Infertility is a condition characterized by the inability to conceive or carry a pregnancy to term despite regular, unprotected sexual intercourse for at least one year for couples under 35 years old, or six months for couples over 35 years old. It affects both men and women and can be caused by various factors related to reproductive health, hormonal imbalances, lifestyle factors, genetic factors, or underlying medical conditions.
Causes of Infertility:
Female Factors: Common causes of female infertility include:
- Ovulation disorders, such as polycystic ovary syndrome (PCOS) or irregular menstrual cycles.
- Fallopian tube blockage or damage, which can prevent the sperm from reaching the egg or the fertilized egg from implanting in the uterus.
- Endometriosis, a condition where tissue similar to the lining of the uterus grows outside the uterus and interferes with fertility.
- Age-related decline in ovarian function and egg quality, particularly after the age of 35.
- Uterine abnormalities or structural issues that affect the ability to conceive or carry a pregnancy.
Male Factors: Common causes of male infertility include:
- Abnormal sperm production or function, such as low sperm count, poor sperm motility (movement), or abnormal sperm morphology (shape).
- Varicocele, a condition characterized by enlarged veins in the scrotum, which can impair sperm production or function.
- Ejaculation disorders, such as retrograde ejaculation, where semen enters the bladder instead of being ejaculated out of the penis.
- Genetic factors or hormonal imbalances that affect sperm production or function.
- Lifestyle factors, such as tobacco use, excessive alcohol consumption, drug use, obesity, or exposure to environmental toxins, which can affect sperm quality.
Combined Factors: In some cases, infertility may be due to a combination of male and female factors, or it may be unexplained, where no specific cause can be identified despite thorough testing.
Diagnosis:
Diagnosis of infertility typically involves a comprehensive medical history, physical examination, and various tests to evaluate both male and female reproductive health. Diagnostic tests may include:
- Semen analysis to assess sperm count, motility, and morphology in men.
- Ovulation testing to determine if a woman is ovulating regularly.
- Hormone testing to evaluate hormone levels related to ovarian function, such as follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, and anti-Müllerian hormone (AMH).
- Imaging tests, such as transvaginal ultrasound or hysterosalpingography (HSG), to evaluate the uterus and fallopian tubes.
- Ovarian reserve testing to assess the quantity and quality of a woman’s remaining eggs.
Treatment:
Treatment for infertility depends on the underlying cause and may include:
Medications: Fertility medications, such as clomiphene citrate, letrozole, or gonadotropins, may be prescribed to stimulate ovulation in women or improve sperm production in men.
Surgery: Surgical procedures, such as laparoscopy to remove endometriosis or repair blocked fallopian tubes, or varicocele repair in men, may be recommended to address structural issues or correct underlying conditions.
Assisted Reproductive Technologies (ART): ART procedures, such as in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), or intrauterine insemination (IUI), may be recommended for couples with severe infertility or who have not responded to other treatments.
Lifestyle Changes: Making lifestyle changes, such as maintaining a healthy weight, quitting smoking, reducing alcohol consumption, and managing stress, can help improve fertility outcomes in some cases.
Alternative Therapies: Some couples may explore alternative therapies, such as acupuncture, herbal supplements, or mind-body techniques, to support fertility treatment or promote overall well-being.
