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Infertility

Obstetrics and GynaecologyUrologyReproductive Medicine

In medical terms, infertility refers to the inability to achieve pregnancy after one year of regular, unprotected sexual intercourse. This definition applies to women under the age of 35. For women aged 35 and older, the medical community typically recommends seeking professional help if pregnancy has not been achieved within six months due to the decline in fertility with age.

Factors

Causes of infertility:

Male Factors:	Poor lifestyle habits (such as smoking and alcohol consumption) Any issues affecting sperm production or transport (varicocele, undescended testicles, damage to reproductive organs due to surgery or inflammation) Hormonal problems History of chemotherapy, radiation therapy, reproductive organ trauma, surgery, or infection Genetic factors
Female Factors:	Ovarian dysfunction Hormonal imbalances leading to ovulation disorders Pelvic inflammatory disease or endometriosis causing tubal blockage or pelvic adhesions Congenital uterine structural abnormalities or functional abnormalities Age 35 or older

Unknown Causes: If thorough medical history and comprehensive examinations fail to provide a clear explanation for infertility in couples, this condition will be classified as "Unexplained Infertility."

Diagnostic & Examination Methods

The following examinations help identify the causes of infertility:

Male Sperm Analysis: Semen analysis determines if sperm is standard, including measuring semen volume acidity and examining sperm count, morphology, and motility.
Female Ovulation Status: Recording menstrual cycle body temperature, urine, or other ovulation tests.
Female Reproductive Tract: Ultrasound scan, hysterosalpingography, laparoscopic surgery and dye test, hysteroscopy.

Treatments

Treatment methods for infertility include:

Medications

Stimulating ovulation or increasing sperm count through medication.

Surgical treatments

Correcting damaged fallopian tubes and endometriosis through surgery.

Assisted Reproductive Technology

Intrauterine insemination (IUI)

Method: Extracting morphologically normal and motile sperm from the male's semen, then artificially injecting it into the uterine cavity after ovulation to increase the chances of fertilization.

Suitable for:
- Women with mild endometriosis
- Men with mild sperm issues
- Couples with unexplained infertility
- Couples experiencing difficulty with intercourse
In Vitro Fertilization (IVF)

Method: Retrieving sperm and eggs from both partners, fertilizing them in a laboratory to form embryos, and then transferring them into the woman's uterus for implantation.

Suitable for:
- Women with diminished ovarian function or obstruction, damaged fallopian tubes, abnormal endometrium, etc.
- Men with insufficient sperm count, quality, or motility
- Couples with unexplained infertility
- Couples carrying genetic disease genes who need preimplantation genetic testing (PGT)
- Couples who have tried other methods, such as intrauterine insemination (IUI), without success

If the male's sperm is weak, intracytoplasmic sperm injection (ICSI) can increase the chances of fertilization.
Intracytoplasmic Sperm Injection (ICSI)

Method: Directly injecting a single sperm into a female egg retrieved outside the body to improve fertilization rates.

Suitable for:
- Men with sperm issues
- Couples who have tried other methods but failed to achieve successful fertilization
Preimplantation Genetic Testing (PGT)

Method: Extract some cells from embryos for genetic testing to identify whether embryos carry chromosomal or genetic abnormalities, and select normal embryos for implantation into the uterus.

When planning for pregnancy, couples can consult obstetricians or specialists in reproductive medicine and undergo Pre-pregnancy/Pre-marital Checkup Plan to increase the chances of successful conception.

For women aged 35 and above, as well as individuals with the following risk factors, it is recommended to consult obstetricians or specialists in reproductive medicine early in the planning for pregnancy and undergo physical examinations if necessary. Further tests may be needed if required.

Women	Men
Have undergone treatments such as radiation therapy, chemotherapy, or other treatments that may affect fertility.
Have experienced miscarriages.	Had mumps during childhood.
Have irregular menstrual cycles or absence of menstruation.	Have had prostatitis
Experience pain or discomfort during intercourse, have difficulty with intercourse	Have experienced undescended testicles
Have had endometriosis.	Have had varicocele
Have had pelvic infections.	Experience difficulty with erections or ejaculation
Have had surgery on the pelvis or ovaries.