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
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.
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.
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
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
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!