Facts a

Despite better understanding about the process of conception, misconceptions still exist

Fo r many of us, having a family i s a lifelong dream. But for some t he dream stays exactly rh at, and for some the journey ro pareuthood is long and challenging

From what we are taught in our science lessons to wha t we see and hear around us, it is easy to assu me thar intercourse equals pregnancy; bur is it really as simp le as that?

Fertiliry is nor always as sti-aightforwa rd as it would seem; one in six peop le e n coLrnter infertility. Infertility is defined as unsuccessful conception after l 2 months of unprotecred intercourse for women und er 35, and for women over 35 this decreases to 6 months However, in society the re is a common misconception of fertility, thar all factors associated with conceiving a child are solely related to women When in acrual fact, the reality is very different.

Dr Ashish D as from C ity

Fertility Ce n tre in Brisbane sca red that "a third of the probl ems are fema le, a tl1ird of the problems are ma le and a third of the prob lems are combined".

Dr Das is a fertili ty specialist and co- fou nder of the C ity

Fertility Ce n tre, which celebrated irs 10'" birthday tl1is year, an d specialises in Gynaecology, IVF and fe r tiliry care. He has over t\VO decades of exper ience under his bel t and i s known for his excellent rapport with patients, as well as h is friendl y and caring nature. He also provides a comprehensive male fertility servic e.

Another common misconception within the Indian community is t hat women a re sole ly resp onsible fo r bearing a child, a n h eir that will carry forward the family name. Due to this dose- mindedness, when a woman is unable to bear a child, many suffer taunts a nd curses, and many are also ostraci sed for being haanj (infertile). For m a ny couples, the heartache and yea rs of yearning fo r a c hild could have been an d can be avoided by understanding and accepting that a man's sexual

Dr Ashish Das

health also plays a major role in me start and d evelopment of a new life, and by carrying t he 'x' or 'y' chromosom e, the sperm determines tl, e gender of the child.

,cl always rec ommend ro my patients that both partners get tested; after all it is a team effort and also it is easy to test male fertility. That way, if the man's sexual h ealth is in p e rfect condition, we can eliminate any male factor in tl1e infertility;' said Dr Das.

The main causes of male in ferti lity incl ud e the following, to name a few:

Azoosperm.ia

Th e Lack of sperm in semen. Thi s rare co n dition is som etimes symptomatic of testicular disease or b lockage O ften , the cause o f testi cular disease is unknown, bur it rnay be related to mtrn1ps or to gen etic disorders.

Bila teral absence of the Vas

Defe.cens

This greatly affects a m an 's fertility since the sperm are essentiall y smck in the testic les, w ith no way of reaching the uretl1ra and out of tl1e body O n e of tl1e major symptoms of this i s Azoospermia.

Cryptochidism

Is a likely diagnosis when a man's tes tes h ave nor descended into me scrotum

Epididymitis

Th is is w here the sperm undergo the fi n al maniration process. If infec t ed, tl,e epidid ym i tis can malfunction o r become a hostile en vironment fo r sperm Obv ious s igns of epididym i ti s include swollen, painful testicles.

Hyperprolactenem.ia

This i~ the excessive pro duction of the hormone Pro.lactin (whi ch produces milk in pregnancy a nd tl1at supp r esses ovulation). In men, abnormal ProLactin levels can lead to sexual dysfunctio n. It can be symptomatic o f the below Hypothyroidism (A condition in which the body lack s Thyro id hormone).

Symptoms in men m ay be associated wi.th: i m potence, visual disrurbances, su dden weight loss or gain, fatigue or dep ression Immunological irtfeniliry

This is when the immune system reacrs to its own sperm as if they were invadi n g cells which can be caused by an infection or a vasectomy In such circumstances, the immune system attacks the sperm

Klinefelters syndrome ls a chromosomal disorde r in men, characterised by oo sperm i11 the e jaculate or a low sperm count. This is a genetic disorder and several physical cha.ractecistics c an d eter m i ne that Klin efel rers is present, such as small testes or a small penis.

Sperm problell.lS

T he odds of co nceptio n are l owered when sperm concentratio n s are lower tlian norm al, a condition known as O Ligospermia. If sperm have poor swimming ability (Astl,cnozoospermia) (motility) or are misshapen ( f eratozoosper mia) (morphology), tl1e sperm's ability to fertilise the egg is compro m ised. Sper m pro b lems ca n be caused by hormonal imbalance and genetic abnormalities. :Environmen t.'ll fac rors such as exposure to hig h temp erawres, smoking and alcohol can al.so cause these abnormalities. lofertiliry in women can b e caused by several factors, such as:

\V/e are a,vare that age significantly impacts the fe r tility of a woman, and begins co declin e after tl1e age of 35 years, bm many of us do nor know w h y The reason for this is because, unlike men, women are born with a set number of eggs (approx 300,000), th erefo re as the woman ages, so do her eggs.

Ainenorrhea

A medi cal term used for the ab senc e of menstruation

Symptoms usually include: abnormal hair growth, breast milk production in cl,e absence of a pregnancy and troubl e witl1 balance, vision or coordination.

A11ovulation

A medical term used for a when a woman d oes n ot ovulate, and occurs without symptom

Endomerriosis

Resu lts when blood Aows backwards tlnou g h tl1e fallopian wbes and grows outside the merus Endomettiosis c an block the fall o p ian robes and prevenc sp erm from reaching th e fallopi an tube and fe r tilising tl1e egg Common symptoms of E nd omettiosis include painful an d heavy m e nstrual bleeding and painful i ntercou.cse

''Factors such as stress, smoking, alcohol, weight, diet and exerci se affect ferti lity in both men and women and red uce the chances of conception

''Polycysric Ovarian Syndrome (PCOS)

This is when th e ovaries secrete bigh amoun ts of androgen s (male hormones), which can ofte n cause problems with ovula ti on. Symptoms associated with PCOS indude: weight gain, abnor m al hair growth, irregular periods, acne, enlarged ovaries o r oily skin.

J'vlan y of u s are tmaware but o ur lifestyle choices and riming of intercourse play a major role in c h ances of concep ti on Factors such as stress, smoking, alcohol, weight, diet aod exercise affect fertility in both me n and women and reduce tl,e chances of co n ception. The fcrlility window i n a woman aL~o p lays a major role in the chances of conception. B y having timed intercourse you increase yo ur chan ce of conc eption. The days leading up to ovulation in a woman are known to be tl1e most fertile; this correspo n ds to second and tl,e beginning of tl1e third week in a normal 28 day cycle - at ar0tmd the 14' h day. A wo m an's bod y provides signals when the egg has been released and during fertile periods. This is done by monitoring tl, e cervical mucus A trusted m eclmd of understanding tl1e ovulation signals is the Billings ovulation method. H owever, these days wi th the latest technologies and apps on ph ones which can accurately calculate fertile days, it has become m uch easier

Jf you feel your fertility may not qui te be w h at it could be i t is essential to 6nd o u t as soon as possible, and tl1e best way to do so is togetl1er as a team.