Introduction

Infertility or issues with the male/ female reproductive system is an agenda gradually affecting millions of people worldwide. Medically it is defined as a disease of the male or female reproductive system, impacting the pregnancy status even after 12 months or more of unprotected sex; that said the psychological impact of the condition often has far-reaching consequences. It is often females that have to face the social stigma associated with it more than males. Buy Clomid Online In Australia is the best medication used to treat infertility in women.

Statistics

Since 2013, Australia’s fertility rate has fallen by 7.5%. The department of health has registered a marked increase in infertility issues in Australia with one in seven couples not being able to get pregnant within the 12-month span. The problem increases after 12 months with almost 15% of couples not able to achieve being pregnant. The overall result of the situation has edged down the fertility rate to 1.74 per woman which in turn has affected the capital.

It is important to understand the pathophysiology of pregnancy to get a better idea of the situations

Pathophysiology of fertility

The whole pregnancy process starts with sperm cells and eggs. Among the millions of sperms ejaculated, one is sufficient to fuse with the egg for a positive status on pregnancy. Eggs are contained in the ovaries of the female reproductive system and mature monthly through body hormones while being aided by the menstrual cycle. These hormones are responsible for the thickening of the uterus line in preparation for pregnancy.

Halfway through the menstrual cycle, the mature egg leaves the ovary through ovulation and travels through the fallopian tube towards the uterus. The sperm joining with the egg at this point accelerates the process of fertilization. This is preceded by the fertilized egg traveling through the fallopian tube towards the uterus.

This is followed by implantation (the fertilized egg getting attached to the lining of the uterus) and the subsequent development of the embryo, placenta, and fetus.

A disruption in any of the above-mentioned course of events disrupts the fertilization procedure and in turn, results in infertility/abnormal pregnancy situation. The body sends out signs that being identified at the right time can make it easy to make a decision regarding treatment options.

Here are some of these symptoms

How to identify if you have fertility issues?

– Irregular periods

Irregular periods or abnormal ovulation phases account for 30%-40% of all cases of infertility. It is still possible to get pregnant with an irregular period but the ovulation time fluctuates in such cases which decreases the success rate of embryonic fertilization.

– Painful or heavy periods

Painful periods in themselves are not an identification factor for infertility. But the factors associated with painful periods like

• Endometriosis – abnormal growth of tissue lining the uterus
• Adenomyosis – endometrium growing within and into the muscle of the uterus
• Fibroids – benign muscular growths in/on uterus, cervix, or pelvic ligaments

All of these can disrupt the normal menstrual phase and affect the fertility phase.

– Lack of periods

Amenorrhea or lack of periods can be a result of

• failure of ovaries
• problems in CNS or hormones related to menstruation
• problems with other reproductive organs

All of which can cause a significant impact on the fertility capacity of the individual

– Painful intercourse

Painful intercourse or dyspareunia can be a result of fibroids, endometriosis, or a combination of either. The underlying problem can result in fertility conditions. The pain in itself can deter healthy ovulation impacting the condition.

– Hormone fluctuations

Hormonal fluctuations are considered the leading cause of infertility in women. Either associated with PCOS or anovulation, it can manifest in the form of

• decreased libido
• increased facial hair
• acne breakouts
• menstruation imbalance

All of these conditions are indicative of fertility issues and should be dealt with in time to reduce the impact of the problem

Impact of the problem

Addressing the problem is important in a lot of ways but mostly to remove the psychological burden from the female that suffers even if it is the male’s fault. Studies have shown that infertility issues result in the majority of anxiety in the lives of couples accompanied by emotional distress. A survey of 200 couples visiting a fertility clinic found 50% of the women and 15% of men describing it as the most upsetting period of their lives.

That coupled with the stigma of social pressure results in reduced self-esteem with the subsequent fear of contraceptives and protected sex methods. In such situations, it becomes important to address the root cause of the problem and get help accordingly.

The WHO recognizes that provision of high-quality services for family planning and fertility care services is one of the core elements of reproductive health. Only through the timely acquisition of medical help can it work further in developing guidelines on prevention and treatment of the issue while promoting global research on the situation.

When to get medical help?

It is important to get medical help depending on how long have you been trying to conceive.

If you are 35 or less – The physician recommends trying for a period for getting period before trying treatment measures.

If you are between 35 – 40 – Physician advises waiting no more than 6 months before getting help for your condition

If you are above 40 – You are advised to get treatment right away without the pre-existing waiting period

If you have a previous diagnosed history of endometriosis or polycystic ovary – as these can increase the risk of complications associated with conceiving or carrying the pregnancy to its completion.

Diagnostic Tests to identify the cause of infertility

Causes of female infertility

The chief causes of infertility can be summed up as endometriosis and the presence of fibroids as discussed previously. Other than these other causes are-

• Ovulation problems

Ovulation issues or failure to release the egg into the tube can be a result of

• PCOS – Polycystic Ovary Syndrome
• As a result of thyroid problems
• Due to premature ovarian failure resulting in the ovaries before the age of 40
• Scarring from previous surgery

Surgeries like pelvic or cervical surgery can scar the structure of the reproductive organs resulting in infertility.

