What is Infertility?

Infertility is a medical condition in which couple is unable to conceive a child after a certain period of time, typically one year of regular sexual intercourse without protection for couples under 35, or six months for those over 35. So, It can affect both men and women and may result from a variety of factors.

In women, infertility causes are ovulation disorders (e.g., polycystic ovary syndrome or hormonal imbalances), blockage of fallopian tubes, uterine problems (like fibroids or endometriosis), or relates to age decline in egg quality and quantity. In men, it might stem from low sperm count, poor sperm motility or morphology, blockages in the reproductive tract, or hormonal issues. Lifestyle factors (e.g., smoking, excessive alcohol, or stress), environmental exposures, and certain medical treatments (like chemotherapy) can also contribute to infertility in either sex.

Sometimes, infertility is without any explanation, meaning no specific cause is there despite thorough testing. Estimation is that about one-third of infertility cases are due to female factors, one-third to male factors, and the remaining third to a combination of both or unknown reasons. Treatments vary depending on the cause and can include medication, surgery, or ART like in vitro fertilization (IVF).

Facts about Infertility

• Prevalence: Infertility affects about 10-15% of couples globally, according to the World Health Organization (WHO).
• Timeframe: Diagnosis is typically after 12 months of intercourse without protection without conception for those under 35, or 6 months for those over 35
• Common Issue: Roughly 33% of cases has link to female factors, 33% to male factors, and 33% to a mix of both.
• Age Impact: Fertility declines with age, especially for women after 35 and men after 40, though men can remain fertile longer.
• Not Absolute: Infertility doesn’t always mean a complete inability to conceive some couples may still achieve pregnancy with assistance.
  

Symptoms of Infertility

Primary Symptom:

The main sign is the inability to conceive after regular, sex without protection for the specific time.

Women:

Irregular or absent menstrual cycles, painful periods, or hormonal signs like excessive hair growth or acne (e.g., in PCOS).

Men:

Changes in sexual function (e.g., erectile dysfunction), low libido, or physical signs like swelling/pain in the testicles.

Causes of Infertility

Women Factors

• Ovulation Disorders: Polycystic ovary syndrome (PCOS), thyroid issues, or premature ovarian failure.
• Tubal Issues: Blockage of fallopian tubes (e.g., from pelvic inflammatory disease or prior surgery).
• Uterine Problems: Fibroids, polyps, or endometriosis affecting implantation.
• Age: Decline in egg quantity and quality, especially after 35.
  

Men Factors

• Sperm Issues: Low sperm count, poor motility, or abnormal shape (e.g., from varicocele or genetic factors).
• Blockages: Obstructions in the reproductive tract preventing sperm release.
• Hormonal Imbalances: Low testosterone or pituitary gland issues.
• Environmental: Exposure to toxins, radiation, or excessive heat (e.g., frequent sauna use).
• Lifestyle: Drug use, anabolic steroids, or heavy smoking.
  

Other Factors

• Common Factors: Issues in both partners.
• No Explanation: No clear cause in about 10-20% of cases.
• Medical History: Cancer treatments (chemo/radiation), chronic illnesses (diabetes), or infections (e.g., STDs).
  

Diagnosis of Infertility

Medical history review (e.g., menstrual cycle patterns, sexual habits) and physical exams for both partners.

Women:

• Ovulation Testing: Blood tests for hormone levels (progesterone, FSH, LH) or ovulation kits.
• Imaging: Ultrasound to check ovaries/uterus, hysterosalpingography (HSG) to assess fallopian tubes.
• Laparoscopy: Rarely, to visually inspect for endometriosis or scarring.
  

Men:

• Semen Analysis: Checks sperm count, motility, and morphology.
• Hormone Testing: Testosterone and other levels.
• Imaging: Ultrasound for blockages or testicular issues.
• Additional Tests: Genetic screening or biopsies if initial results suggest deeper issues.
  

Treatment of Infertility

Women

• Medications: Clomiphene or letrozole to stimulate ovulation; gonadotropins for more complex cases.
• Surgery: Correcting tubal blockages, removing fibroids, or treating endometriosis.
• Assisted Reproductive Technology (ART): IUI- Intrauterine insemination (sperm enters directly in uterus).
• Assisted Reproductive Technology (ART): IVF- Eggs fertilizes outside the body, then implants.
• Lifestyle Changes: Weight management, quitting smoking, reducing stress.
  

Men

• Medications: Hormone treatments (e.g., hCG) for imbalances or antibiotics for infections.
• Surgery: Varicocele repair or clearing blockages.
• Sperm Retrieval: For severe cases, sperms are extracts directly from testicles for use in ART.
• Lifestyle: Avoiding toxins, improving diet, cutting alcohol/drugs.
  

Both

• ART: IVF or ICSI (intracytoplasmic sperm injection) for common or unclear causes.
• Donor Options: Using donor eggs, sperm, or embryos.
• Surrogacy: If pregnancy is not viable for the woman.
  

Success Rates

Vary widely by age, cause, and treatment. For example, IVF success drops from ~40% per cycle for women under 35 to ~10% for those over 40.