Infertility is a growing problem globally and is considered as a difficulty in falling pregnant after 6 months to 1 year of unprotected sex, without the use of contraceptives. Sterility refers to the inability to conceive, irrespective of treatment options, but in infertility, pregnancy may be possible after treatment. Infertility affects both men and women, and in some cases, both partners may need treatment for successful conception.
Fertilisation, Conception and Pregnancy
Every month, the ovaries in a woman release a mature egg cell (ovum) into the fallopian tube. This tube connects the ovary to the uterus. If a sperm cell is able to fertilise the egg cell in the fallopian tube, then the couple have conceived (conception). This fertilised egg then enters the uterus, implants on the wall of the uterus and ideally the foetus will grow and develop (pregnancy) until the baby is delivered. As simple as this procedure may seem, there are are host of possible complications and contributing factors that can either prevent successful pregnancy or cause an early loss of the foetus (miscarriage).
Causes of Infertility
The cause of the difficulty in conceiving may either be due to the male or female or both partners but infertility tests must be conducted before making any diagnosis. Infertility may be termed primary infertility, where the person has not previously conceived naturally, or secondary infertility, when the person has previously conceived one or more children but is now experiencing a difficulty. The causes of primary and secondary infertility are the same although there are many cases where no definite cause can be identified.
Causes of Infertility in Females
- Fallopian tube blockage or damage. This can occur after surgery, may occur as a result of inflammation due to certain gynaecological disorders (salpingitis, pelvic inflammatory disease) or even due to sexually transmitted diseases (STD’s) like chlamydia. There is significant evidence that repeated invasive fertility procedures may also contribute to adhesions and inflammation of the fallopian tubes, often exacerbating the very problem that is being treated.
- Problems with ovulation means that the egg cell may not be released from the ovary (anovulation), may be of poor quality or there is irregular ovulation due to hormonal disorders like polycystic ovary syndrome (PCOS) or hyperprolactinaemia.
- Endometriosis is a condition where uterine tissue implants in areas outside of the uterus and causes significant inflammation of the female reproductive system, thereby leading to infertility.
- Growths like uterine fibroids or cancer.
- Certain medical disorders may contribute to infertility, and these may include hyper- or hypothyroidism, Cushing’s syndrome, diabetes or insulin resistance, kidney disease or autoimmune disorders like SLE (lupus). HIV/AIDS may also be a contributing factor and result in repeated miscarriages.
- Prescription drugs may also contribute to infertility.
- Lifestyle factors are also an important contributing factor and cases of obesity, anorexia, smokering excessive alcohol intake and caffeine or use of narcotic drugs may result in infertility.
Causes of Infertility in Males
- Problems with sperm may include a low sperm count, lack of sperm or impaired or distorted sperm.
- Low testosterone levels may also be a contributing factor.
- Disorders affecting the male reproductive organs may include variocele, undescended testes, blockage of the ejaculatory ducts, lack of semen from the prostate, or birth defects like hypospadias.
- Erectile dysfunction, premature ejaculation or difficulty ejaculating.
- Sexually transmitted diseases (STD’s) like chlamydia or childhood infections like mumps.
- Lifestyle including smoking, alcohol abuse and use of narcotic drugs.
- Environmental factors including exposure to toxins, heavy metals and heat damage may also be linked to changes in the sperm, thereby leading to infertility.
- Nutrition may also play an important part in male infertility as certain vitamin or mineral deficiencies may lead to a low sperm count.