• Cervical mucus problem

Cervical mucus is important for facilitating the sperm to swim through it easily. Insufficient mucus can in turn cause hindrance in the pathway of sperm resulting in infertility problems.

• Pelvic inflammatory condition

Also referred to as inflammation of the upper female genital tract, it scars the fallopian tube and is a major cause of infertility problems.

• Sterilization

Previous surgical blockage of fallopian tubes is opted for my woman not wanting to get pregnant or have more children.

• Effect of medication

Side effects of medications like NSAIDs, chemotherapy, and neuroleptic medication can affect the ovaries and make it difficult to conceive.

• Age

Treatment options

Treatment options once started by the physician consist of 3 main types of options

– Medications

Medications are introduced in the first phase of the treatment period in an effort to regulate the disrupted menstrual phases and induce ovulation

Some of the main medications are

Clomid

Clomid works by stimulating an increase in the number of hormones supporting the occurrence of ovulation. Clomid in Australia is considered an important medication and advised by gynecologists and health experts alike. Clomid has an 80% rate of ovary stimulation. It is estimated that around 40-45% of women using Clomid get pregnant within six cycles of use.

Apart from Clomid, Tamoxifen, Metformin and  Gonadotrophin are other medications popular as fertility-promoting drugs. But of all, Clomid is considered a ‘first-line medication and subsequently one of the most trusted brands in the market. Apart from treating women with ovulation issues, it increases the egg count which helps in low sperm cases.

Additionally, the fewer side-effects associated with its use have further improved its popularity and made it the starting treatment mode in infertility cases.

– Intrauterine insemination

It is the next step of fertility treatment preferred by gynecologists. It involves putting sperm inside the uterus through artificial methods to enable healthy sperm to get closer to the egg. For better results, medical practitioners advise a combined result of IUI with Clomid or other medications to increase the number of eggs available for fertilization. This in turn improves the chances of pregnancy.

– Surgical intervention

Laparoscopy ( for checking the inside of the abdomen or pelvis), Fimbrioplasty ( surgical fallopian tube reconstruction), and IVF ( In-Vitro Fertilization) are some of the surgical procedures advised as the 3rd step of fertility treatment. Depending on your reproductive health and the treatment plan of the surgeon, you are advised of any of these options.

Some of the preventive measures that are advised by physicians worldwide for patients with risk of fertility issues are

Preventive measures

Maintain a healthy weight

Overweight and underweight women both are at an increased risk of infertility. A stable BMI is important for healthy living and promoting fertility.

Avoid alcohol

Alcohol has been known to increase the risk of irregular periods and fertility problems. Additionally, it can affect ovulation, making it increasingly difficult to conceive.

Reduced stress

Studies have found women having high levels of the alpha-amylase enzyme in their saliva ( a stress marker) take 29% longer to conceive. Stress can also lead to alcoholism and decreased libido further complicating things.

Quit smoking

Infertility rates in men and women who smoke have been found to be higher than in other cases. It is said that the chemicals in a cigarette decrease the sperm while destroying eggs important for fertilization.

Lifestyle choices

STDs like Chlamydia and gonorrhea are a major reason behind the scarring of reproductive organs and subsequent infertility. Lifestyle choices if improved can contribute significantly toward fertility.

Fertility awareness

Fertility awareness parameters like ovulation phase, discontinuing contraceptives, and keeping track of the menstrual cycle can go a long way in preventing infertility problems.

References

https://fertilitysa.com.au/2021/02/17/delayed-conception-infertility-on-rise/

https://www.google.com/amp/s/amp.smh.com.au/politics/federal/not-so-busy-australia-s-fertility-rate-falls-to-record-low-20191211-p53j2u.html

https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/multimedia/fertilization-and-implantation/img-20008656

https://www.verywellfamily.com/getting-pregnant-without-period-4129279

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https://www.nhs.uk/conditions/infertility/diagnosis/

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https://www.who.int/news-room/fact-sheets/detail/infertility

https://www.maxhealthcare.in/blogs/infertility-when-seek-medical-help

https://www.webmd.com/infertility-and-reproduction/guide/absence-periods

https://www.nhs.uk/conditions/infertility/causes/

https://www.kjkhospital.com/top-9-causes-infertility-women/

https://www.verywellfamily.com/clomid-treatment-101-1960183#:~:text=Success%20Rate,-Clomid%20will%20jump&text=(This%20isn’t%20the%20same,within%20six%20cycles%20of%20use.

https://www.researchgate.net/figure/Cumulative-conception-following-clomiphene-citrate-for-up-to-12-cycles_fig1_13772030

https://www.freedomfertility.com/blog/9-things-you-should-know-about-clomid/

https://www.infertilityivfhouston.com/blog/2015/04/29/the-benefits-of-combining-clomid-157677

https://www.webmd.com/baby/features/infertility-stress#:~:text=The%20Science%20Behind%20Stress%20and,to%20 those%20who%20had%20less.