www.womanthismonth.com April 2019 31 At what stage of trying for a baby is a couple considered to have a fertility issue? Infertility means not being able to get pregnant after one year of trying (or six months if a woman is 35 or older). Somewhere around 25 per cent of couples will be pregnant at the end of the first month of trying. About 50 per cent will have conceived in six months. Between 85 and 90 per cent of couples will have conceived by the end of a year. How is this officially diagnosed? You may have a general physical exam, including a regular gynaecological exam. Specific fertility tests may include: • Ovulation testing, hysterosalpingography, ovarian reserve testing, other hormone testing and imaging tests. Depending on your situation, rarely the testing may include: • Hysteroscopy, laparoscopy or genetic testing, which helps determine whether there's a genetic defect causing infertility. Not everyone needs to have all, or even many, of these tests before the cause of infertility is found. What are the main types and causes of infertility? Ovulation disorders, polycystic ovary syndrome (PCOS), hypothalamic dysfunction, premature ovarian failure, too much prolactin, damage to fallopian tubes (tubal infertility), endometriosis, uterine or cervical causes. There are also cases of unexplained infertility. How prevalent is infertility in Bahrain and the wider Middle East? Although no official studies have been conducted, I get a significant number of inquiries from patients asking advice about infertility issues. It is difficult to say whether these numbers are increasing, decreasing or static, but it’s a prevalent problem that needs to be addressed adequately. Unexplained infertility is a common problem mainly for young couples who go through rounds of examinations without getting an answer. What are the various types of treatment available? Thanks to technology, there are many treatments available. Sometimes only one person needs treatment, other times both partners will require a combination of treatments together. Fertility treatments often include medications that help with hormones and ovulation, sometimes combined with minor surgical procedures. Two of the most common fertility treatments are: • intrauterine insemination (IUI) • in vitro fertilisation (IVF) Fertility treatment is not the same path for everyone. For couples contemplating pregnancy, there are steps both women and men can take to increase their chances of conception. Step one for both: maintain your overall health. This includes proper nutrition, a regular exercise regimen and maintaining a healthy weight, especially for women. Stress reduction is also important for women trying to conceive. Unfortunately, many stress relievers people use – such as alcohol, caffeine and tobacco – can sabotage pregnancy efforts. Exercise, meditation, yoga and getting enough sleep can all help reduce stress. If one type of treatment is unsuccessful, is a different result likely with another method? When speaking about fertility treatment, it is commonly assumed that everyone’s fertility treatment path looks like this: first Clomid, then IUI with injectables, then IVF. However, it is more complicated than that. Everything depends on the cause of infertility and individual response to infertility treatment. Is there hope for those who experience unexplained infertility? Yes, sometimes nothing may be seriously wrong: some couples with unexplained infertility will conceive without any treatment help within one to two years of diagnosis. No one knows why or what was wrong, but it happens. A healthy, fertile couple has about a 30 per cent chance of conceiving in any given month. Notice that the odds are not 100 per cent. They aren’t 100 per cent for anyone! Your emotional struggle to conceive is just as real even without a definitive diagnosis. Some might say it’s more intense, because, without answers, you may feel more confused by the situation. Your possible physical problem is also just as real, even if it can’t or hasn’t been diagnosed yet. INFERTILITY 101 Ob-gyn specialist, Dr Natasha Nikolic, shares the knowledge she has learned after more than 24 years in the field. showcase
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