Odessa Regional Medical Center is one of the only hospitals in Texas to offer advanced treatment for infertility, which is a more common problem than most would expect. Approximately 15 to 20 percent of all couples experience infertility, causing pain and frustration for those involved with this difficult medical diagnosis.

Primary infertility describes a couple that after having regular intercourse without contraception for at least one year without getting pregnant. Those with secondary infertility are couples that have previously been able to achieve pregnancy, but later attempts have been unsuccessful.

Females, while still in the womb (by five months in utero), achieve the most number of oocytes/eggs they will ever have. By birth, that number has decreased by half. As they age, females lose many eggs each day until menopause. Since the eggs they carry at age 35 are the same ones they carried even before birth, the chance for chromosomal abnormalities increases. Males are able to produce sperm throughout their lifetime. However, a decrease in sperm production due to health complications can occur.

Fertility can be caused by a wide range of factors. Approximately 30 to 40 percent of all infertility is due to a "male" factor. These include: retrograde ejaculation (the entry of semen into the bladder instead of going out through the urethra during ejaculation), impotence, hormone deficiency, environmental pollutants, scarring from sexually transmitted disease (STDs), and/or decreased sperm count.

A "female" factor is responsible for 40 to 50 percent of infertility. Female infertility can be caused by the following: scarring from STDs or endometriosis, ovulation dysfunction, poor nutrition, hormone imbalance, ovarian cysts, pelvic infection, and/or tumors. The reasons for the remaining 10 to 30 percent of infertility cases are often never known.

Women are most fertile in their early 20s. As a woman ages beyond 30 (and particularly after age 35), the likelihood of conceiving is less than10 percent per month. In addition to age-related factors, increased risk for infertility can include:

• Multiple sexual partners (increases the risk for STDs)
• Sexually transmitted disease (STD)
• History of pelvic inflammatory disease (PID)
• Mumps (men)
• A varicocele (varicose veins within the scrotum)
• Eating disorders (women)
• Anovulatory menstrual cycles (menstrual cycles where no egg was produced)
• Endometriosis
• Abnormalities of the uterus or cervical obstruction
• Chronic diseases, such as diabetes 

Preventing infertility starts with the practice of safe sex, since many STD’s can frequently cause infertility. Gonorrhea and chlamydia are the two most frequent causes of STD-related infertility. These diseases can cause scarring of the fallopian tubes and subsequent decreased fertility, absolute infertility, or an increased incidence of ectopic pregnancy. Mumps immunization to prevent mumps in males is important in preventing mumps-related sterility. Some forms of birth control carry a higher risk for future infertility, such as the IUD. Women who choose the IUD as a form of birth control should be aware of the very slight risk of infertility associated with its use.

There are a variety of tests that can be used to diagnose fertility issue in men and women. A comprehensive medical examination of both partners is the first step to an accurate diagnosis. Tests that may be performed include:

• Semen analysis
• Measuring basal body temperature to determine the woman’s time of ovulation
• Monitoring cervical mucus changes throughout the menstrual cycle
• Postcoital test (PCT) is used to evaluate sperm-cervical mucus interaction
• Blood tests to measure the serum hormone levels for either or both partners
• Endometrial biopsy
• Measuring urinary luteinizing hormone to predict ovulation
• Progestin challenge is sometimes performed with sporadic or absent ovulation
• Hysterosalpingography (HSG) is an X-ray procedure done with contrast dye that enables
  evaluation of potential transport from the cervix through the uterus and fallopian tubes
• Laproscopy is sometimes used for direct visualization of the pelvic cavity
• Pelvic exam (women) to determine if there are cysts

Treatment will depend upon the cause of the infertility for any given couple. Options range from education and counseling, to the use of medications that treat infections or promote ovulation. Sometimes artificial reproductive technologies, such as in-vitro fertilization (IVF) or Intra- Cytoplasmic Sperm Injection (ICSI), are the appropriate form of treatment.

The types of Artificial Reproductive Technology (ART) include:

• In Vitro Fertilization (IVF) - This is the original “test tube” technique.
• Intra-Cytoplasmic Sperm Injection (ICSI) - With this technique, a single human
  sperm cell is injected into the cytoplasm of the egg.
• Micro-Epididymal Sperm Aspiration (MESA) / Testicular Sperm Aspiration (TESA) -
  Sperm harvested by these techniques is specific to male infertility.

For more information on the Regional Fertility Lab at Odessa Regional Medical Center, please email clwallace@iasishealthcare.com.