Infertility
What are the symptoms of infertility?
Formulary medicine only, to be obtained at a network GP, dentist or pharmacy.
What causes infertility?
Various factors in either or both partners can lead to infertility. General health status, lifestyle choices, and exposure to certain environmental elements can also hinder conception. Other causes can encompass menstrual irregularities in women and hormonal imbalances in men.
Infertility testing
Should you decide to go for testing and start potential treatment for infertility, bear in mind that it requires dedication from both partners. It will also entail questions about your sexual practices, and potentially uncomfortable tests and procedures that can be performed over several months. Even when undergoing all of this, there is regrettably no guarantee that you will conceive. The cost of infertility testing and treatment is expensive, and for many couples, the biggest concern is whether they can afford these costs.
PMB cover for Infertility
If you belong to a medical scheme, infertility is covered as a Prescribed Minimum Benefit (PMB).
PMBs include the diagnosis, treatment and care of infertility but the medical and surgical management that is guaranteed for members of medical schemes is limited to certain procedures and interventions. These include:
1. Hysterosalpingogram. This test evaluates the condition of your uterus and fallopian tubes to determine the presence of physical problems like possible blockages of the fallopian tubes
2. Blood tests to test for the presence of the following:
Day 3 FSH/LH. FSH stands for "folliclestimulating hormone" and LH stands for "Luteinizing hormone". Both are released by a gland in the brain. In women, FSH stimulates the production of eggs, and a hormone called oestradiol during the first half of the menstrual cycle and LH triggers ovulation. Their presence is measured by a blood test on the third day of a woman's menstrual cycle.
Oestradiol. Oestradiol, which is the predominant estrogen (the sex hormone in women), acts as a growth hormone for tissue of the reproductive organs.
Thyroid function (TSH). TSH stands for Thyroid Stimulating Hormone. Thyroid dysfunction may cause problems such as anovulation (no ovulation, or no release of an egg) and menstrual irregularities. d. Prolactin. This hormone is secreted by the pituitary gland in the brain. Prolactin stimulates lactation (milk production). A high level of prolactin can delay puberty, interfere with ovulation, and decrease libido in men. Low prolactin levels can cause menstrual disorders and lead to inadequate lactation.
Rubella. The German measles virus can cause severe abnormalities in babies if the mother contracts it during pregnancy.
HIV. Women with HIV may find it more difficult to fall pregnant. HIV-infected women experience reduced pregnancy rates and higher rates of miscarriages. HIV/AIDS may induce sterility, increase foetal mortality, and decrease the production of sperm, all contributing to a reduced fertility.
VDRL. This is the abbreviation of the laboratory test for syphilis. Syphilis is one of the leading sexually transmitted diseases that cause infertility.
Chlamydia is a sexually transmitted disease that often leads to reduced fertility.
Day 21 Progesterone. Progesterone is a female hormone produced mainly by the placenta in the ovary. It is measured on the 21st day of a woman's cycle. Progesterone prepares the lining of the uterus (womb) to receive and sustain the fertilized egg and so makes pregnancy possible.
3. Laparoscopy. This surgical procedure is used to determine whether any physical problems are present, e.g. scar tissue, tumours, and other abnormalities in the uterus, fallopian tubes, and ovaries.
4. Hysteroscopy is a surgical procedure in which a scope instrument is inserted through the vagina and cervix into the cavity of the uterus to determine if there are any physical problems inside the uterus.
5. Surgery (uterus and tubal) covers rectifying any physical problems, including blocked fallopian tubes and the removal of growths.
6. Ovulation defects and deficiencies can be addressed through "chemical" treatment like medication to induce ovulation.
7. Semen analysis (volume; count; mobility; morphology). The Mixed Agglutination Reaction or MAR-test is used to check for anti-sperm antibodies. Sperm analysis checks the volume of semen, count of sperm in the semen, the movement and structure of the sperm, and also whether antibodies are present in the semen.
8. Basic counselling and advice on sexual behaviour, temperature charts etc.
9. Treatment of local infections.
Source: Council for Medical Schemes, CMS Script Issue 1 of 2010