Most medical experts today refer to infertility as not being able to get pregnant after at least one year of sexual intercourse between a woman and her partner. However, some women are able to get pregnant but then have repeated miscarriages and are said to be infertile.

Pregnancy is in most cases judged from criteria of sexual intercourse because in order for pregnancy to occur there should be a combination of female and male gametes in each case.

Dr Olivier Nyakio works in the gynaecology department of Butare teaching hospital; he says that infertility can result of interference of all or one of the steps that lead to pregnancy.

The complex chains of events or steps that lead to pregnancy involve; a woman must release an egg from one of her ovaries; the egg must go through a fallopian tube; a man’s sperm must fuse with the egg from the female and fertilise the egg along the way; the fertilised egg must attach to the inside of the uterus (implantation).

Dr Nyakio explains that the problem of infertility is not only linked to the female problem because for fertilisation to occur there should be a combination of male and female gametes.

The probability of infertility risk factors that originate from either man or woman is a half. The other factors may be caused by either male or female factors or by unknown factors that are hereditary from both.

Problems with ovulation account for most cases of infertility in women. Without ovulation, there are no eggs to be fertilised.

Some signs that a woman is not ovulating normally include irregular or total absence of menstrual periods. Some of the less common causes of fertility problems in women include; blocked fallopian tubes due to pelvic inflammatory disease, physical problems with the uterus, and uterine fibroids.

Dr Nyakio also reveals that there are things that increase risk factors of infertility in women and many factors can affect a woman’s ability to have a baby.

These include; age, stress, poor diet, athletic training, being overweight or underweight, tobacco smoking, alcohol and sexually transmitted diseases and other health problems that cause hormonal change.

Aging decreases a woman’s chances of having a baby because; the ability of a woman’s ovaries to release eggs ready for fertilisation declines with age; the health of a woman’s eggs declines with age - as a woman ages she is more likely to have health problems that can interfere with fertility, and  the older a woman gets the higher the risk of miscarriage.

The doctor says that healthy women under the age of 30 should not always worry about infertility unless they have tried to get pregnant for at least a year and failed.

In this case, women should contact doctors about fertility evaluation. Besides, men should also contact doctors if this much time has elapsed.

Important to understand is that a woman’s chance of having a baby decreases rapidly every year after the age of 30 and therefore getting a complete and timely fertility evaluation is especially important.

Problems like irregular periods and no menstrual periods, very painful periods, endometriosis, pelvic inflammatory disease and more than one miscarriage should be investigated.

Sometimes doctors can find the cause of a couple’s infertility by carrying out a complete fertility evaluation. This process usually begins with physical exams and health and sexual history of the couple. If there are no obvious problems like poorly timed intercourse or absence of ovulation, tests are always required.

For a woman, the first step in testing fertility is to find out if she is ovulating each month. There are several ways to do this and a woman can track her ovulation at home by: recording changes in her morning body temperature for several months, recording the texture of her cervical mucus for several months, and using a home ovulation test kit that are usually bought from drug or grocery stores.

Infertility in women can be treated with medicine, surgery, artificial insemination or assisted reproductive technology. In many cases doctors recommend specific treatments for infertility based on; test results, how long the couple has been trying to get pregnant, the age of both the man and woman, the overall health of the partners and the preference of the partners.

Drugs used in this case include; Clomiphene citrate for ovulation, Human menopausal gonadotropin drugs such as Repronex, Pergonal, and Follicle-stimulating hormone drugs such as Gonal-F, Follistim. 

And also the Gonadotropin-releasing hormone that is given to women who do not ovulate regularly and Bromocriptine used for women with ovulation problems due to high levels of prolactin. Prolactin is a hormone that causes milk production.

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