Infertility is a condition in which a couple is not able to conceive even with regular sex performed without using any protection for a considerable period. Infertility could be either in the male partner or in the female partner of a couple. In case either of the partners suffers from infertility, the female partner would not get pregnant.
If the female partner does not conceive even after the regular sexual intercourse of one year without using any birth-control protection, it is most likely that either of the partners suffers from infertility. Around 85% of the women succeed in conceiving within one year from when the couple starts regular sexual intercourses without using any birth-control measures.
Around 7% of the remaining women also conceive in the second year with continual trials. If still, some woman is unable to conceive, there is a strong possibility of infertility in one of the partners. For a woman to conceive, an egg must be released from one of her two ovaries. This process is known as ovulation.
Post the ovulation, her male partner’s sperm needs to be added to her egg to fertilize. This is possible through the sexual intercourse in normal scenarios. The fertilized egg transfers to the uterus or womb through the passage known as the fallopian tube. Once after reaching the uterus, the fertilized egg is implanted in it. Any obstruction in this process may result in infertility.
Infertility could be treated through medication, artificial insemination, surgery, or assisted reproduction methodologies. Infertility is not a very rare condition. In the US, near to 10% of females in the age group of 15 to 44 years observe difficulty in conceiving. When we talk about globally, around 8-12% couples observe infertility.
Infertility in males or females could be caused because of numerous reasons. The major symptom of infertility in either of the sex partners is the inability of conceiving even with regular sexual intercourse (at least once in every 2-3 days) without using any birth prevention measure.
It is not necessary that an individual suffering from infertility observes additional symptoms. Some symptoms may be observed in the individuals based on the cause of infertility. The probable symptoms of infertility in women are mentioned below:
- Irregularity in Monthly Periods: Normally, a woman observes menstrual cycle or periods in every 28 days. Few days above or below this duration is meant to be normal if the cycles are consistent. For instance, if a woman observes periods in every 30 days, it is fine for her to have those between 27 to 33 days in any month. However, the more difference of days could be related to hormonal problems or Polycystic Ovarian Syndrome (PCOS), which may lead to infertility.
- Pain or Over-bleeding During Periods: Many women observe abdominal spasm or experience heavy bleeding during their periods, which cause be associated with endometriosis. This may also be a cause of infertility.
- Skipping of Periods: Normally periods are paused either from conceiving till the childbirth or post the menopause. However, several women also skip the periods in between irrespective of those reasons, which may impact their capacity to conceive. The several temporary reasons for skipping of periods include intensive workout and stress. In any case, you must consult your gynaecologist at the earliest if the period is missed.
- Symptoms Associated with Hormonal Imbalance: Those factors also affect the fertility and may produce the symptoms such as:
- Skin allergy
- Reduced interest in sex
- The growth of hairs on the face
- Hair thinning and fall
- Drastic weight gain
- Observing pain during sex
- Reduced sexual desire due to hormonal problems.
- Swelling or pain in the testicles.
- Impotency or facing problem in maintaining an erection of the penis due to hormonal problems or stress.
- Unable to ejaculate semen during the sexual intercourse.
- The smaller size of testicles or observing those hard, which makes them difficult to produce and release sperm.
The various causes of infertility in women and men are mentioned below:
- The conceiving capability of women starts reducing from the age of around 32-33 years. The same for men starts reducing from the age of 40 years. They must try to conceive before this age.
- The major causes of infertility in men include low sperm count, low sperm motility, and abnormal sperms. These may be caused due to multiple reasons like hormonal disorders, surgery, testicular infections, cancer, climatic conditions, genetic factors, and more.
- Active or passive smoking reduces the fertility in both women and men. It also slows down the progress of fertility treatments. It may also cause loss of pregnancy after conceiving.
- Overconsumption of alcohol may cause infertility in both women and men.
- Being overweight may reduce fertility in both women and men.
- Malnutrition, especially the deficiency of iron, folic acid, zinc, and vitamin B-12, may cause infertility majorly in women. Women on a vegetarian diet must consult their doctor for good supplements when they plan to conceive.
- Both the excessive or lack of exercise can cause infertility in both women and men.
- Sexually Transmitted Infections (STIs) may harm the fallopian tube of a woman, which moves the fertilized egg into the uterus. STIs also cause infertility in men.
- Inhalation or consumption of herbicides, pesticides, metals and solvents could cause fertility disorders in both women and men.
- Mental stress may also affect the ovulation in females. It may also cause impotence in men.
- Certain ovulation disorders can cause infertility in women. Those may include premature ovarian failure, Poly Cystic Ovary Syndrome (PCOS), Hyperprolactinemia, poor egg quality and more.
- Some other diseases like cancer and thyroid disorders may also impact the fertility.
- It is found in the studies that the high level of cholesterol in the blood may also cause infertility in women.
- The following medication and treatments may cause infertility in both women and men:
- Non-steroidal Anti-inflammatory Drugs (NSAIDs) such as aspirin, naproxen, or ibuprofen may cause infertility in women. Whereas, the immune-suppressants (like Sulfasalazine) and steroids may cause infertility in men.
