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Monday, July 6, 2009
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Ask the doctor Q. What is infertility? A. Infertility is defined by the World Health Organization as the inability to achieve conception after a 12-month period of unprotected intercourse. Infertility is a common problem affecting some 15 percent of people of reproductive age. In categorizing the various causes of infertility it helps to identify them as factors.
Q. What are the causes of infertility? A. From what we know today in contemporary reproductive science, 40 percent of infertility is male factor (sperm) related to abnormal sperm production or function; 40 percent is female factor such as ovulation disorders, tubal disease or endometriosis; 10 percent is a combination of male and female factor and 10 percent of infertility is unexplained. So we must dispel the myth that infertility is always a female problem. The men must participate.
Q. What is the chance of conceiving a child? A. The normal monthly success rate for couples trying to conceive naturally at age 25 is 25 percent. This figure decreases with increasing female age particularly after age 35. Seventy-five percent of couples aged 25 will conceive in less than six months but by age 35 to 39 the chance of conception drops to 25 percent in that time frame. The average age of women having their first child today is 29 and rising annually. One in six couples of reproductive age experience difficulties conceiving a child.
Q. What is the available range of fertility treatments in The Bahamas? A. Solving the puzzle of infertility does not always require a high tech approach. A good physician should employ the most cost effective and timely approach to achieve success initially. This in turn is guided by the patient's age, health status and duration of infertility.
Treatments include: Ovulation induction: Medications (oral or by injection) are used to stimulate egg production and often used with timed intercourse or insemination. Insemination: With this technique, carefully prepared sperm are passed into the uterus at the most fertile time. Fertility surgery: Includes the treatment if endometriosis, tubal microsurgery, the removal of fibroids and the correction of uterine abnormalities. IVF: After a course of controlled ovarian stimulation eggs are collected and fertilized in the laboratory. Some of these fertilized eggs become embryos which can then be transferred into the uterus. ICSI: This is a different, more complicated adjunct to IVF where the embryologist injects a single sperm into the egg. This technique is an excellent treatment if the sperm is of poor quality and results in a higher fertilization rate.
Dr. Anthony Carey Obstetrician/Gynecologist
Do you have a medical question that needs answering? We would love to hear from you. Send us your question and look out for the next "Ask the Doctor" column. You can send your question via email to askthedoctor@doctorshosp.com, or to Doctors Hospital P.O. Box N 3018, Nassau, Bahamas or The Nassau Guardian.
This informative column is intended to educate the community about important issues regarding their health and is not intended as a substitute for consultation with a primary physician. For more information or for a physician referral, please call 302-4707.
Monday, July 6, 2009 |
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