Infertility can be aptly defined as the inability
to become pregnant despite regular, unprotected intercourse
for more than one year. Conception becomes a struggle
for these couples. The truth is women in fertile couples
have only 20% chance of conceiving every month.
The Facts on Fertility
and Infertility
• Fertility peaks at 24 regardless of gender
• After ovulation there are 12-24 hours for
the egg to get fertilized
• A healthy sperm can swim at speeds of 2-3mm
per minute
• A quarter of sperm in a normal sperm count
motility problems
• Among couples having regular unprotected sex
the success rate is something like this: 25% conceive
in the first month, 60% conceive within 6 months,
80% conceive within one year, 90% conceive within
19 months
• Each month a couple has a 20% chance of making
a baby
• 15-20% of couples have problems conceiving
• Fertility rate begins to decline from the
age of 25 for the woman
• Infertility treatments are more successful
in couples under 30
• The odds of having problems conceiving grow
bigger with age i.e. the older you get the longer
it takes to conceive.
• Even after proper medical investigation, no
proper diagnosis can be offered as to why some people
remain infertile
Female Infertility
The reasons for the inability to conceive are not
fully understood. However some causes of female infertility
that have been identified are explained in brief below.
Failure to ovulate is the prime cause of infertility
in women.
Ovulation problems occur when the
hormones responsible for the various stages of ovulation
are absent or not in the right proportion; too little
of one or too much of the other will affect the chances
of releasing an egg. So if both LH (luteinizing hormone)
and FSH (follicle-stimulating hormone) are present
but not in the right balance, ovulation is affected.
This inability to release an egg is found in about
a third of all infertile women and is usually due
to hormones. Other causes for this failure are pinned
to damaged ovaries or in rare instances, the ovaries
have run out of eggs.
PCOS Polycystic ovary syndrome is
a result of excessive production of the male hormone
leading to more LH in ratio to FSH which causes the
ovaries to become polycystic. Eggs in the ovaries
develop inside follicles and when one egg is mature
enough it is released. With PCOS, the ovaries fill
up with cysts of immature follicles which impede in
egg maturity. Periods become infrequent, obesity results
and the woman starts to have excessive facial and
body hair
Fibroids are benign tumors that grow
within the uterine wall. The size varies from a pea
to a football! Often symptom-less, fibroids are common
in women over 30. Its presence may cause the uterus
to misshapen and compress either one or both of the
fallopian tubes. Fibroids can interfere with implantation
of the embryo and also prevent the fertilized egg
from successfully reaching the uterus depending on
its location. Symptoms that may occur include heavy
periods with clots which last long, severe cramps,
and inability to become pregnant among others
Endometriosis occurs when the cells
that normally make up the lining of the uterus or
the endometrium grow elsewhere inside the body. During
each menstrual cycle the woman will bleed causing
the internal organs to glue up with blood and endometrial
tissue. The symptoms are painful heavy periods. Fertility
gets affected if the ovaries, tubes or uterus become
damaged
PID or Pelvic Inflammatory disease
is an inflammation of the pelvic area which includes
the fallopian tubes, ovaries and the uterus. It is
due to bacterial infection which causes Chlamydia
and gonorrhea. PID can be mild (inability to conceive)
to the occasionally life-threatening form. Symptoms
include severe abdominal pain, fatigue, fever, and
heavy painful periods
Ectopic Pregnancy is one that develops
inside the fallopian tubes or elsewhere inside the
abdominal cavity other than the uterus. Women who
have suffered an ectopic pregnancy are at a greater
risk of having another such pregnancy. The treatment
unfortunately can cause tubal damage leading to infertility
in some cases. However many fortunate women have gone
on to have normal pregnancy and delivery after one
bad experience.
Early or premature menopause is as common
as 1 in every 100 women and can affect someone as
young as 20. In the more common instances of premature
menopause the last period occurs before the age of
40. women who experience premature menopause are more
likely to suspect pregnancy for the cessation of periods
rather than as a sign of menopause. Symptoms are the
similar at whatever age the menopause occurs.
Male Infertility
In one third of infertility cases, the problem lies
with the man's reproductive system, mainly sperm abnormalities.
Problems with sperm are the most common cause of infertility
in men. Sperms take about 7 weeks to develop and are
vulnerable to exterior influences during the development
stage
Problems with Sperm
Low sperm count can range from none
to a lower than average number. The normal range is
35 to 200 million per ml of semen. Sperm count is
considered poor if each ml contains below 20 million
and a high proportion of it is abnormal. Many men
with low sperm count go on to father children. The
problem is not in the count but in the quality.
Abnormal sperm is one where the sperm
may not be properly formed. Majority of the sperm
tend to be abnormal or have poor motility or activity
rate. The sperm are just not fast enough. Low sperm
count, and sperm abnormalities are caused by hormones,
anatomy, immunological factors and even environment.
Anatomical Problems
Testicular failure is when the testes
did not descend properly into the scrotum after birth
and remained in the abdomen, or the man sustained
some injury to the testicles, had chemotherapy or
had mumps in adulthood. Sperm production may be non-existent
or inhibited. However it does not always affect both
testes.
Blocked vas deferens is when the
tubes that are supposed to transport sperm from the
testicles to the seminal vesicles become blocked because
of some defect of infection. it can exist from birth
(defect) or the result of an infection (e.g. gonorrhea).
Ejaculation problem is when the male
suffers from retrograde ejaculation where the semen
instead of making its way into the vagina goes backwards
into the bladder during intercourse. About 1% of men
face this problem of not ejaculating during orgasm
Immunological Factors
Both men and women produce antibodies to sperm which
stand in the way of fertilization. Antibodies are
found in semen, on the sperm or in the blood of the
male while in women they are found in the cervical
mucus or in the blood. Antibodies are found in 5-10%
of infertile couples
Antibodies affects fertility especially those that
are found on the surface of the sperm. They can affect
sperm activity, the penetration ability and the sperm's
ability to fertilize the egg
Environmental Factors
Men are vulnerable to work hazards that may cause
their sperm count to dwindle. Men who work with the
pesticides, X-rays, paint products, heavy metals such
as lead, mercury or arsenic can encounter sperm count
problems.
Besides the individual problems that affect male and
female fertility specifically and separately, there
are general reasons why some couples are having to
deal with infertility. Stay hydrated by drinking adequate
amount of water to repair and maintain your reproductive
system. 8 glasses or more of water is necessary to
prevent dehydration. Get enough sleep especially in
the nights. In the night billions of cells that make
up the body are renewed. Good quality sleep on a regular
basis is essential for a healthy reproductive system
and a necessary feature of pre-conceptual care. Don't
give up!
