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Infertility is the inability to naturally conceive a child or to carry a pregnancy to full term. There are many reasons why a couple may not be able to conceive, or may not be able to conceive without medical assistance.Common believes that it is easy to have a child and are often surprised when the woman does not fall pregnant as soon as they start trying for a baby. The chance of getting pregnant in each menstrual cycle (each month) is very high.

However, it may take a long time to conceive, even if everything is looks normal, because some may just be a bit weak. Eight out of every ten women trying for a baby will fall pregnant within the first six months. Women who do become pregnant without any medical assistance generally do so within 8 months of trying. It is common for couples to seek help and advice if there is difficulty conceiving. Overall, around 15 per cent (one in six) of all couples will seek help.

The point at which they may want to seek help will depend on various factors. For example, if they are over 35 years of age or if they have any worrying symptoms, such as infrequent periods and so on, the couple should seek help after about six months of trying.

INFERTILITY WOMEN

Ovulation is the end of a complicated series of events leading to the release of an egg from the ovary. If that egg is fertilized by a sperm and implants in the lining of the womb (endometrium), a pregnancy has started.

All of a woman's eggs will already be present when she is born. From the early years of childhood, she starts to lose eggs, but it is calculated that a woman aged 50 still has about 1000 of her eggs left.

A woman's cycle begins with a hormonal signal from the pituitary gland at the base of the brain. It releases a follicle-stimulating hormone (FSH), which stimulates the ovaries. FSH stimulates a group of about 20 follicles on the surface of the ovary to grow. Within the follicles are the developing eggs.

Another hormone, estrogen, is produced by the ovary and in response to increasing estrogen levels; the largest follicle continues to develop. This is why most pregnancies result in only a single baby.

Another hormone, luteinizing hormone (LH), also produced by the pituitary gland, causes the follicle in the ovary to release the egg. This release of the egg (or ovum) is called ovulation.

After ovulation, the empty follicle forms a structure called the corpus lustrum which produces a hormone called progesterone. Levels of progesterone rise after ovulation and prepare the womb to receive a fertilized egg (embryo). Fertilization by a sperm, if this occurs, takes place in the Fallopian tube, which then moves the early embryo along towards the womb itself. If the egg isn’t fertilized, or the embryo does not implant in the womb, the progesterone levels fall and a period starts. The whole cycle then begins again.

INFERTILITY MAN

The man's role in conception is the production and ejaculation of sperm cells. To fertilize an egg, a man must be capable of producing adequate numbers of swimming (motile) sperm. Only a few of these sperm cells will in the end reach the egg, and only one will actually enter and fertilize it.

During puberty, the testes become active and start to produce sperm. From his teens until about the age of 70, a man will typically produce 5,000 sperm cells every minute. Ejaculation produces semen, which is a mixture of two per cent sperm cells and 98 per cent liquid produced by the glands in the testes. Production of sperm is under the control of FSH and LH, the same hormones that control the woman's fertility.

WOMEN

Female infertility occurs when the woman does not conceive after one year of attempting to become pregnant. Other signs and symptoms depend on the underlying cause of the woman's infertility.

MAN

The history should include prior testicular (penis) insults (torsion, cryptorchidism, trauma), infections (mumps orchitis, epididymitis), environmental factors (excessive heat, radiation, chemotherapy), medications (anabolic steroids, cimetidine, and spironolactone may affect spermatogenesis; phenytoin may lower FSH; sulfasalazine and nitrofurantoin affect sperm motility), and drugs (alcohol, marijuana). Sexual habits, frequency and timing of intercourse, use of lubricants, and each partner's previous fertility experiences are important. Loss of libido and headaches or visual disturbances may indicate a pituitary tumor. The past medical or surgical history may reveal thyroid or liver disease (abnormalities of spermatogenesis), diabetic neuropathy (retrograde ejaculation), radical pelvic or retro peritoneal surgery (absent seminal emission secondary to sympathetic nerve injury), or hernia repair (damage to the vas deferens or testicular blood supply).

