Many couples aspire to start a family, and with regular sexual activity, about 80% will conceive within a year. However, approximately 15% to 20% of couples face infertility issues. The immediate thought for many is to pursue in vitro fertilisation (IVF), but this is not the only option available. Infertility arises from male factors in about one-third of cases, female factors in another third, while the remaining third may involve issues from both partners or remain unexplained. Identifying the root cause of infertility allows for targeted treatments, which may resolve the issue without solely relying on IVF.
Causes of Infertility in Men and Women
According to Professor Li Tin Chiu, a specialist at the Union Reproductive Medicine Centre, male infertility is often attributed to sperm quality, quantity, motility, and conditions like azoospermia. Other possible causes include infections of the reproductive tract, blockages in the vas deferens, erectile dysfunction, hormonal imbalances, and varicocele, which can reduce sperm production.
For women, factors such as hormonal imbalances, ovulatory disorders, polycystic ovary syndrome (PCOS), reproductive organ abnormalities, infections leading to blocked fallopian tubes, endometriosis, and issues with the uterus or cervical mucus can contribute to infertility.
Identifying Causes and Targeted Treatments
Here are some common causes of infertility along with their potential treatments:
Oral or injectable medications to induce ovulation, potentially combined with IUI
Hydrosalpinx
Surgical intervention is necessary before IVF can be successful; if natural conception fails after treatment, IVF may be considered
Uterine issues (e.g., fibroids, polyps)
Surgical treatment of uterine issues is required to enhance IVF success rates
Genetic issues or recurrent miscarriages
Third-generation IVF (PGD/PGS)
Ovarian decline (e.g., FSH > 15)
Very low success rate for IVF; egg donation should be considered
Professor Li notes that many people approach him solely for IVF, yet numerous methods exist for treating infertility. The key is to pinpoint the specific cause. Rushing into IVF without identifying the underlying issue can waste time and money, especially since IVF does not guarantee success for everyone. A frequent reason for failed treatments is the lack of comprehensive evaluations. Couples can proactively assess their fertility before attempting conception. Women can undergo blood tests (FSH & AMH) and ultrasound scans (to check follicle count), while men can conduct sperm analyses to improve their chances of conception.
