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Infertility, including tubal reversal
Infertility is the failure to become pregnant after 1 year of regular,
unprotected sexual intercourse.
One reason a woman is infertile is that she is not ovulating or releasing
eggs (anovulatory).
This failure to ovulate may be caused
by: hormone imbalance including thyroid
gland problems, tumors in the pituitary
gland, ovary problems, such as a tumor
or cyst, a menstrual cycle that is too
short, weight loss, including eating disorders
such as anorexia and bulimia or intense
exercise, overweight, too much stress
Damage of fallopian tube or uterus can
also cause infertility. These organs may
be damaged from a previous infection,
such as: a sexually transmitted disease,
pelvic inflammatory disease. Other reasons
for infertility could be an uterus with
an abnormal shape or position, polyps
or fibroids in the uterus, surgery to
remove a tubal pregnancy, endometriosis
(tissue from the uterus growing outside
the uterus), adhesions (scar tissue) inside
the uterus or in the pelvis.
On occasion the problems is with your cervix(mouth of the womb), such
as: a cervix that is very narrow or closed
and/or abnormal cervical mucus.
In rare cases, a woman's body is allergic to sperm and destroys it.
Some rare genetic problems also cause infertility.
Also do not forget the biological clock: A woman becomes less fertile
as she is getting older, especially after age 35.
To diagnose the problem you and your partner will have a physical examination
and you will be asked about:
1. Your sexual history, including previous pregnancy, miscarriage,
or abortion
2. Your history of medical conditions
such as illnesses and infections
3. Your family history
4. Use of drugs and alcohol
5. Sexual intercourse practices, such
as how often you have sex and whether
you use lubricants
6. Genital or abdominal surgery
7. Genital development.
Some possible testing to help determine the cause of infertility will
be:
1. A count of your partner's sperm to
see if the cause of infertility is too
few sperm or abnormal sperm. (this is
done because …..”it takes
two to tango” ).
2. Urine and blood tests to check for
infections and a hormone imbalance
3. Tests of samples of cervical mucus
and tissue from the lining of your uterus
to check for ovulation
The doctor may tell you how to take and chart your body temperature
each morning. A woman's temperature rises
after ovulation and therefore, the chart
helps checking for ovulation.
You may have procedures to check for a
blockage in the fallopian tubes or uterus,
or adhesions, such as: laparoscopy (a
scope is inserted into your abdomen to
evaluate the pelvic organs) and/or a hysteroscopy
(a scope is inserted in the uterus through
the vagina) or a hysterosalpingogram (an
x-ray of the uterus and fallopian tubes
after they are injected with a special
dye) or a hystero-sonogram (sterile saline
is injected into the uterus while having
an ultrasound).
Treatment for infertility may include medication, such as hormones or
antibiotics, or surgery. Sometimes a combination of treatments for both
partners is necessary. You may be asked to keep a record of your daily
temperature to track ovulation. This will help predict when you are
most fertile or if the drugs you are taking stimulate egg production.
If your partner's sperm count is low, artificial insemination is an
option. The sperm is collected at several different times and then placed
in your body during the most fertile time in your menstrual cycle. This
procedure has varying success. Another choice is to use sperm donated
by another man.
In vitro fertilization is another option that has good success rates.
For women that have had tubal ligation in the past and want a reversal
of surgery, a successful corrective tubal surgery is possible, on occasion
(For more information see below Tubal Reversal) All depending on the
type of tubal surgery performed at the time of sterilization.
Finally: The period of investigation and treatment for infertility can
be stressful for a couple. It can put unusual strain on your relationship.
Counseling may help you get through any difficult times. Your doctor
can help.
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