect fibroids, cysts, or ovulation problems.
        • Laparoscopy: A minimally invasive surgical procedure where a thin scope is inserted through a small abdominal incision to directly examine the pelvic organs for endometriosis, scar tissue, or other issues.

Additional considerations:

    • Age: Age is a factor, and women over 35 may undergo additional tests to assess ovarian reserve, the remaining number of eggs.
    • Partner evaluation: Male infertility is also a common cause, so your partner may need to undergo semen analysis to evaluate sperm count, motility, and morphology.

It’s important to remember that this is a general overview, and the specific tests your doctor recommends will depend on your situation and medical history.

If you’re concerned about your infertility, consulting a healthcare professional is the best option. They can guide you through the diagnosis process and guide you for treatment options.

Diagnosing Male Infertility

Diagnosing male infertility involves a similar approach to diagnosing female infertility, with a focus on the male reproductive system. 

Here’s a breakdown of the male diagnosing steps:

Initial Consultation:

    • Medical history review: Your doctor will discuss your medical history, including childhood illnesses, surgeries, testicular injuries, chronic health problems, and medications. They’ll also inquire about your lifestyle habits like smoking, alcohol consumption, and exposure to environmental toxins.
    • Physical examination: A general physical exam focuses on the genitals to assess for any abnormalities in testicular size or varicoceles (enlarged veins in the scrotum).

Diagnostic Tests:

    • Semen analysis: This male infertility test involves collecting a semen sample (usually through masturbation) and analyzing it in a lab. It evaluates various factors like:
        • Sperm count: The calculation of sperm per milliliter of semen. Low sperm count below 15 million per milliliter can be indicative of infertility.
        • Motility: Mobility is the ability of sperm to move and swim effectively. Poor sperm motility can hinder the ability to reach the egg.
        • Morphology: The size and shape of the sperm. Sperm with abnormal morphology may have difficulty fertilizing an egg.
        • Volume: The total amount of seminal fluid produced during ejaculation.
        • pH: The calculation of acidity or alkalinity of the semen.

Additional Tests:

    • Hormonal testing: Blood tests can assess hormone levels like testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH). Hormonal imbalances can affect sperm production.
    • Scrotal ultrasound: This painless imaging test uses sound waves to create detailed pictures of the testicles and scrotum. It can help detect abnormalities like varicoceles, cysts, or blockages.
    • Testicular biopsy: A small tissue sample is extracted from the testicles using a needle to examine sperm production under a microscope.

Partner Evaluation:

During the evaluation process, the doctor may recommend that your partner undergo testing for potential causes of infertility as well.

(Note: The tests your doctor recommends will depend on your situation and medical history. 

If you’re concerned about male infertility, talking to a healthcare professional is crucial. They guide you through the diagnosis process and explore potential treatment options to help you achieve pregnancy.)

Treatments For Infertility

Infertility treatments depend on the underlying cause and can involve various approaches for both men and women.

Infertility Treatment for Women

Infertility treatments for women address various causes and can range from simple lifestyle changes to complex procedures. Here’s a breakdown of some options:

Lifestyle modifications

    • Healthy weight management: Obesity can disrupt ovulation and hormone regulation. Maintaining a healthy weight can improve fertility.
    • Dietary and exercise adjustments: A balanced diet rich in fruits, vegetables, whole grains, and regular exercise can enhance overall health and potentially boost fertility.
    • Limiting alcohol and caffeine: Excessive consumption of these substances can negatively impact egg quality and ovulation.
    • Smoking cessation: Smoking harms sperm quality and decreases egg health. Quitting smoking improves fertility potential.

Medications to address ovulation problems

    • Ovulation induction drugs: These medications stimulate the ovaries to produce mature eggs.
    • Clomiphene citrate: A common first-line medication to trigger ovulation.
    • Letrozole: Another medication used for ovulation induction.
    • Gonadotropins: Injectable hormones that stimulate multiple egg development, often used in conjunction with IVF.

