The rising incidence of infertility is attributed to stress, sedentary lifestyle, improper food and sleeping habits, as these factors are negatively impacting reproductive health. While infertility cases are cropping up, young adults are majorly affected, and nearly 10 to 15% of newly married couples have fertility issues.
The prime reason for the increasing fertility concerns in couples is subjective to various lifestyle, occupational, and environmental factors. Moreover, infertility and reproductive impairment is increasing social stigma causing psychological and psychosomatic disorders.
Infertility is when the couple is unable to have children even after trying for more than a year. Long-term implications of infertility can leave couples with less or no social support, depression, distress, and high anxiety levels. A fertility score can help you understand your chances of having children and know how you can move ahead with fertility treatment.
In this Article
What is infertility?
A decline in the ability to give birth to a child due to a disease or restriction of the reproductive anatomy is infertility. According to the Mayo clinic, almost one-third of the infertility cases are due to female infertility, one-third are contributed by male infertility, and the remaining one-third can be due to both male and female fertility factors.
Female factors include ovulatory problems, structural abnormalities, blocked tubes, reproductive tract infections, low ovarian reserves, endometriosis, fibroids, ovarian cysts, and many more. Not to forget, increasing age is also one of the contributing factors.
Male infertility can be because of lifestyle and environmental factors influencing spermatogenesis (sperm production). Other reproductive factors include blocked tubes, ejaculatory problems, and erectile dysfunction, among others.
Infertility Tests in Men and Women
Lifestyle habits, such as excessive caffeine, alcohol intake, smoking, and high or low body weight, are potential contributors to infertility. Doctors advise optimisation of BMI and avoidance of caffeine, smoking, and alcohol for better chances of fertility.
Semen analysis in men is one of the most common fertility tests for men. According to the World Health Organisation (WHO), the normal sperm count for men ranges from 15 million to greater than 200 million sperms per millilitre (mL) of semen. According to WHO, a sperm count of less than 15 million sperm per mL or 39 million sperm total per ejaculate is considered a low sperm count or oligospermia.
Infertility tests in females include ovulation evaluation, hysterosalpingogram, and ovarian reserve test. Diagnostic laparoscopy and hysteroscopy are commonly performed minimally invasive tests for fertility.
If the tests show normal results or when the exact cause of infertility cannot be identified, it is unexplained infertility.
What is a Fertility Score Test?
While understanding infertility and the cause of infertility is essential, the physicians perform a reproductive health promotion or assessment while scoring fertility in a couple based on parameters, such as
- Age of the couple,
- Duration of infertility in both or either of the partners,
- Duration of Marriage,
- Lifestyle and environmental impact on fertility, and
- Type of fertility treatment required.
This kind of assessment can help improve fertility and fertility treatment outcomes by clearly understanding the reasons for infertility. Hence, known as the Fertility Score Test.
The fertility Score Predictor (FSP) application is a simple and effective method that aids in understanding the fertility potential with a wider social framework. The method involves the calculation of the couple’s score depending on various fertility scoring parameters and determining the fertility treatment a couple can benefit from.
- The FSP app educates the couple, their family, and physicians by devicing an effective treatment module and clearing the possible delay among aspiring couples.
- FSP is an efficient tool for couples seeking pregnancy without hesitation, getting into the vicious treatment cycle.
- FSP eases the decision-making process for couples unable to decide the mode of treatment.
- FSP is a user-friendly application that enables couples to clearly understand the severity and complication of the situation.
- FSP supports couples through awareness programs on infertility treatments.
Know your fertility Score: Take the Test
Here is a glimpse of how the fertility scores are allocated based on different questionnaires and conditions of an individual.
1) Age of the person:
- 16-25 = 5 pts.
- 25-29 = 4 pts.
- 30-34 = 3 pts.
- 35-37 = 2 pts.
- 38-40 = 1 pt.
- 41 or older = 0 pts.
2) Length of the menstrual cycle (from the day one of one period to the next without hormonal interventions):
- Regular periods (27-34 days) = 3 pts.
- Slightly delayed periods (35-40 days) = 2 pts.
- Very Short (24-26 days) or Unpredictable periods= 1 pt.
