Health and other general medical difficulties: For endometriosis, infection or scar tissue, surgery can be carried out to get the pelvis or fallopian tubes back to normal. If that doesn't work, the next option is IVF. Sexual dysfunction, such as vaginismus, where women cannot have sex, can also cause infertility. Women who have had chemotherapy or radiotherapy as part of cancer treatment or those with certain conditions such as Cystic Fibrosis or Rheumatoid Arthritis may also need fertility assistance.
Injuries and surgery such as surgical intervention for undescended testes in childhood can cause problems. Testicular infection such as chlamydia or mumps affecting the testes.
Some men have no sperm at all, and in these cases, a testicular biopsy where sperm is surgically removed from the testes can be performed.
Issues such as erectile difficulties can also cause infertility in men. "We would see some men who have had a vasectomy, but the majority of male sperm problems are unexplained," says Dr Wingfield stated. Lifestyle issues: Smoking, steroids or testosterone injections as well as recreational drugs such as cannabis.
According to Dr Wingfield men are encouraged to improve their lifestyle and to consider taking some vitamins if their diet is suboptimal.
However, in the majority of cases where there is a significant sperm problem, IVF would be recommended - and often ICSI, which is a type of IVF.
"the woman needs to be producing an egg so she needs to be ovulating. The man needs to have sperm and then the sperm and the egg need to be able to meet up, so they need to be able to have sex. When they do have sex the woman's pelvis and her fallopian tubes need to be normal because the egg and the sperm meet in the fallopian tube, fertilise there and form an embryo. Then the embryo moves down to the uterus."
Unexplained infertility In unexplained infertility Dr Wingfield said that couples may have to keep trying for a little longer to conceive naturally. If that doesn't work then the next steps would be Intrauterine Insemination (IUI) or IVF.
Source: Irishtimes irishtimes.com