What Are The Best Treatments and Remedies For Infertility

Infertility is the inability of a person, animal or plant to reproduce by natural means. It is usually not the natural state of a healthy adult, except notably among certain eusocial species. In humans, infertility is the inability to become pregnant after one year of intercourse without contraception involving a male and female partner. Being infertility of great concern to both the sexes, Siddha Spirituality of Swami Hardas Life System brings out in-depth information, treatments, and remedies, which could be vital for every one of us.

How WHO defines Infertility

Infertility is “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse, and there is no other reason, such as breastfeeding or postpartum amenorrhoea. Primary infertility is infertility in a couple who have never had a child. Secondary infertility is a failure to conceive following a previous pregnancy. Infertility may be caused by an infection in the man or woman, but often there is no obvious underlying cause.

What are the effects of Infertility

Psychological effects

The consequences of infertility are manifold and can include societal repercussions and personal suffering. 

Infertility may have psychological effects. Partners may become more anxious to conceive, increasing sexual dysfunction. Marital discord often develops, especially when they are under pressure to make medical decisions. Women trying to conceive often have depression rates similar to women who have heart disease or cancer. Emotional stress and marital difficulties are greater in couples where infertility lies with the man.

Older people with adult children appear to live longer. Why this is the case is unclear and may depend on part on those who have children adopting a healthier lifestyle, support from children, or the circumstances that led to not having children.

Social effects

In many cultures, the inability to conceive bears a stigma. In closed social groups, a degree of rejection may cause considerable anxiety and disappointment. Some respond by actively avoiding the issue altogether. Middle-class men are the most likely to respond in this way.

In the United States some treatments for infertility, including diagnostic tests, surgery, and therapy for depression, can qualify one for Family and Medical Leave Act leave.

What are the causes of Infertility

Immune infertility

In both men and women, ASA production are directed against surface antigens on sperm, which can interfere with sperm motility and transport through the female reproductive tract, inhibiting capacitation and acrosome reaction, impaired fertilization, influence the implantation process, and impaired growth and development of the embryo.

The antibodies are classified into different groups: There are IgA, IgG, and IgM antibodies. They also differ in the location of the spermatozoon they bind on (head, midpiece, tail). Factors contributing to the formation of anti-sperm antibodies in women are a disturbance of normal immunoregulatory mechanisms, infection, violation of the integrity of the mucous membranes, rape, and unprotected oral or anal sex.

Sexually transmitted infections

Infections with the following sexually transmitted pathogens have a negative effect on fertility: Chlamydia trachomatis and Neisseria gonorrhoeae. There is a consistent association between Mycoplasma genitalium infection and female reproductive tract syndromes. 

Genetic

Mutations to NR5A1 gene encoding Steroidogenic Factor-1 (SF-1) have been found in a small subset of men with non-obstructive male factor infertility where the cause is unknown. Results of one study investigating a cohort of 315 men revealed changes within the hinge region of SF-1 and no rare allelic variants of fertile control men. Affected individuals displayed more severe forms of infertility such as azoospermia and severe oligozoospermia.

Other causes of infertility

Common causes of male and female infertility

• DNA damage reduces fertility in female ovocytes, as caused by smoking, other xenobiotic DNA damaging agents such as radiation or chemotherapy, or accumulation of the oxidative DNA damage 8-hydroxy-deoxyguanosine.
• DNA damage reduces fertility in male sperm, as caused by oxidative DNA damage, smoking, other xenobiotic DNA damaging agents such as drugs or chemotherapy, or other DNA damaging agents including reactive oxygen species, fever, or high testicular temperature. The damaged DNA related to infertility manifests itself by the increased susceptibility to denaturation inducible by heat or acid or by the presence of double-strand breaks that can be detected by the TUNEL assay.
• Diabetes mellitus, thyroid disorders, undiagnosed and untreated coeliac disease, adrenal disease, Hyperprolactinemia, Hypopituitarism.
• The presence of anti-thyroid antibodies is associated with an increased risk of unexplained subfertility with an odds ratio of 1.5 and a 95% confidence interval of 1.1–2.0.
• Toxins such as glues, volatile organic solvents or silicones, physical agents, chemical dust, and pesticides. Tobacco smokers are 60% more likely to be infertile than non-smokers.

German scientists have reported that a virus called adeno-associated virus might have a role in male infertility, though it is otherwise not harmful. Other diseases such as chlamydia and gonorrhea can also cause infertility, due to internal scarring.

Obesity

The obesity epidemic has recently become is a serious issue, particularly in industrialized nations. The rising number of obese individuals may be due in part to an energy-rich diet as well as insufficient physical exercise.  In addition to other potential health risks, obesity can have a significant impact on male and female fertility. BMI (body mass index) may be a significant factor of fertility, as an increase in BMI in the male by as little as three units can be associated with infertility.

A relationship also exists between obesity and erectile dysfunction (ED). ED may be the consequence of the conversion of androgens to estradiol. As the number of adipose tissue increases, there is more aromatase available to convert androgens, and serum estradiol levels increase. Other hormones including inhibin B and leptin, may also be affected by obesity.

Obese women have a higher rate of recurrent, early MISCARRIAGE compared to non-obese women.