INFERTILITY WOMEN

Diagnosis of infertility begins with a medical history and physical exam. The healthcare provider may order tests, including the following:

• an endometrial biopsy, which tests the lining of the uterus
• hormone testing, to measure levels of female hormones
• measurements of thyroid function (a thyroid stimulating hormone(TSH)level of between 1 and 2 is considered optimal for conception)
• laparoscope’s, which allows the provider to see the pelvic organs
• measurement of progesterone in the second half of the cycle to confirm ovulation
• Pap smear, to check for signs of infection
• pelvic exam, to look for abnormalities or infection
• a postcoital test, which is done after sex to check for problems with secretions (not commonly used now because of test unreliability)
• special X-ray tests

Diagnosis of infertility should be made by physicians who are fellowship trained as reproductive endocrinologists. Reproductive Endocrinologists are usually Obstetrician-Gynecologists with advanced training in Reproductive Endocrinology & Infertility (in North America). These highly educated professionals and qualified physicians treat Reproductive Disorders affecting women but also children, men, the postmenopausal woman. These specialized professionals treat primarily, infertility for both sexes.

Prospective patients should note that reproductive endocrinology & infertility practices do not see women for general maternity care. The practice is primarily focused on getting their patients pregnant.

INFERTILITY MAN

The diagnosis of infertility begins with a medical history and physical exam. The provider may order blood tests to look for hormone imbalances or disease. A semen sample may be needed. The volume of the semen is measured, as well as the number of sperm in the sample. How well the sperm move is also assessed.

The cornerstone of the male partner evaluation is the history. It should note the duration of infertility, earlier pregnancies with present or past partners, and whether there was previous difficulty with conception.

A complete examination of the infertile male is important to identify general health issues associated with infertility. For example, the patient should be adequately virilized; signs of decreased body hair or gynecomastia may suggest androgen deficiency.

The scrotal contents should be carefully palpated with the patient standing. As it is often psychologically uncomfortable for young men to be examined, one helpful hint is to make the examination as efficient and as matter of fact as possible.

The per testicular area should also be examined. Irregularities of the epididymis, located posterior-lateral to the testis, include indurations, tenderness, or cysts.

Fertilization only happens if intercourse takes place almost around the time of ovulation. Ovulation only takes place once in every menstrual cycle, which means that there are only a few days each month when a woman can fall pregnant. However, intercourse and ovulation don't need to be at exactly the same time as healthy sperm can survive for about 48 to 72 hours inside a woman's body and a woman's egg lives for about 12 to 24 hours after ovulation.

Fertility is therefore a result of sperm and egg meeting each other almost immediately after ovulation. Ovulation occurs 14 days before the onset of a period normally but for some cases it has been proven that the women can ovulates during a high hormonal activities. This is reasonably predictable if the cycle is regular, but may be very unpredictable if the cycle is irregular.

The hormone balance must be correct to ensure an egg develops and ovulates normally. Intercourse must take place during the fertile part of the cycle or at the time of high hormonal activities in the body. There must be an adequate number of strong sperm and no mechanical barrier such as blocked Fallopian tubes or others cyst, which may prevent sperm reaching the egg.

Tests to predict ovulation.
Ovulation raises the body temperature slightly, so for many years women were advised to take their temperature every morning to find out when they were ovulating.

This will give information about the number of sperm per milliliter, the percentage of sperm swimming normally (motility), and the percentage of abnormal sperm. There can be considerable variation in the results between different samples, which is why a reduced semen analysis will always be checked with one or two repeat tests.

The sperm must first looks normal in quantity and then the sperm must not be too thin, must be thick enough but not too dry like type.

INFERTILITY WOMEN

1. Stagnation of Kidney and Ovary's Qi.
2. Kidney and Ovary cold- Yin deficiency.
3. Physical blockage- fallopian tube or cyst.
4. Liver and Kidney Qi deficiency- Hormonal problems, irregular menstruation.
5. Stress- Liver complications.

INFERTILITY MAN

1. Kidney's Qi deficiency.
2. Liver complications.
3. Lung's Qi deficiency.

All of these can be treated in 1 week to 6 months depending on what and how many symptoms. Usually only CHINESE MASTER'S Way of Medication and Herbal medicine and the DO'S and DO NOT is enough to achieve for a great baby. If for very special case you have to come over to Acupuncture and Herbal Treatment centre in KL for INTENSIVE treatment.

2 weeks will be sufficient for the course, let them guild you through and give you your Baby.

Infertility can be defined as the failure to achieve pregnancy after regular unprotected sex for at least 2 months. 'Primary' infertility means failure to achieve a first pregnancy, 'secondary' infertility means failure to achieve a subsequent pregnancy.

