Infertility is a devastating problem that occurs in more or less 10% of the general population. Infertility can be due to the man, the woman or by the both. While aging remains a big factor in woman’s fertility, there are many other factors that can influence the odds of pregnancy. This article is a comprehensive guide on the causes, clinical manifestations and available treatments for infertility.
Overview on Infertility
- Definition of Infertility: Infertility is a diagnosed medical problem which refers to inability of a woman to conceive a healthy baby after 1 year of trying, or 6 months for woman aged 35 and older. Women who are able to get pregnant but not capable of sustaining it can be classified as infertile.
The complete process of pregnancy commences from ovulation when the woman releases the egg, goes towards the uterus through fallopian tubes, unites with the sperm cell (fertilization) and burrows into the uterine wall (implantation).
- Combined Infertility and Unexplained Infertility: Combined infertility is a term used when both the man and the woman contribute to the causes of infertility. Combined infertility often precedes unexplained fertility when doctors are not able to identify the primary reason of infertility following a number of diagnostic tests.
- Two Types of Infertility: Infertility can be primary or secondary. Primary infertility is when the couple is unable to produce a baby after unprotected sex while secondary infertility is when the woman had become pregnant but has difficulty trying to conceive now.
Signs & Symptoms of Infertility
Besides not able to get pregnant – which is a major sign of barrenness – there are other symptoms associated with infertility. It should be noted however that these symptoms can be affected by a number of factors; thus, they may vary from one person to another.
- Women: Signs and symptoms of infertility in women, which are primarily caused by problems on ovulation and menstrual cycle, include abnormal, painful and irregular periods and sometimes, amenorrhea (absence of period). On the other hand, if the cause of infertility is hormonal, women may experience skin changes (e.g acne), decrease sex drive, abnormal hair growth, loss or thinning of hair and weight gain.
- Men: Infertility symptoms in men are subclinical, meaning they usually go unnoticed in the early stage. Common symptoms of men infertility are ejaculation problem, presence of lumps in testicles, changes in hair growth, decreased sexual desire and small-sized testicles.
Risk Factors and Causes of Infertility
Major Causes of Men Infertility
- Varicocele: Varicocele is the presence of large veins in the testicles. Too much heat in the testicles can alter the quantity and shape of the sperms.
- Decreased Sperm Count: Also called oligozoospermia, decreased sperm count is defined as having less than 20 million sperms per ml of semen. It s estimated that 1 in 10 men suffer oligozoospermia.
- Motility: Injuries in the male reproductive system can affect sperm production and motility.
- Risk Factors: Factors that can contribute to male infertility are drugs, alcohol, pesticides, chemical agents, smoking, age, mumps, hormonal problems, medications and cancer treatment.
Major Causes of Female Infertility
The primary culprit of infertility in women is the problem on ovulation wherein either no egg is released or the egg is unable to mature. The following are the other causes of female infertility.
- PCOS: A medical problem that commonly affects obese and overweight people.
- Primary Ovarian Insufficiency (POI): POI is a condition wherein the ovaries stop to function before the age of 40.
- Medical Conditions: Some of the least common causes of female infertility are problems and deformities in the reproductive system such as ectopic pregnancy, fibroids, lumps, pelvic inflammatory disease or endometriosis.
- Risk Factors: Factors that can contribute to female infertility are age, unhealthy diet, stress, excessive exercise, obesity, alcohol, smoking and sexually transmitted disease (STD).
Diagnostic Tests for Infertility
Diagnostic tests for infertility include physical exams, interview, health and sexual histories and laboratory tests. Essentially speaking, diagnostic tests for male infertility center on assessing the characteristics of semen particularly the quantity, shape and movement. Hormones may be assessed as well. In women, ovulation is carefully tracked and bodily changes (basal temperature, cervical mucus) are monitored. Doctors may conduct ultrasound to check for problems in ovaries.
Female fertility testing such as Hysterosalpingography and laparoscopy can be performed to provide more precise and accurate results. Hysterosalpingography is the utilization of electromagnetic radiation in uterus and fallopian tubes to check for deformities and physical blocks that can prevent the sperm from reaching the egg. The procedure involves the use of a special dye which is injected into the uterus. On the other hand, laparoscopy is the utilization of a device called laparoscope that is inserted through a small cut in the lower abdomen. Laparoscopy not only detects the blocks in ovaries and fallopian tubes but also in uterus. Scarring and health disorders such as endometriosis can be diagnosed by laparoscopy.
Medical Treatments for Infertility
Fertility treatment options can be in the form of pharmacologic therapy and surgery. It should be mentioned however that these treatment modalities are variable for every patient depending on the following factors:
- How long couples have been trying to conceive
- Previous fertility test results
- Age of the woman and the man
- Health and sexual histories
- Preferred treatment modality
The following are fertility treatment options for men and women.
- Behavioral therapy in the case of premature ejaculation and impotence
- Medications such as antibiotics for infection and fertility drugs to induce ovulation such as Clomiphene citrate (Clomid)
- Surgical procedure
Note: Most fertility drugs raise the chance of getting pregnant with twins or multiples.
Infertility occurs when the couple is unable to conceive a child after one year of unprotected sex. A woman who has the capacity to get pregnant but unable to sustain the whole pregnancy is another case in point of infertility. Infertility can be combined (when both the man and woman cause the barrenness) or unexplained (when the cause of infertility remains untraceable). Infertility can be treated with behavioral therapy (men infertility), medications and surgery.