Category Archives: Infertility

Unexplained Infertility? Have You Considered Ovulation Induction Treatment?

Unexplained Infertility

When a couple tries for a baby for more than a year and fails, and the doctor doesn’t find any obvious anomaly like blocked fallopian tubes, etc, the condition is referred to as “unexplained infertility”. However, there’s no reason to lose heart. Research reveals that countless such couples have gone on to have healthy babies either naturally or by taking recourse to fertility treatment.

What is ovulation induction treatment?

In unexplained infertility, the male and female partners are subjected to a comprehensive evaluation to arrive at the best treatment option. If the female partner is not ovulating regularly, the fertility expert might suggest ovulation induction treatment. This method uses hormonal therapy to stimulate development and release of eggs, or ovulation.

The drugs used in this therapy were designed to induce ovulation among women who failed to do so naturally, especially those with irregular periods, the target being to produce a healthy egg. Ovulation induction is also used to boost the count of eggs that mature in a single cycle so that chances of conception go up. In fact, more recent research has shown the benefits of using fertility medications to treat even ovulatory women with unexplained infertility, to induce multiple eggs to mature, thus boosting pregnancy rates.

What are the fertility drugs commonly used in ovulation induction?

Medications stimulate the release of hormones that drive egg production. The ones commonly used are:

# Clomiphene citrate: This is an oral medication that blocks estrogen receptors to induce ovulation. This is a fertility agent which induces superovulation or release of multiple eggs in a single cycle.

# Human menopausal gonadotropin (hMG): This medication comprises FSH or follicle stimulating hormone and LH or leutinizing hormone. It stimulates developments of eggs in women who don’t ovulate on their own or suffer from irregular ovulation. It is also used to boost egg count in ovulating women. This medication is available only in injectable form and can be used with both IUI (intrauterine insemination) and IVF (in-vitro fertilization).

# Follicle stimulating hormone: FSH medications, available only in injectable form, are used to stimulate development of numerous eggs during a single ovulation induction cycle. It is either used in isolation or in tandem with hMG to induce superovulation.

# Human chorionic gonadotropin (hCG):hCG, self-administered as an injection, coaxes final maturation of the eggs, thus triggering ovulation. It also helps prepare the uterus lining to facilitate implantation of the fertilized egg.

# Leuprolide & synthetic gonadotropin (FSH/LH) inhibitor:This drug, available in injectable form, stymies the secretion of LH and FSH in the brain, and is used to clear the decks for treatment with ovulation induction drugs. It boosts follicle recruitment by blocking the fetching of a dominant follicle for the subsequent menstrual cycle. It also guards against premature ovulation by blocking LH release.

Are there any risks that these medications carry?

Most women don’t show any significant side-effects from the oral or injectable medications. However, some of these symptoms are reported at times:

  • Hot flashes
  • Mood swings
  • Bloating
  • Tenderness in breast
  • Abdominal pain
  • Pelvic pressure
  • Nausea

What is the generic success record of ovulation induction?

Success rate depends on the diagnosis and a clutch of other factors, not least the woman’s age. However, fertility experts concur on a generic success rate of about 20 to 25% pregnancy per cycle. This treatment is definitely recommended as ‘more than worth a shot’.

Impact of Thyroid Disorder on Fertility

hypothyroidism and infertility

Our thyroid gland produces hormones that control our metabolism which is responsible for vital functions. Thyroid disorders are a clutch of conditions when this very important gland malfunctions, resulting in either too much (hyperthyroidism) or too little (hypothyroidism) production of thyroid hormones.

Can thyroid disorders interfere with fertility?

Hypothyroidism is sometimes associated with infertility among women, since low levels of these hormones could impair fertility by impeding the release of an egg from the ovary.

Hypothyroidism is often precipitated by an autoimmune disorder or pituitary disorder, which in itself might cause a roadblock to fertility. There’s also a risk of early miscarriage because of lack of implantation. Having said that, hyperthyroidism can also impact fertility. While thyroid disorders and fertility issues are more often than not linked to women, sometimes the male partner is also affected since these conditions could damage sperm quality and hinder motility, besides reducing semen volume.

What are some common symptoms of hypothyroidism?

  • Heavy or frequent periods
  • Feeling tired and sore all the time
  • Dryness of skin and hair, thinning hair
  • Tendency to forget things
  • Hypersensitive to cold
  • Tendency to put on weight
  • Constipation

How can hypothyroidism impact fertility?

  • It can disrupt the menstrual cycle, rendering conception difficult
  • It can impede ovulation or release of an egg from the ovary
  • It raises the risk of miscarriage
  • It can result in pre-term birth

Can hyperthyroidism impact fertility too?

Yes, hyperthyroidism, which is often caused by an autoimmune disorder called Graves’ disease, can also impact fertility, in pretty much the same ways as hypothyroidism, like disturbing the periods, raising the risk of miscarriage and premature birth, etc.

How important is it to have thyroid disorders treated?

It is extremely critical to have your thyroid disorder medically evaluated and treated before you plan to have kids. It can reduce the risks related to pregnancy. For women, correcting infertility is hugely dependent on addressing hypothyroidism.

The treatment protocols for a dysfunctional thyroid would vary from patient to patient, depending on the severity of the condition and symptoms. More often than not, these disorders are treated with medication and regular monitoring. Close surveillance and follow-up will be the key. Very rarely does a thyroid disorder require surgery.

Women trying for pregnancy with hypothyroidism should work in tandem with a fertility expert for proper monitoring and cutting risks. Sometimes when hypothyroidism is corrected and yet the fertility problem remains, some other intervention could be required, which your fertility expert can then suggest.

So please remember that the thyroid gland could be tiny in size, but mammoth in its significance. So ignore symptoms of thyroid dysfunction at your own peril. Very often, the early warning signs of a dysfunctional thyroid are not heeded, which can result in fertility issues later.

So if you are experiencing irregular periods or any of the symptoms mentioned above, please see your doctor without procrastinating. The more you delay diagnosis, the more the chances of complication with your pregnancy, while an early detection of a thyroid condition will enable your doctor to prescribe medication in time, boosting your chances of hassle-free conception.

A few critical points to remember:

  • Let your doctor know if you are planning to conceive
  • Thyroid disorders are highly treatable and pregnancy shouldn’t be a problem once the condition is corrected
  • If you have received treatment for Graves’ disease, there’s a slim chance that your baby might suffer from a temporary phase of hyperthyroidism. This can, however, be treated
  • Do not alter your medication dosage without consulting your doctor if you are being treated for hyperthyroidism
  • You can have a passing disorder called postpartum thyroiditis, which often dissipates without any treatment
  • If there’s a family history of thyroid disorders, do consult your doctor before planning a pregnancy

In situations where a couple fails to conceive even after normalizing the thyroid levels post lifestyle modifications and medications, assisted reproduction provides an effective solution. In-vitro fertilization (IVF), Intra uterine insemination (IUI) and Intracytoplasmic sperm injection (ICSI) are recommended procedures that can help in inducing pregnancy and reducing chances of miscarriage.