Primary infertility is an extremely common problem, affecting more than one in seven (15 per cent) couples attempting their first pregnancy in all the cities of the world. Among those experiencing difficulty with conception, a male fertility problem is considered important in around 40 per cent of couples. In 15 per cent of couples it will be solely a male fertility problem and in around 25 per cent, there will be a problem in both partners.

Why do men get fertility problems?

There are several causes of fertility problems in men. They include:
Obstructive problems (blockages in sperm-carrying tubes)
Testicular injury and disease
varicocele
Sperm disorders
Genetic disorders
Problems with erection and ejaculation
Hormonal problems
General medical disorders that reduce fertility, weak conditions
Western drugs that reduce fertility
Environmental toxins and radiation.
Obstructive problems
A blockage in sperm-carrying tubes has many potential causes. The most common are outlined below.

Groin surgery (including hernia repair and fixation of undecided testicles).

Trauma to the scrotum sack covering the testicles (even fairly minor sporting injuries).

Infection (particularly chlamydia, gonorrhoea and tuberculosis).
Previous vasectomy (a form of contraception that involves tying the sperm-carrying tubes).

Some men have congenital (present at birth) absence of the vas deferens on one or both sides. The vas deferens is the tube that conducts the testicular component of semen to the urethra, which then carries semen through the penis to the outside world. About 10 per cent of men with an obstructive cause for their infertility will have this problem. The seminal vesicles (where other semen components are made) are often absent too.
Another rare obstructive cause is Berry-Perkins-Young syndrome, in which sufferers have a chronic chest disease (bronchiectasis), chronic sinusitis and obstructive infertility, Lung's Qi obstruction.

Testicular injury and disease

A blow to the testicles, which may occur in sport or during a fight, can cause swelling of the testicles, or bleeding in or around them. This probably causes the blood supply to the testicles to fail, resulting in permanent damage to the sperm production mechanism. Torsion of the testicles (twisting of a testicle on its cord) can have a similar effect if it is not treated very quickly with surgery. Viral infections can cause inflammation of the testicles (orchitis, which usually appears as painful swelling of the testicles) and failure of sperm production.

Mumps is the best-known cause, but is not the only one. Mumps will only affect fertility if it causes orchitis and, even then, only rarely. Undecided testicles (cryptorchidism) are another common cause of failure of sperm production.

Infertility - Varicocele

A varicocele is a dilation of the testicular veins in the spermatic cord that leads from the testicles to the abdomen. The role of this condition in causing infertility is uncertain and highly controversial. Varicoceles occur in 15-20 per cent of fertile men and 30-40 per cent of men with fertility problems. They can occur on either or both sides, but are far more common on the left.

Infertility- Sperm disorders

Disorders of sperm numbers, movement and shape are common in men with infertility. Prolonged abstinence from ejaculation can affect sperm motility. Modern techniques can identify structural and biochemical abnormalities within the individual sperm.

Infertility- Genetic disorders

Problems with chromosomes (packages of genetic material) occur in about 2 to 20 per cent of infertile men and can affect their fertility in two ways:

chromosome disorders can affect the development of the testicles. These are usually disorders of the sex chromosomes, by far the most common being Klinefelter's syndrome. In this disorder, instead of having 46 chromosomes, including one X and one Y chromosome (46XY), the man has an additional X chromosome (47XXY).
Chromosome abnormalities can disrupt cell division and sperm production.
Problems with erection and ejaculation
Problems with sex are the principal cause of infertility in about 5% of couples. This can be due to:
Impotence (inability to attain or maintain an erection adequate for intercourse)
Premature ejaculation
Failure to ejaculate
Inability to achieve vaginal penetration for other reasons.
Hormonal problems

Testosterone deficiency can reduce fertility and may be caused by problems with testicular testosterone production, or problems with the pituitary gland or hypothalamus in the brain, which control testosterone production. Overproduction of prolactin (hyperprolactinaemia), a hormone produced by the pituitary gland, may also reduce fertility.

General medical disorders that reduce fertility
There are several conditions that may reduce fertility:
Fever: influenza, pneumonia, or even a severe cold can cause a high fever, which will adversely affect sperm production and quality. These changes usually recover over a few weeks.

Diabetes: in the longer term, diabetes can cause problems with erection and ejaculation through causing damage to the function of the 'automatic nervous system'.