Low weight

Obesity is not the only way in which weight can impact fertility. Men who are underweight tend to have lower sperm concentrations than those who are at a normal BMI. For women, being underweight and having extremely low amounts of body fat are associated with ovarian dysfunction and infertility and they have a higher risk for preterm birth. Eating disorders such as anorexia nervosa are also associated with extremely low BMI.

Although relatively uncommon, EATING DISORDERS can negatively affect menstruation, fertility, and maternal and fetal well-being.

Female causes of Infertility

The following causes of infertility may only be found in females. For a woman to conceive, certain things have to happen:

• Aaginal intercourse must take place around the time when an egg is released from her ovary;
• The system that produces eggs has to be working at optimum levels, and
• Her hormones must be balanced.

For women, problems with fertilisation arise mainly from either structural problems in the Fallopian tube or uterus or problems releasing eggs. For example, endometriosis can cause infertility with the growth of endometrial tissue in the Fallopian tubes or around the ovaries. Endometriosis is usually more common in women in their mid-twenties and older, especially when postponed childbirth has taken place.

Another major cause of infertility in women may be the inability to ovulate. Malformation of the eggs themselves may complicate conception. For example, the polycystic ovarian syndrome is when the eggs only partially develop within the ovary and there is an excess of male hormones. Some women are infertile because their ovaries do not mature and release eggs.

Other factors that can affect a woman’s chances of conceiving include being overweight or underweight or her age as female fertility declines after the age of 30.

Common female causes of Infertility

Some common causes of infertility of females include:

• Ovulation problems e.g. polycystic ovarian syndrome, PCOS, the leading reason why women present to fertility clinics due to anovulatory infertility.
• Tubal blockage
• A pelvic inflammatory disease caused by infections like tuberculosis
• Age-related factors
• Uterine problems
• Previous tubal ligation
• Endometriosis
• Advanced maternal age
• Immune infertility

Common male causes of Infertility

The main cause of male infertility is low semen quality. There may be testicular malformations, hormone imbalance, or blockage of the man’s duct system.

Infertility associated with viable, but immotile sperm may be caused by primary ciliary dyskinesia. The sperm must provide the zygote with DNA, centrioles, and activation factor for the embryo to develop. Antisperm antibodies cause immune infertility. Cystic fibrosis can lead to infertility in men.

Combined causes of infertility

In some cases, both the man and woman may be infertile or sub-fertile, and the couple’s infertility arises from the combination of these conditions. It may be that each partner is independently fertile but the couple cannot conceive together without assistance.

Unexplained causes of infertility

In the US, up to 20% of infertile couples have unexplained infertility. In these cases, abnormalities are likely to be present but not detected by current methods. Polymorphisms in folate pathway genes could be one reason for fertility complications in some women with unexplained infertility. However, a growing body of evidence suggests that epigenetic modifications in sperm may be partially responsible.

How to Diagnose Infertility

If both partners are young and healthy and have been trying to conceive for one year without success, a visit to a physician or women’s health nurse practitioner (WHNP) could help to highlight potential medical problems earlier rather than later. The doctor or WHNP may also be able to suggest lifestyle changes to increase the chances of conceiving.

Women over the age of 35 should see their physician or WHNP after six months as fertility tests can take some time to complete, and age may affect the treatment options that are open in that case.

A doctor or WHNP takes a medical history and gives a physical examination. They can also carry out some basic tests on both partners to see if there is an identifiable reason for not having achieved a pregnancy. If necessary, they refer patients to a fertility clinic or local hospital for more specialized tests. The results of these tests help determine the best fertility treatment.

What is the Treatment for Infertility

Treatment depends on the cause of infertility but may include counseling, fertility treatments, which include in vitro fertilization. According to ESHRE recommendations, couples with an estimated live birth rate of 40% or higher per year are encouraged to continue aiming for a spontaneous pregnancy. Treatment methods for infertility may be grouped as medical or complementary and alternative treatments.

Drugs used for both women and men include clomiphene citrate, human menopausal gonadotropin (hMG), follicle-stimulating hormone (FSH), human chorionic gonadotropin (hCG), gonadotropin-releasing hormone (GnRH) analogs, aromatase inhibitors, and metformin.

What are the Medical treatments for Infertility?

Medical treatment of infertility generally involves the use of fertility medication, medical device, surgery, or a combination of the following. If the sperm are of good quality and the mechanics of the woman’s reproductive structures are good, a course of ovulation induction may be used.

The physician or WHNP may also suggest using a conception cap cervical cap, which the patient uses at home by placing the sperm inside the cap and putting the conception device on the cervix, or intrauterine insemination (IUI), in which the doctor or WHNP introduces sperm into the uterus during ovulation, via a catheter. In these methods, fertilization occurs inside the body.

If conservative medical treatments fail to achieve a full-term pregnancy, the physician or WHNP may suggest the patient undergo in vitro fertilization (IVF). IVF and related techniques (ICSI, ZIFT, GIFT) are called assisted reproductive technology (ART) techniques.

ART techniques generally start with stimulating the ovaries to increase egg production. After stimulation, the physician surgically extracts one or more eggs from the ovary, and unites them with sperm in a laboratory setting, with the intent of producing one or more embryos. Fertilization takes place outside the body, and the fertilized egg is reinserted into the woman’s reproductive tract, in a procedure called embryo transfer.

Other medical techniques are e.g. tuboplasty, assisted hatching, and preimplantation genetic diagnosis.

In vitro fertilization