Infertility Counseling : Be informed!!

Infertility or difficulty in conceiving is becoming a common problem these days. Late marriages, late planning for children, overweight, smoking, alcohol etc. factors cause problems in conceiving. Many couples wait for too long before they seek professional advice. But in infertility timing is very crucial.

Increasing age causes reduced fertility in females and to a lesser extent in males, more chances of developing fibroids , endometriosis etc and medical issues too. Fertility problems add a lot of stress in lives of majority couples. This makes fertility counseling an important part in every Gynecologist or infertility OPD. The following pictures discuss causes of infertility.

NICE guidelines : Fertility problems assessment and treatment UK defines infertility as below... A woman of reproductive age who has not conceived after one year of regular unprotected intercourse, without any known cause of infertility should be offered clinical assessment and baseline investigations along with husband. • It should be offered earlier if 1. Age of woman is 36 years or more 2. there is known clinical cause of infertility or history of predisposing factors of infertility. Some adaptations from these guidelines for couples trying to conceive. • Both partners having difficulty in conceving should see the doctor together because both are affected by decisions about investigations and treatment. • Both partners should be advised basic investigation together unless indicated otherwise. • You have the right to know all the choices and be a part of decision making process. • The stress related to fertility issues in one or both partner can affect their relationship. It can also reduce sex drive and frequency of intercourse which adds to the fertility problem. • Counseling should be sought when needed in stressful situations. • Over 80% of couples in general population will conceive within 1 year if 1. Age of woman is less than 40 years 2. Couple doesn't use any contraception 3. Have regular sexual intercourse • About half of those who do not conceive in first year will conceive in 2 nd year. • Female fertility declines as age increases. This too happens to a lesser extent in males. • Couples trying for pregnancy should have sexual intercourse every 2-3 days which optimises the chance of pregnancy. • Excessive alcohol intake in males decreases semen quality. • There is association between smoking in men and reduced semen quality. Stopping smoking will improve general health • Smoking in females decreases fertility, this is true for passive smoking also. • Women trying for pregnancy should limit alcohol intake and avoid intoxication to decrease risk to developing baby. • There is no proven relation between tea,coffee, cold drink intake and infertility. • Women who are obese, have a Body mass index more than 30 can take longer to conceive. • Weight loss helps in ovulation and increased chance of conception in non ovulating obese women. • Strict diet and exercise regime helps • Obese men who have BMI more than 30 are more likely to have fertility issues. • Some occupations can have impact on male or female infertility, this information should be shared with your doctor. • Use of any medicines or over the counter drugs should be informed to your doctor, as this may interfere with fertility. • Folic acid tablets should be advised to all women trying for pregnancy, to be started 1-2 months before planning and continued till 12 weeks to decrease neural tube defects in baby. • Women having a previous baby with neural tube defect, taking antiepilepsy medicine or suffering from diabetes should take a higher dose of folic acid 5 mg/day.

You can contact us for any infertility advice and counseling. All infertility treatments are available with us. Source : Adapted from NICE guidelines : Fertility problems assessment and treatment UK

Disclaimer : These are the views of a qualified doctor and author. These are general suggestions and do not replace actual check up with a doctor. Any resemblance to anybody is coincidental.

Author information : Dr Harita N. Kothia, Obstetrician and Gynecologist, Mumbai.

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