Infertility(2)

Here are woman's common reasons to cause infertility:

Ovulation Disorders
Absent or infrequent ovulation can be due to hormonal abnormalities,polycystic ovarian or previous cancer treatment.

Test: The doctor takes a history to find out if menstrual patterns have been atypical. Other tests include ultrasound to determine the number of follicles in the ovaries,hormone tests and a physical exam to identify the signs of hormonal disorders,such as weight gain or atypical hair growth.

Treatment: A heavy woman may be advised to lose weight. Other treatments entail oral drugs such as clomiphene ( Clomid) or hormone injections to jump-start ovulation. The next step might be IVF or in vitro maturation.

Bottom Line: Pregnancy rates are as high as 40 to 60% with IVF and 40% with ICSI.

Mechanical Problems
Blockages in the Fallopian tubes can prevent the egg from reaching the uterus for implantation. Sources of obstruction include endometriosis,which can cause blockages around the woman's reproductive organs and in the Fallopian tubes,where fertilization usually occurs and through which the eggs travel from the ovaries to the uterus.

Test: In a hysterosalpingogram,dye is injected into the uterus and observed on an X-ray to see if it flows easily through the Fallopian tubes. A similar test can be done with ultrasound .If other tests are not conclusive, the next step might be a laparoscopy, a look inside the pelvis with an imaging device containing a tiny camera.

Treatment: Microsurgery to clear the Fallopian tubes may help improve fertility,but success rates will be higher if IVF is also used.

Bottom Line:Pregnancy rates are high as 40 to 60% with IVF and 40% with ICSI.

Immunological Infertility
Again, a controversial and unproven area, but reseachers have speculated that a woman may develop antibodies to her partner's sperm,thereby immobilizing or killing them.

Test:In the past, women often underwent post-coital analysis, a test in which,several hours after intercourse,sperm removed from the woman's cervix are examined to see how many are alive and mobile. Blood tests might check for anti-sperm antibodies. Nowadays,when standard tests are normal,women are not usually tested for immunological infertility but treated as if they had unexplained fertility.

Treatment: Proceed IVF or ICSI as soon as possible.

Bottom Line:High pregnancy rates with IVF/ICSI/IUI, more than 60% in women under age 35.

Idiopathic(Unexplained) Infertility
There is a lot we still don't know about the complex combination of factors affecting fertility. For instance, women with endometriosis have lower rates of pregnancy even when their tubes are not blocked,and it's not understood why. And in other cases,for some unknown reason,perfectly normal-looking sperm can't penetrate the egg.

Test: The diagnosis is by exclusion. Standard tests come out normal.

Treatment: Any treatment that can help the sperm meet up with the egg: IUI,IVF or ICSI.

Bottom Line:In women younger than 35,the success rate is more than 60% per treatment,even if the couple my never know what caused their inferlity.