Surgery to address physical blockages or abnormalities

    • Procedures address blocked fallopian tubes, which prevent sperm from reaching the egg.
    • Endometriosis surgery to remove or reduce endometrial tissue growth outside the uterus, potentially improving fertility.
    • Uterine fibroid removal may be necessary if fibroids are blocking implantation or causing other issues.

Assisted reproductive technologies (ART)

Other considerations

    • Age: A woman’s fertility naturally declines with age after 35. Treatment options and success rates depend on women’s age.
    • Emotional well-being: The diagnosis and treatment process can be emotionally challenging. Consider couples counseling or support groups for emotional support.

Consulting a healthcare professional like a gynecologist or fertility specialist is crucial. They can diagnose the cause of your infertility, recommend the most suitable treatment plan for your situation, and address any questions or concerns you may have.

Infertility Treatment for Men

Male infertility can result from a variety of factors, including hormonal imbalances, structural issues, genetic conditions, lifestyle factors, and more. 

Here’s a breakdown of common treatment:


    • Medications for hormonal imbalances: Hormonal imbalances can affect sperm production. Medications or hormone therapy can regulate hormone levels and improve sperm health.


    • Varicocele repair: A minimally invasive surgical procedure to correct enlarged veins in the scrotum (varicocele) that can improve sperm production.
    • Surgery for blockages: Surgery to unblock obstructions in the vas deferens, the tubes that carry sperm from the testicles.

Assisted Reproductive Technologies (ART)

    • Intracytoplasmic sperm injection (ICSI):  ICSI is a specialized technique used during IVF where a single sperm is injected directly into an egg for fertilization, often used for severe male factor infertility.  
    • Sperm retrieval techniques: If sperm are not present in ejaculated semen, surgical procedures like testicular sperm aspiration (TESA) or microsurgical sperm extraction (MESA) are used to retrieve sperm directly from the testicles for use in ICSI.

Other Considerations:

    • Semen analysis: This is a diagnostic test to assess sperm count, motility, morphology (shape), and other factors. The results will guide treatment options.

Consulting a healthcare professional like a urologist or fertility specialist is crucial. They can diagnose the cause of your infertility, recommend the most suitable treatment plan based on your specific situation, and address any questions or concerns you may have. Remember, early infertility diagnosis often leads to better outcomes.

Choosing Treatment

Which is the best Infertility Treatment?

IVF (In Vitro Fertilization) is the best and most effective fertility treatment with a high success rate, but it’s not necessarily the best option for everyone. 

Why is IVF considered the best infertility treatment?

    • High success rates: IVF boasts some of the highest success rates compared to other fertility treatments, especially for couples with severe infertility issues.
    • Overcome various infertility problems: IVF can address a range of infertility causes in both men and women, including blocked fallopian tubes, ovulation problems, severe male factor infertility, and even some genetic conditions.
    • Choice of embryos: Multiple embryos are created, allowing for genetic testing and selecting the healthiest embryos for implantation, potentially increasing the chances of a successful pregnancy.

IVF Treatment In Nepal

IVF (In Vitro Fertilization) is a popular and affordable infertility treatment option for couples in Nepal. Several reputable IVF clinics in Nepal offer high-quality fertility treatments with experienced doctors and top facilities for patients.

The IVF in Nepal stimulates ovulation, retrieving mature eggs, fertilizing eggs with sperm in a lab, and transferring the embryo into the uterus. The cycle usually takes three weeks.

In Nepal, the IVF success rate is about 75-80% for clinical pregnancy, higher than the 60% worldwide average. 

A Note From Sishu Clinic

At Sishu Clinic, we can fulfill your dream of creating a family. Our team of fertility specialists, embryologists, and nurses is dedicated to providing personalized care and advanced treatment options to help you achieve your dream of parenthood. We offer a comprehensive range of services, including in vitro fertilization (IVF), intrauterine insemination (IUI), ovulation induction, and many others utilizing the latest technologies to maximize your chances of success.

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