Infertility: Many Reasons for Hope


Not being able to fall pregnant naturally is a great shock to prospective parents-to-be, and a diagnosis of infertility can feel like a hopeless situation. However, as Dr Tony Rodrigues of Medfem Fertility Clinic explained in an interview on eNCA, only very few couples diagnosed with infertility will find themselves at a point where they have no further options and all hope is lost.

During the interview, eNCA presenter Uveka Rangappa asked the questions so many couples struggling with infertility may be afraid of asking:

* When is there no possibility of having children?
* At what point would you say to a couple ‘I’m sorry we’ve tried everything’?
* Is there a deadline?
* How much hope is there for us as a couple?

As Dr Rodrigues explains, it is quite rare these days to have to tell a couple “you can’t have a baby”, not even for same sex couples. There are so many possibilities, treatments, alternatives and options, that reaching the desired endpoint for a couple – to add a baby to their family – is almost always possible.

What is crucial is an accurate diagnosis of the cause of infertility in a couple. This is because there are a wide range of possible causes of infertility. In addition, in about one-third of infertility cases, the fertility challenge is due to the female partner, while in another one-third of infertility cases, the fertility challenge is due to the male partner. For the remaining one-third of cases, the fertility challenge is a combination of male and female factor issues. Furthermore, in 25% of couples, there is also more than one factor contributing to infertility.

Only once the cause of the infertility has been determined accurately, is it possible to choose the exact treatment required.

For example, the cause of one couple’s infertility might be as simple as incorrect thyroid levels, it could be as easy as taking a cheap little thyroid tablet to achieve a pregnancy. The solution could be as low-tech as the timing of ovulation or getting the basics right, such as choosing a healthy lifestyle without smoking, drinking or recreational drugs; getting proper nutrition; and managing stress.

Certain conditions known to cause infertility are also easier to detect than others, for example, polycystic ovarian syndrome (PCOS) is known to cause infertility and has recognisable symptoms such as irregular cycles and skin problems. Also, thanks so to technologies such as a laparoscopy, fertility specialists are able to look into the abdomen with a camera and check for conditions such as endometriosis and fibroids – and can even treat it surgically at the same time.

There are also a whole range of assisted reproduction techniques for men and women and even pre genetic testing can be done to check the chromosomes in embryos. In the case of a severe male factor or where the female partner is of advanced maternal age, it may be necessary to go straight to in vitro fertilization (IVF). If a woman is of advanced maternal age (ie over 35) and is no longer producing quality eggs, there is the option of using donor eggs. If there is a severe male factor, donor sperm is an option, along with either IVF or Artificial Insemination (AI) or Intrauterine Insemination (IUI). Where a woman has a serious problem with her uterus that cannot be repaired, surrogacy is also an option. Even after all of that, there is still the alternative of adoption. These are also options for same-sex couples.

Fortunately, couples in South Africa have access to world-class clinics, such as Medfem Fertility Clinic, where all of these technologies and alternatives are available.

How much hope is there for you?

As mentioned, there are many reasons for hope if you are struggling with infertility, with many possibilities, treatments, alternatives and options. What is crucial is an accurate diagnosis of the unique cause of your infertility as a couple, so that the right treatment can be selected.

We are often able to get a very good idea of what is causing your fertility challenges during your very first consultation at Medfem Fertility Clinic, when we get to know you and also complete a range of fertility tests.

This fertility testing is particularly important if a woman is over 35 years old or if either partner has known risk factors for infertility. A semen analysis should be performed before the female partner undergoes any invasive testing.

What happens during a fertility consultation?

During your initial fertility consultation, you and your partner will spend between 30 minutes and 1 hour with one of our fertility specialists.

You can expect an extensive review of your medical history, a comprehensive infertility work up (physical exam), female blood tests, additional testing, and in depth explanations and answers to all your questions. Your fertility specialist will also discuss your fertility treatment options with you, to develop a personalised fertility treatment plan that fits you best.

To help determine which infertility tests will be most appropriate, your fertility specialist will ask about your history of sexual activity, as well as lifestyle issues such as smoking, drug and alcohol use, and caffeine consumption, any medications being taken, and your general medical and emotional health. Your fertility specialist will also need to know your menstrual history, the history of previous pregnancies and their outcomes. It is also important to know the family history, including family members with infertility, birth defects, genetic mutations, or mental retardation.

In addition to all these factors, there is also a long list of possible medical causes of infertility in both men and women, making accurate, reliable infertility tests for the female partner and for the male partner crucial.

Infertility Tests For Women

A number of laboratory tests can be done to pinpoint a possible female factor. Your consultation will also include an evaluation of ovulation and hormonal assessment of egg quality through a blood test; and an evaluation of uterine health via pelvic ultrasounds. Blood and urine tests to measure hormone levels: FSH, for example, will provide an indication of ovarian function, while the measurement of Anti-Mullerian Hormone (AMH) will provide an evaluation of ovarian reserve. Blood tests for prolactin levels and thyroid function are also measured as these hormones may indirectly affect fertility.

If this initial fertility work-up does not reveal abnormalities, more extensive tests may help reveal abnormal tubal or uterine findings using ultrasound; hysteroscopy; laparoscopy and hysterosalpingogram (HSG).

Infertility Tests For Men

A medical history and physical examination are standard assessments in all men, as well as several tests covering everything from insulin and glucose levels to hormone levels and antibodies.

A semen analysis measures the amount of semen produced and determines the number and quality of sperm in the semen sample. A semen analysis assesses sperm quality and all sperm parameters including the sperm concentration, motility, forward progression, morphology (shape), and the absence or presence of antisperm antibodies.

If the results of semen analysis are normal, one test should be sufficient. If the results are abnormal in at least two tests, further andrological investigation is indicated.

Find Hope in Your Fertility Journey

After undergoing all the fertility testing described above during your initial fertility consultation at Medfem Fertility Clinic, we will have a fairly good idea of what is causing your infertility, which treatments are best suited to your situation and how much hope you can have to achieve a pregnancy.

Setting up your fertility consultation is as simple as clicking here or contacting us on +27 (11) 463 2244.

We look forward to meeting you!

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