- Chemotherapy may cause temporary or permanent ovarian failure. Radiation therapy aimed near to the reproductive organs can cause fertility disorders in both females and males.
- Illegal drugs such as cocaine and marijuana cause infertility in women.
Infertility is caused by multiple reasons. So, you could not prevent it completely. Following are some prevention steps that you can take to avoid infertility:
- Try to plan a baby within the prescribed age limit (by 33 years for women and 40 years for men).
- Avoid smoking and consumption of alcohol. Quit those completely in case the conceiving is unsuccessful even after attempting over 6-8 months of regular sexual intercourse without using any birth control measures.
- Maintain a healthy weight.
- Adopt a balanced and healthy diet. Your meals should contain fruits, vegetables, whole grains and other plant-based food items. Consult your doctor for health supplements, as need.
- Follow a moderate exercise plan.
- Get treated by the doctor at the earliest in case you observe any symptom of a sexually transmitted disease.
- Avoid mental stress and anxiety. Do meditation, if needed.
- Do not consume medicines, until strongly required.
In case a female does not conceive even after the regular sexual intercourse of one year without using any birth-control protection, the doctor may prescribe one of the following investigations post enquiring about multiple factors:
- Transvaginal Ultrasound: This process is performed on women and intends to evaluate the shape and structure of the fallopian tubes, uterus, and ovaries. It could also detect the abnormalities in the uterus such as polyps, fibroid, and distal fallopian tube occlusion. Else than that, it checks for the abnormalities in the ovaries like the existence of a cyst. This process also evaluates the antral follicle count, which specifies the availability of eggs produced by the ovaries.
- Laboratory Tests: Either or both the men and women may also be prescribed certain laboratory tests using a blood sample. Those may identify the functionalities of the hormones (like Estradiol and FSH), which relate with the functioning of ovaries and egg generation. Other tests may be performed for the identification of thyroid functions and factors affecting the menstrual cycle.
- Hysterosalpingogram (HSG): Specific to women, this test evaluates the defects in fallopian tubes and uterus. Those may include fibroid, polyp, the scar of the uterine cavity (Asherman syndrome), and more. Once identified, those may be corrected surgically.
- Analysis of Semen: In this test, the semen of the male partners is analysed based on the following parameters:
- The volume ejaculated in one time must be at least 1.5 to 2 ml.
- The concentration of the sperms (called as sperm count) must be at least 20 million per 1 ml of semen.
- The sperm in the semen must have the motility of at least 50%.
- All the three parameters of the sperm’s size, head, midpiece, and tail, must not have any abnormality.
Once the infertility is confirmed and its cause is identified, your doctor would prescribe the best-suited treatment. The possible treatments for infertility are discussed below:
- Medication: Female partners may be prescribed medication courses (through pills and injections) to improve the egg development and stimulate the ovulation process. The most prescribed drug for stimulating ovulation is clomiphene citrate, which should be taken for 3 to 7 days from the starting days of the periods. Additionally, the gynaecologist may also prescribe the gonadotropins injections to the impacted woman that regulates the development of eggs in the ovaries.
- Intrauterine Insemination (IUI): In this process, the male partner’s sperms are extracted, washed and placed directly into the uterine cavity. This process bypasses the cervix and brings a high concentration of sperm with higher mobility to flow from the tube and ovulate the eggs. This methodology is prescribed in the cases where the sperm mobility of the male partner is lesser than required.
- In Vitro Fertilization (IVF): In vitro this process, the eggs and sperms are first extracted from the bodies of woman and man respectively. Those are then fertilized externally in an embryology laboratory to form embryos, which are then implanted in the uterus of the woman. The fertilization of eggs to embryos normally takes 3 to 5 days for their development in the culture media. In normal cases, one or two embryos are injected in the uterine cavity using a catheter. With the successful process, the pregnancy test must result in positive post 2 weeks.
- Third Party Reproduction: This process is a bit like IVF. The only difference is that the embryos, in this case, are produced externally using some other individual’s eggs or sperms.
- Surgery: In extreme cases of abnormalities in the reproductive organs, the doctor may recommend a surgery for correcting the problem. The various types of such surgeries may include hysteroscopy, laparoscopy and abdominal myomectomy or uterine fibroid removal.
Infertility is a normal disorder that does not cause any major or fatal complication. It is seen that when women could not conceive even after trying for multiple years, she along with the male partner could suffer from stress and depression. At times, the couple may also feel embarrassment in the society.
Myth #1: Infertility could only occur in women.
Both men and women can suffer from infertility.
Myth #2: Infertility in women is incurable.
In most of the cases, infertility in women is treatable.
Myth #3: Infertility in men can only be a psychological problem, and not physical.
Infertility in men in most cases could be caused by physical problems like low sperm count, hormonal disorders, and more.
Myth #4: The babies born through the IVF method are comparatively unhealthy.
The babies born through the IVF method are normal and healthy.
Infertility is a normal disorder, which could be found in both males and females. In most of the cases, it could be treated through medication or surgery. In the extreme cases, women could be conceived through other methods like IVF. The couple must not be panic in case the female member could not conceive for a long duration. The doctors would provide detailed education about this problem and the possible treatments available.
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