Quick Facts About Infertility
- Infertility is NOT an inconvenience; it is a disease of the reproductive system
that impairs the body's ability to perform the basic function of reproduction.
- Infertility affects about ten percent of the reproductive-age population (Source:
National Survey of Family Growth, CDC 1995).
- Infertility affects men and women equally.
- Most infertility cases, 85% to 90%, are treated with conventional medical therapies
such as medication or surgery.
- While vital for some patients, in vitro fertilization and similar treatments account
for less than 3% of infertility services.
A: Infertility is a disease of the reproductive system that impairs one of
the body's most basic functions: the conception of children. Conception is a complicated
process that depends upon many factors: on the production of healthy sperm by the
man and healthy eggs by the woman; unblocked fallopian tubes that allow the sperm
to reach the egg; the sperm's ability to fertilize the egg when they meet; the ability
of the fertilized egg (embryo) to become implanted in the woman's uterus; and sufficient
embryo quality.
Finally, for the pregnancy to continue to full term, the embryo must be healthy
and the woman's hormonal environment adequate for its development. When just one
of these factors is impaired, infertility can result.
A: No one can be blamed for infertility any more than anyone is to blame
for diabetes or leukemia. In rough terms, about one-third of infertility cases can
be attributed to male factors, and about one-third to factors that affect women.
For the remaining one-third of infertile couples, infertility is caused by a combination
of problems in both partners or, in about 20 percent of cases, is unexplained.
The most common male infertility factors include azoospermia (no sperm cells are
produced) and oligospermia (few sperm cells are produced). Sometimes, sperm cells
are malformed or they die before they can reach the egg. In rare cases, infertility
in men is caused by a genetic disease such as cystic fibrosis or a chromosomal abnormality.
The most common female infertility factor is an ovulation disorder. Other causes
of female infertility include blocked fallopian tubes, which can occur when a woman
has had pelvic inflammatory disease or endometriosis (a sometimes painful condition
causing adhesions and cysts). Congenital anomalies (birth defects) involving the
structure of the uterus and uterine fibroids are associated with repeated miscarriages.
A: Couples are generally advised to seek medical help if they are unable
to achieve pregnancy after a year of unprotected intercourse. Women above the age
of 40yrs should seek help after 6 months of unprotected intercourse if they are
unable to get pregnant. The doctor will conduct a physical examination of both partners
to determine their general state of health and to evaluate physical disorders that
may be causing infertility. Usually both partners are interviewed about their sexual
habits in order to determine whether intercourse is taking place properly for conception.
If no cause can be determined at this point, more specific tests may be recommended.
For women, these include an analysis of reproductive hormones levels and ovulation,
x-ray of the fallopian tubes and uterus, and laparoscopy. For men, initial tests
focus on semen analysis.
A: Most infertility cases -- 85 to 90 percent -- are treated with conventional
therapies, such as drug treatment or surgical repair of reproductive organs.
A: In infertile couples where women have blocked or absent fallopian tubes,
or where men have low sperm counts, in vitro fertilization (IVF) offers a chance
at parenthood to couples who until recently would have had no hope of having a "biologically
related" child.
In IVF, eggs are surgically removed from the ovary and mixed with sperm outside
the body in a Petri dish ("in vitro" is Latin for "in glass"). After about 40 hours,
the eggs are examined to see if they have become fertilized by the sperm and are
dividing into cells. These fertilized eggs (embryos) are then placed in the women's
uterus, thus bypassing the fallopian tubes.
IVF has received a great deal of media attention since it was first introduced in
1978, but it actually accounts for less than five percent of all infertility treatment
in general.
A: Yes. IVF was introduced in Singapore in 1983. IVF currently accounts for
about 99% of ART procedures. The average live delivery rate for IVF in 2000 was
29.9 per cent per retrieval--a little better than the 20 per cent chance in any
given month that a reproductively healthy couple has of achieving a pregnancy and
carrying it to term.
The desire to have children and be parents is one of the most fundamental aspects
of being human. People should not be denied medically appropriate treatment to fulfill
this goal.