If any couple thinks that they are the only unfortunate in state of family building, but the fact is different. In the United States, 10 to 15% of couples are infertile.
Infertility is defined in most couples as the inability to conceive despite frequent unprotected sex for at least one year. Infertility can be the result of a problem with you or your partner or a combination of factors that prevent pregnancy.
Causes of male infertility
Infertility in men can be caused by a number of factors and is often diagnosed by sperm analysis. During the analysis of sperm, the number of sperm (concentration), motility (movement) and morphology (shape) will be checked by an expert.
A slightly abnormal cement test does not mean that a man should be infertile. However, sperm analysis can help determine if and how male factors contribute to infertility.
Damage to the testicles or ejaculatory function
- Varicocele, a condition in which the veins in a man’s testicle enlarge. Although there are usually no symptoms, varicocele can affect the amount or form of sperm.
- Testicular trauma can affect sperm production and lead to a reduction in sperm count.
- Alcohol abuse, smoking, anabolic steroid use and illicit drug use.
- Cancer treatment that involves some form of chemotherapy, radiation, or surgery to remove one or both testicles.
- Medical conditions such as diabetes, cystic fibrosis, certain types of autoimmune disorders and certain types of infections can cause testicular failure.
Hormonal diseases
Poor hypothalamic or pituitary function. The hypothalamus and pituitary gland produce hormones that maintain normal testicular function. The production of too much prolactin, a hormone produced by the pituitary gland (usually due to the presence of a benign pituitary tumor), or other conditions that affect the function of the hypothalamus or pituitary gland may result in reduced or no sperm production.
These conditions may include benign and malignant (cancer) tumors of the pituitary gland, congenital adrenal hyperplasia, exposure to too much estrogen, too much testosterone, Cushing’s syndrome and frequent use of drugs called glucocorticoids.
Genetic diseases
Genetic conditions such as Klinefelter’s syndrome, Y chromosome microdeletion, myotonic dystrophy, etc.
Risk factors for male infertility
Age
Although age plays a more important role in predicting female infertility, couples with a male partner of 40 years or older are more likely to report problems.
- Overweight or obesity.
- Smoking.
Excessive use of alcohol and drugs (opioids, marijuana)
Testosterone exposure:
This can happen if a doctor prescribes testosterone injections, implants or a topical gel for low testosterone levels, or if a man is taking testosterone or similar drugs illegally for augmentative purposes.
Radiation exposure:
Frequent exposure of the testicles to high temperatures may occur in men due to wheelchairs, or frequent use of the sauna or whirlpool.
Exposure to certain medicines such as flutamide, cyproterone, bicalutamide, spironolactone, ketoconazole or cimetidine
Exposure to environmental toxins, including exposure to pesticides, lead, cadmium or mercury.
Causes of female infertility
Women need externally functioning ovaries, fallopian tubes and uterus to conceive. Conditions that affect one of the organs can contribute to female infertility. Some of these conditions are listed below and can be diagnosed by several different tests.
Decreased ovarian function (presence or absence of ovulation and effect on “ovarian age”)
The average length of a woman’s menstrual cycle is 28 days. The first day is defined as the first day of “full flow”. Regular prognostic periods, which occur every 21 to 35 days, are likely to indicate ovulation.
A woman with irregular periods will probably not ovulate.
Ovulation can be predicted using an ovulation prediction kit and can be confirmed by a blood test to check a woman’s progesterone levels on day 21 of the menstrual cycle.
Although there are many tests to assess female honor function, no test is a complete predictor of fertility. Commonly used markers of honor function include follicle-stimulating hormone (FSH) on days 3 to 5 of the menstrual cycle, antimüllerian hormone (AMH), and antral follicle count (AFC) by transvaginal ultrasound.
Decreased ovarian function can be caused by many conditions and should be examined by a doctor. If a woman does not ovulate during the menstrual cycle, it is called anovulation.
Possible causes of anovulation include the following:
Polycystic ovary syndrome (PCOS) is a condition in which women do not ovulate or ovulate irregularly. Some women with PCOS have high testosterone levels, which can cause acne and excessive hair growth.
PCOS is the most common cause of female infertility.
