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<p>Has anyone ever noticed that some couples have children shortly after marriage as planned, while many others try for years without any sign of pregnancy? So, what exactly is the real cause of infertility? Let&#8217;s find the answer together.</p>
<h2><span style="color: #00826a;">How long should you try to have a child before it is considered “infertility”?<strong><br />
</strong></span></h2>
<p>Infertility is a condition where a married couple has regular sexual intercourse without contraception for 1-2 years or more but still does not conceive. This condition often occurs in couples who marry late or are over 32 years old.</p>
<h2><span style="color: #00826a;">What are the possible causes of infertility?</span></h2>
<p><span style="color: #00826a;"><strong>Causes from the male side</strong></span></p>
<ul>
<li>Inflammation or infection in the testicles</li>
<li>Varicocele (enlarged veins in the scrotum)</li>
<li>Blockage of the sperm ducts</li>
<li><span style="color: #000000;">Behaviors harmful to the body such as regular alcohol consumption, heavy smoking, and drug addiction</span></li>
</ul>
<p><span style="color: #00826a;"><strong>Causes from the female side</strong></span></p>
<ul>
<li>Anovulation (lack of ovulation)</li>
<li>Blocked fallopian tubes</li>
<li>Uterine fibroids</li>
<li>Adhesions in the pelvic cavity or uterine horns</li>
<li>Endometriosis</li>
<li><span style="color: #000000;">Behaviors harmful to the body such as regular alcohol consumption, heavy smoking, and drug addiction</span></li>
</ul>
<h2><span style="color: #00826a;">Approaches to treating infertility</span></h2>
<p>First approach… treat the identified cause</p>
<ul>
<li>If sperm quality is poor, medication to improve sperm quality will be used</li>
<li><strong><span style="color: #00826a;">Surgery:</span></strong> In cases of blocked fallopian tubes, uterine fibroids, ovarian cysts, pelvic adhesions, and varicose veins in the scrotum</li>
</ul>
<h2><span style="color: #00826a;">Second approach… treatment using current fertility technologies</span></h2>
<ul>
<li>In vitro fertilization (IVF) is an artificial fertilization method where eggs and sperm are combined outside the body to form embryos in a laboratory dish, then the embryos are transferred into the woman’s uterus</li>
<li>Intracytoplasmic sperm injection (ICSI) is a step in IVF treatment where a single sperm is injected directly into an egg. Once fertilization occurs and embryos form, they are transferred into the uterus, similar to IVF. This method is suitable for cases where the male has low sperm count or abnormal sperm motility</li>
<li>Intrauterine insemination (IUI) involves injecting the strongest sperm directly into the uterus during the woman’s ovulation to place sperm as close to the egg as possible</li>
<li>Retrieving sperm from the testicles (PESA, TESE, MESA) is done when no sperm are present in the ejaculate. These methods extract sperm directly from the testicles or sperm ducts and are used in conjunction with ICSI</li>
</ul>
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<p>&nbsp;</p>
<p><span style="color: #00826a;"><strong>Dr. Korakot Namsena</strong></span><br />
Obstetrician and Gynecologist<br />
Women’s Health Center, Phyathai Nawamin Hospital</p>
</div>


Age may not be the only factor causing difficulty in having children. Some people are not very old but have been married for a long time and still haven't conceived. What could be the reasons, and what treatments are available? Let's find the answers.

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Married for a long time but still not pregnant. Having difficulty conceiving like this... what treatment options are available?

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