Understanding infertility and its causes

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Infertility refers to the failure to conceive or achieve pregnancy. In general terms, it means the inability to conceive a child even after a year of regular sexual intercourse without any protection. Women who are able to conceive but not carry a pregnancy may also be diagnosed with infertility. Infertility is not just a problem faced by women; men can be detected with infertility too.

Usually there are two types of infertility

Primary Infertility: It refers to couples who are unable to conceive after at least 1 year of trying for a child.

Secondary Infertility: It refers to those couples who have been successful to get pregnant at least once, but are unable now.

Infertility is a common problem faced by couples worldwide. According to a research conducted by a Bangalore based company, Inito, around 27.5 million couples were facing infertility only in India in 2018. The research revealed that around 10-15% of married couples in India face infertility.

Causes of infertility in Men

Low Sperm count: When the semen which a man ejaculates has low levels of sperm it causes problems in conceiving. A sperm count fewer than 15 million is considered low.

Low Sperm Mobility: The sperm fails to ‘swim’ well as to reach the egg to fertilise it.

Abnormal Sperm: The sperm may have an abnormal shape which makes it harder for it to move and fertilise an egg.

Medical conditions: Conditions like cancer, testicular infection etc. may cause infertility.

Ejaculation disorders: If ejaculatory ducts are blocked, sperms may be ejaculated into the bladder.

Genetic: A man should have an X and Y chromosome. If he has two X and a Y chromosome the testicles will develop abnormally which would result in a low sperm count.

Causes of Infertility in Women

Ovulation Disorders: It is the most common cause of infertility among women. Ovulation is the monthly release of an egg. Eggs may never be released or released only in cycles.

Cholesterol: High cholesterol level may cause infertility problems in women, according to some studies.

Weight: Obesity and weight loss can lead to infertility among both men and women.

Sexually Transmitted Infections: Sexually transmitted diseases like Chlamydia and HIV can cause infertility in women.

Age: The ability to conceive among women starts to fall around the age of 32 years. This may lead to infertility.

Smoking and Alcohol: Any level of smoking or alcohol consumption may lead to infertility. Smoking during pregnancy can lead to pregnancy loss. Even passive smoking has been linked with low fertility levels.

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The biological clock is a term that refers to the mechanism which controls the physiological activities of an organism. This can change on daily, seasonal, yearly, or other regular cycles. When the term biological clock is ticking is used, it often refers to the decrease of female fertility with advancing maternal age. For this reason, women are rushed into the institution of marriage and coerced to have children as soon as they can, because beyond a certain age, the fertility rate decreases in women and men. As women age, their ovulation starts becoming irregular and the uterus sometimes develops fibroids too. As they enter perimenopause conception chances decrease and eventually become nil after menopause.

The ideal age to plan the first pregnancy is medically slated as 18-25 years. This is the time when a woman is most fertile. But now with the lifestyle changes, many women push family planning to a later age which should be normalized because procreation should not be the only aim of any woman. Many women are changing this by choosing to become mothers only when they are mentally prepared to have a baby, and not on the basis of their biological clock. They prefer choosing to live their life with their partners, have a career, or travel before they can get into the family game.

Recently, actor Mona Singh said in an interview that she is in no hurry to have a baby. She got married to Shyam Gopalan last year, and says she got her eggs frozen five years ago, when she was 34.

Other medical conditions that can hinder conception apart from biological clock

Premature ovarian failure:

the woman’s ovaries stop working before she is 40. This can be hereditary and needs to be watched out for in women of the same family.

Blocked fallopian tubes:

When Fallopian Tubes are blocked, eggs cannot reach the uterus which impedes fertilization and eventually pregnancy. Single tubal blockage as well as both tube blockage is equally fatal. Blocking of fallopian tubes is one of the major causes of infertility among women and accounts for 40% of cases of infertility.

PCOS:

Polycystic ovarian syndrome (PCOS) is a condition in which a woman’s levels of the sex hormones estrogen and progesterone are out of balance. This is the main cause of infertility in today’s women. This leads to the growth of ovarian cysts (benign masses on the ovaries). PCOS can affect a woman’s menstrual cycle, fertility, cardiac function, and appearance.

Endometriosis:

This is a condition in which tissue that normally grows inside the uterus (endometrial) grows outside it. Most often this is on the ovaries, fallopian tubes, and tissue around the uterus and ovaries; however, in rare cases, it may also occur in other parts of the body. The main symptoms are pelvic pain and infertility.

Ectopic Pregnancy:

An ectopic pregnancy occurs when the fertilized egg attaches itself to a place other than inside the uterus. Almost all ectopic pregnancies occur in the fallopian tube and are thus sometimes called tubal pregnancies. The fallopian tubes are not designed to hold a growing embryo; thus, the fertilized egg in a tubal pregnancy cannot develop properly and must be treated. An ectopic pregnancy happens in 1 out of 50 pregnancies.

Sperm motility:

This contributes as a 30% factor towards infertility. Male infertility is usually caused by problems that affect either sperm production or sperm transport. Through medical testing, the doctor may be able to find the cause of the problem. About two-thirds of infertile men have a problem with making sperm in the testes.

Fertility experts usually receive couples who have failed with numerous attempts and treatments. Treatment starts with counseling as most of them are disheartened and disappointed already. They are prepared for the treatment procedures as it needs great motivation and needs many visits and attempts.

Thanks to the development in medical technology and scientific advancement, many infertile and childless couples have successfully conceived today. Treatments and options like IVF, IUI, egg freezing, surrogacy, sperm donation have changed fertility and conception and helps couples who are unfertile or have crossed their reproductive age or do not want to undergo pregnancy and childbirth for health/personal reasons to still plan a family biologically. Child adoption, of course, remains a great option too.

Also Read Why some miscarriages are still a mystery?