Some couples find it difficult to conceive even after having unprotected sexual intercourse.
This may be due to infertility.
Infertility can exist in both men and women.
What Is It?
In general, infertility is defined as not being able to get pregnant (conceive) after one year of unprotected sex.
Women who do not have regular menstrual cycles, or are older than 35 years and have not conceived during a 6-month period of trying, should consider making an appointment with a reproductive endocrinologist.
This is the healthcare professional who specializes in infertility.
These doctors may also be able to help women with recurrent pregnancy loss – 2 or more spontaneous miscarriages.
Pregnancy is the result of a process that has many steps.
To get pregnant, the following conditions must be met:
- A woman’s body must release an egg from one of her ovaries (ovulation).
- A man’s sperm must join with the egg along the way (fertilize).
- The fertilized egg must go through a fallopian tube toward the uterus (womb).
- The fertilized egg must attach to the inside of the uterus (implantation).
Infertility may result from a problem with any or several of these steps.
Impaired fecundity is a condition related to infertility and refers to women who have difficulty getting pregnant or carrying a pregnancy to term.
What Causes Infertility In Women?
The most common causes of female infertility include problems with ovulation, damage to fallopian tubes or uterus, or problems with the cervix.
Age can contribute to infertility because as a woman ages, her fertility naturally tends to decrease.
Ovulation problems may be caused by one or more of the following:
- A hormone imbalance
- A tumor or cyst
- Eating disorders such as anorexia or bulimia
- Alcohol or drug use
- Thyroid gland problems
- Excess weight
- Intense exercise that causes a significant loss of body fat
- Extremely brief menstrual cycles
Damage to the fallopian tubes or uterus can be caused by one or more of the following:
- Pelvic inflammatory disease
- A previous infection
- Polyps in the uterus
- Endometriosis or fibroids
- Scar tissue or adhesions
- Chronic medical illness
- A previous ectopic (tubal) pregnancy
- A birth defect
- DES syndrome (The medication DES, given to women to prevent miscarriage or premature birth can result in fertility problems for their children.)
Abnormal cervical mucus can also cause infertility.
Abnormal cervical mucus can prevent the sperm from reaching the egg or make it more difficult for the sperm to penetrate the egg.
What Causes Infertility In Men?
Semen is the milky fluid that a man’s penis releases during orgasm.
Semen consists of fluid and sperm.
The fluid comes from the prostate gland, seminal vesicle, and other sex glands.
The sperm is produced in the testicles.
During orgasm, a man ejaculates (releases semen through the penis).
The seminal fluid helps transport the sperm during ejaculation.
The seminal fluid has sugar in it – sugar is an energy source for sperm.
Abnormal semen is responsible for about 75% of all cases of male infertility.
Unfortunately, in many cases, doctors never find out why.
The following semen problems are possible:
- Low sperm count (low concentration) – the man ejaculates a lower amount of sperm, compared to other men. Sperm concentration should be 20 million sperm per milliliter of semen. If the count is under 10 million there is a low sperm concentration (subfertility).
- No sperm – when the man ejaculates there is no sperm in the semen.
- Low sperm mobility(motility) – the sperm cannot “swim” as well as it should.
- Abnormal sperm – perhaps the sperm has an unusual shape, making it more difficult to move and fertilize an egg.
Sperm must be the right shape and able to travel rapidly and accurately towards the egg.
If the sperm’s morphology (structure) and motility (movement) are wrong it is less likely to be able to reach the egg and fertilize it.
What are the Risk Factors?
In medicine, a risk factor is something that raises the risk of developing a condition, disease or symptom.
For example, obese people are more likely to develop diabetes type 2 compared to people of normal weight; therefore, obesity is a risk factor for diabetes type 2.
Age – a woman’s fertility starts to drop after she is about 32 years old, and continues doing so.
A 50-year-old man is usually less fertile than a man in his 20s (male fertility progressively drops after the age of 40).
Smoking – smoking significantly increases the risk of infertility in both men and women.
Smoking may also undermine the effects of fertility treatment.
Even when a woman gets pregnant, if she smokes she has a greater risk of miscarriage.
Alcohol consumption – a woman’s pregnancy can be seriously affected by any amount of alcohol consumption.
Alcohol abuse may lower male fertility. Moderate alcohol consumption has not been shown to lower fertility in most men.
However, it is thought to lower fertility in men who already have a low sperm count.
Being obese or overweight – in industrialized countries overweight/obesity and a sedentary lifestyle are often found to be the principal causes of female infertility.
An overweight man has a higher risk of having abnormal sperm.
Eating disorders – women who become seriously underweight as a result of an eating disorder may have fertility problems.
Being vegan – if you are a strict vegan you must make sure your intake of iron, folic acid, zinc and vitamin B-12 are adequate.
Otherwise, your fertility may become affected.
Over-exercising – a woman who exercises for more than seven hours each week may have ovulation problems.
Not exercising – leading a sedentary lifestyle is sometimes linked to lower fertility in both men and women.
Sexually transmitted infections (STIs) – chlamydia can damage the fallopian tubes, as well as making the man’s scrotum become inflamed.
Some other STIs may also cause infertility.
Exposure to some chemicals – some pesticides, herbicides, metals (lead) and solvents have been linked to fertility problems in both men and women.
Mental stress – studies indicate that female ovulation and sperm production may be affected by mental stress.
If at least one partner is stressed it is possible that the frequency of sexual intercourse is less, resulting in a lower chance of conception.
If you believe that you or your partner may be suffering from infertility, do not hesitate to seek medical advice immediately.