Decreased ovarian reserve (DOR) is a condition in which females are born with all the eggs they may have, and the number of eggs obviously decreases over time. DOR is a condition where at a certain age fewer eggs remain in the ovaries than expected.
It can occur due to congenital (conditions present at birth), medical, surgical or unexplained reasons. Women with DOR can conceive naturally, but produce small eggs in response to infertility treatment.
Functional hypothalamic amenorrhea (FHA) is a condition caused by excessive exercise, weight loss, stress, or perhaps a combination of these factors. It is sometimes associated with eating disorders such as anorexia.
Malfunction of the hypothalamus and pituitary gland. The hypothalamus and pituitary gland produce hormones that maintain normal egg function.
The production of too much of the hormone prolactin in the pituitary gland (usually due to a benign tumor of the pituitary gland) or a malfunction of the hypothalamus or pituitary gland cannot ovulate in a woman.
Premature ovarian insufficiency is sometimes called premature menopause, which occurs when a woman’s ovaries fail before the age of 40. Although some exposures, such as chemotherapy or pelvic radiation therapy, and certain medical conditions can cause POIs, the cause is often unexplained.
About 5% to 10% of women with POI become pregnant naturally and have a normal pregnancy.
Menopause is a natural decline in ovarian function that usually occurs at the age of 50. Basically, a menopausal woman has not menstruated for at least a year.
Many women experience sudden flashes of breath, mood swings, difficulty sleeping and other symptoms.
Fallopian tube obstruction (whether the fallopian tubes are open, clogged or swollen)
Risks of oviduct obstruction (fallopian tube occlusion) may include a history of pelvic infection, broken appendix, gonorrhea, chlamydia, endometriosis, or previous abdominal surgery.
The fallopian tubes can be examined by hysterosalpingogram or chromopertubation.
The hysterosalpingogram is an x-ray of the uterus and fallopian tubes. The radiologist injects the dye into the uterus through the cervix and at the same time performs X-rays to see if the dye is moving freely in the fallopian tubes and shows that it is open.
Chromopertubation is similar to a hysterosalpingogram, but is performed in the operating room during laparoscopy.
The blue pigment enters the uterus and fallopian tubes from the cervix.
This test is used to assess whether the fallopian tubes are open and to see if they have been removed.
Physical properties of the uterus.
Depending on the woman’s symptoms, the uterus may be examined by transvaginal ultrasound for fibroids or other problems, including intrauterine adhesions, endometrial polyps, adenomyosis, and congenital uterine anomalies.
A sonohystogram or hysteroscopy can also be performed for further examination of the uterine environment.
Risk factors associated with female infertility
Ageing
Approximately 1 in 5 (22%) couples where a woman is 30-39 years old have problems giving birth to their first child, compared to approximately 1 in 8 (13%) couples where a woman is younger is around 30 years old.
Fertility decreases with age mainly because the quality of eggs decreases over time. In addition, older women have fewer eggs left and are more likely to have a medical condition that can cause fertility problems.
Aging can also increase a woman’s chances of getting pregnant and having a baby with a genetic abnormality. Along with aging, following are the certain risk factors associated:
- Smoking.
- Excessive alcohol consumption.
- People who are overweight, obese or underweight.
- Large weight gain or loss.
Excessive physical or emotional stress leading to amenorrhea (absence of menstruation).
References:
- https://www.cdc.gov/reproductivehealth/infertility/index.htm#:~:text=PCOS%20is%20the%20most%20common,expected%20for%20a%20given%20age
- https://www.mayoclinic.org/diseases-conditions/infertility/symptoms-causes/syc-20354317
Ravi Sharma is a self-motivated, successful entrepreneur and has a solid experience in the fertility segment. and he is the director at ARTbaby Global (ARThealthcare). He is a pharmacy graduate with post-graduation in business administration and has 14 years of rich experience in the field of infertility segment. He loves to write about IVF, Surrogacy, and other ART (assisted reproductive technology) news, issues, and updates. He is a Pharmacy graduate (B. Pharm) and M.B.A (marketing).
His most recent success includes the successful launch of the medical tourism company, ARTbaby, which offers treatment options for infertility, egg donation, and surrogacy. He likes spending time with his family and writing about various aspects of IVF surrogacy and donating eggs.