High blood pressure: high blood pressure can cause problems with erection, either directly or as a side effect of medication e.g. amlodipine.

Coronary artery disease: coronary artery disease can cause problems with erection. This could be due to generalized hardening of the arteries, in the penis as well as the heart, or to drugs used in the treatment of heart problems.

Neurological disorders: multiple sclerosis, stroke, and spinal cord injury and disease can all cause problems with erection and ejaculation.

Kidney disease: chronic renal failure, which results in a build up of waste products in the body, can adversely affect sperm quality and fertility. It can also cause erection problems.

Cancer: cancers that affect the genital tract or endocrine (hormone-producing) systems may directly reduce fertility. Otherwise, drugs and radiation used to treat cancer may severely reduce sperm production or even stop it altogether. Stress (see below) may also have an effect.

Alcoholism: alcohol is toxic to sperm and overuse of alcohol can reduce sperm quality and fertility.

Stress: stress causes several hormonal changes in the body that can affect fertility. Stress can have many causes, including anxiety over fertility problems.

Drugs that reduce fertility

Infertility-Alcohol Reduces sperm count and quality
Infertility-Tobacco May reduce sperm motility
Infertility-Marijuana May affect hormone production
Infertility-Opiates (heroin, morphine) Affect hormone production
Infertility-Anabolic steroids Affect hormone production

Infertility- Prescribed drugs
Effect Main Use Amiodarone Inflammation of the testicles and epididymis (epididymo-orchitis) leading to problems with sperm production - Abnormal heart rhythm
Cancer chemotherapies May severely reduce sperm count, quality and motility. -Effects may be permanent Cancer
Cimetidine Affects hormone production and reduces sperm count- Peptic ulcer and acid reflux Disease, indigestion
Colchicine May severely reduce sperm count- Gout
Digoxin Affects hormone production- Heart failure; abnormal heart rhythm
Erythromycin May reduce sperm count Chest infections
Gentamicin Reduces sperm count Bacterial infections
Hormonal therapies May disrupt other hormone production various
Ketoconazole Reduces sperm count -Fungal infections
Methotrexate Reduces sperm count - Some cancers; arthritis
Nitrofurantoin Reduces sperm count -Urinary tract infection
Phenytoin Reduces sperm quality and motility -Epilepsy
Spironolactone Affects hormone production- Fluid retention
Sulphasalazine Reduces sperm count and quality -Ulcerative colitis

Infertility- Environmental toxins and radiation Several media reports have highlighted research studies showing that sperm counts are falling and that male fertility is declining, possibly because of environmental pollution. A similar number of studies have shown no change whatsoever, but these do not make such good headlines and often fail to be reported in the media.

Is male fertility in decline? Because evidence exists both one way and the other, the answer must be 'maybe'! One thing is certain, and that is that many more environmental toxins that might affect fertility exist now than 50 years ago.

Potential toxin Origin Effect Alkylphenols Industrial and domestic detergents -Hormonal disrupter
Bisphenol A Lacquers to coat foods; dental treatments -Hormonal disrupter
Dioxins Paper production; transformer disposal - Hormonal disrupter
Organochlorine pesticides (Lindane, DDT, etc,) Lindane used on cereals, soft fruits, and cabbage - Hormonal disrupter
Phthalates Plastics industry Hormonal disrupter, -testicular toxin
Phyto-oestrogens (found in certain types of plant products) some soya products- Hormonal disrupter
Vinclozolin Fungicide used on foods -Hormonal disrupter.

Nearly 90% of all infertility cases, both male and female factor, are overcome through treatment, including surgical and medical techniques. The physicians at Georgia Reproductive Specialists are committed to developing a treatment plan specific to each patient's needs that will lead to the desired result of conceiving a child. Chinese Master in KL treat the patient as a partner in treatment and work with them to determine the treatment option that will be most fitting for their situation based on financial, social, religious, ethical and medical factors. Treatment options include assisted reproductive techniques such as IVF and ICSI, ovulation induction to enhance the production of eggs, surgery to repair reproductive organs and intrauterine insemination to increase the chances for egg fertilization by the sperm.

IT USUALLY TAKE 2 MONTHS OF TRY TO GET PREGNANT, for some difficult cases it may takes a bit longer, so far their research shows 95% change of pregnancy with Chinese Master herbal medicine treatment.

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