In my life right now, I have reached a point where I strongly believe that my parents would do almost anything to ensure my well being. To a large extent, I credit it to the kind of people they are- their backgrounds and philosophies of life, but for the most part, I think it’s because of the magical bond that exists between parents and children especially mothers. No doubt, children are beautiful gifts from God. But the hurt that comes from the inability to have them can only be compared to very few things on earth. Infertility is a cause of great heartache to couples who experience it and in some cases has led to marriages breaking up.
For definition purposes, infertility refers to the inability to conceive after having regular unprotected sex. Infertility can also refer to the biological inability of an individual to contribute to conception, or to a female who cannot carry a pregnancy to full term. In many countries, infertility refers to a couple that has failed to conceive after 12 months of regular sexual intercourse without the use of contraception.
To get pregnant;
• 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.
How common is infertility?
Infertility is fairly common. About 6% of married women (15–44 years of age) in the United States are unable to get pregnant after one year of unprotected sex (infertility). Also, about 12% of women (15–44 years of age) in the United States have difficulty getting pregnant or carrying a pregnancy to term, regardless of marital status (impaired fecundity).
Infertility is not just a woman’s problem
Many couples struggle with infertility and seek help to become pregnant. However, more often than not, it is thought of as only a women’s condition. A CDC study analyzed data from the 2002 National Survey of Family Growth and found that 7.5% of all sexually experienced men younger than age 45 reported seeing a fertility doctor during their lifetime—this equals 3.3–4.7 million men. Of men who sought help, 18% were diagnosed with a male-related infertility problem, including sperm or semen problems (14%) and varicocele (6%).
Causes of infertility
Infertility in men can be caused by different factors and is typically evaluated by a semen analysis. A specialist will evaluate the number of sperm (concentration), motility (movement), and morphology (shape). A slightly abnormal semen analysis does not mean that a man is necessarily infertile. Instead, a semen analysis helps determine if and how male factors are contributing to infertility.
Conditions that can contribute to abnormal semen analyses include;
- Varicoceles, a condition in which the veins on a man’s testicles are large and cause them to overheat. The heat may affect the number or shape of the sperm.
- Medical conditions or exposures such as diabetes, cystic fibrosis, trauma, infection, testicular failure, or treatment with chemotherapy or radiation.
- Unhealthy habits such as heavy alcohol use, testosterone supplementation, smoking, anabolic steroid use, and illicit drug use.
- Environmental toxins including exposure to pesticides and lead.
Women need functioning ovaries, Fallopian tubes, and a uterus to get pregnant. Conditions affecting any one of these organs can contribute to female infertility. Some of these conditions are listed below and can be evaluated using a number of different tests.
Ovulation: Regular predictable periods that occur every 24–32 days likely reflect ovulation. Ovulation can be predicted by using an ovulation predictor kit and can be confirmed by a blood test to see the woman’s progesterone level. A woman’s menstrual cycle is, on average, 28 days long. Day 1 is defined as the first day of “full flow.” A woman with irregular periods is likely not ovulating. This may be because of several conditions and warrants an evaluation by a doctor. Potential causes of anovulation include the following:
- Polycystic ovary syndrome (PCOS): PCOS is a hormone imbalance problem that can interfere with normal ovulation. PCOS is the most common cause of female infertility.
- Functional hypothalamic amenorrhea (FHA): FHA relates to excessive physical or emotional stress that results in amenorrhea (absent periods).
- Diminished ovarian reserve (DOR): This occurs when the ability of the ovary to produce eggs is reduced because of congenital, medical, surgical, or unexplained causes. Ovarian reserves naturally decline with age.
- Premature ovarian insufficiency (POI): POI occurs when a woman’s ovaries fail before she is 40 years of age. It is similar to premature (early) menopause.
- Menopause: Menopause is an age-appropriate decline in ovarian function that usually occurs around age 50. It is often associated with hot-flashes and irregular periods.
- Tubal Patency (whether Fallopian tubes are open, blocked, or swollen): Risk factors for blocked Fallopian tubes (tubal occlusion) can include a history of pelvic infection, history of ruptured appendicitis, history of gonorrhea or chlamydia, known endometriosis , or a history of abdominal surgery.
Female fertility is also known to decline with;
• Age. Many women are waiting until their 30s and 40s to have children. Aging not only decreases a woman’s chances of having a baby but also increases her chances of miscarriage and of having a child with a genetic abnormality.
• Excessive alcohol use.
• Extreme weight gain or loss.
• Excessive physical or emotional stress that results in amenorrhea (absent periods).
Depending on the cause, infertility can be treated using various drugs and also surgical procedures.
- Intrauterine insemination (IUI)
Intrauterine insemination (IUI) is an infertility treatment that is often called artificial insemination. In this procedure, specially prepared sperm are inserted into the woman’s uterus. Sometimes the woman is also treated with medicines that stimulate ovulation before IUI. IUI is often used to treat;
• Mild male factor infertility.
• Couples with unexplained infertility.
- Assisted reproductive technology (ART)
Assisted Reproductive Technology (ART) includes all fertility treatments in which both eggs and sperm are handled outside of the body. In general, ART procedures involve surgically removing eggs from a woman’s ovaries, combining them with sperm in the laboratory, and returning them to the woman’s body or donating them to another woman. The main type of ART is in-vitro fertilization (IVF).
In summary, infertility is a fairly common condition, that can be managed with the right information and medical care. Next week, we will looking at other things motherhood. Don’t forget to check back!