- Rarely occurring periods = 0 pts.
3) Previous pregnancies:
- 1 or more live births = 3 pts.
- 1 or more elective pregnancy terminations = 2 pts.
- 1 or more miscarriages = 1 pt.
- Yet to try for a pregnancy = 1 pt.
- Have tried, not successful = 0 pts.
4) History of pelvic surgeries:
- No prior surgeries = 3 pts.
- Uterine surgeries- D&C, abortion, polyp removal = 2 pts.
- Major surgeries of the uterus, tubes or ovaries- myomectomy, cyst removal, tubal reconstruction = 1 pt.
- Ovary removal = 0 pts.
For more than one surgeries select less than one point
5) Frequency of sexual intercourse:
- More than 3 times a week=5 pts.
- 1 to 2 times per week = 4 pts.
- Once a week or less = 2 pts.
- Nearly once a month = 1 pt.
- Not yet = 0 pts.
6) Age of the mother at menopause:
- 50 or older = 3 pts.
- 45-50 = 2 pts.
- 40-44 = 1 pt.
- Less than 40 = 0 pts.
7) History of sexually-transmitted disease (STDs):
- No STDs = 3 pts.
- Have had herpes, HPV, or any other STD- gonorrhoea or Chlamydia = 2 pts.
- History of gonorrhoea or Chlamydia = 1 pt.
- History of pelvic inflammatory disease (PID) = 0 pts.
If you have more than one STD infection choose the lowest point value.
Assessment of Fertility Score Test for IVF
Fertility score test allocates numbers from 0 to 20 or more and colour codes green, blue, orange, red, and black. The treatment options according to the number and colour demarcation includes:
| Score and colour-code | Treatment options |
| Green (>20 score)- Fertility on a high | Fertility management through diet modifications, stress reduction, lifestyle changes- weight loss, quit smoking and limiting caffeine. Try for natural conception |
| Blue (15–19 score)- Fair chances of getting pregnant | Involves basic investigation, hormonal assays, semen analysis. Timed Intercourse (TIC), ovulation monitoring through basal body temperature (BBT) or sonography. |
| Orange (10–14 score)- Possible chances of enhance fertility | Continuous involvement in Ovulation Induction (OI) with ovulogens and/or gonadotropins. Intrauterine Insemination (IUI) cycles and endoscopy. |
| Red (5–9 score)- Need to see an infertility specialist or reproductive endocrinologist | Assisted Reproduction Techniques through IVF, ICSI, intracytoplasmic Selected Sperm Injection (IMSI). Use of sperm aspiration like TESE, PESA, micro-TESE, blastocyst culture, and time-lapse monitoring during the cycles. |
| Black (<5 score) – Need to seek alternative fertility treatment options | Third party assisted reproduction- using donor gametes, embryo, surrogacy, and uterine transplant. |
Frequently Asked Questions
What are the signs of infertility in women?
The major sign of infertility is the inability to get pregnant. Other symptoms that indicate fertility problems in women are:
- Pain during intercourse,
- Heavy, long, or painful periods,
- Irregular menstrual cycle,
- Hormonal fluctuations,
- Obesity and associated medical conditions.
What can cause a low sperm count or poor sperm concentration?
The poor concentration of actively motile sperm may be due to several factors, including excessive heat- regular use of hot tubs, sauna, or high body temperature, use of illicit drugs, excessive alcohol intake, too much cigarette smoking, occupational exposure to endocrine-disrupting chemicals, certain medications and medical conditions.
How much sperm count is normal?
In men, the normal sperm numbers can be anywhere between 15 million to greater than 200 million sperm per millilitre (mL) of semen. However, sperm numbers less than 15 million sperm per mL of semen is considered a low sperm count.
Conclusion
The infertility condition and nature of fertility treatment required differs from one person to another. A fertility score assesses the various characteristics and conditions affecting your ability to have children. The scoring through numbers and colour demarcations indicate the kind of treatment you need.
You can take advantage of the fertility score prediction application to check your fertility status. Or you can check with your doctor to get a detailed analysis of your fertility and take the best treatment possible to cherish parenthood.
