What is Infertility
According to the United States Centre for Disease Control and Prevention (USCDC), infertility is not being able to get pregnant after one year or longer of unprotected sex. Because fertility in women is known to decline slowly with age, some providers evaluate and treat women aged 35 years or older after 6 months of unprotected sex.
Infertility is a growing problem in today’s society, affecting millions of couples worldwide. It can be a daunting and emotionally challenging experience for couples who want to start a family. This article will explore the types of infertility, its causes, diagnosis, and treatment options.
Statistics on Infertility
Around 1 in 7, couples may have difficulty conceiving. About 84 percent of couples will get pregnant naturally within a year if they have regular unprotected sex every 2 or 3 days. For couples who have been trying to conceive for more than 3 years without success, the likelihood of getting pregnant naturally within the next year is 1 in 4 or less (1).
Types of Infertility
There are 2 types of infertility, namely:
- Primary infertility: Refers to couples who have not become pregnant after at least 1 year of having sex without using contraception. This condition affects an estimated 10-15 percent of couples globally and can be a source of significant emotional stress and strain on relationships.
- Secondary infertility: Refers to couples who have been able to get pregnant at least once but is now struggling to conceive again (2). It is a common fertility issue and affects millions of couples globally.
Difference between Infertility and Subfertility
Subfertility refers to any form of reduced fertility with prolonged time of unwanted non-conception. On the other hand, infertility may be used equally with sterility with only irregular spontaneous pregnancies (3).
It is essential to note that subfertility is a common condition, and many couples can become pregnant with the proper treatment.
Most people think infertility is solely a woman’s problem; however, men and women can experience infertility due to various reasons.
Women Infertility
Women need a functioning ovary, fallopian, and uterus to become pregnant. Conditions affecting any of these organs can contribute to female infertility.
Male Infertility
Different factors can contribute to men's infertility and are generally accessed through semen analysis. When a semen analysis is performed, the number of sperm, movement, and shape are assessed by a specialist. However, a slightly abnormal semen analysis doesn’t mean a man is infertile. The analysis helps determine if and how male factors are contributing to infertility.
Causes of Infertility
There are many causes of infertility, some of which are related to the male partner and some to the female partner. In many cases, infertility is caused by a combination of factors that are unique to an individual. Here are some common causes of infertility in women and men.
- Hormone imbalance: infertility can be caused by ovulatory disorders such as polycystic ovary syndrome (PCOS)
- Tumor or cyst
- Low sperm count or poor sperm motility
- Eating disorders such as anorexia or bulimia
- Alcohol or drug use
- Thyroid gland problems
- Excess weight
- Stress
- Intense exercise that results in a significant loss of body fat
- Severely short menstrual cycles (4).
The Risk Factors of Infertility
- Age: Fertility declines with age in women
- Weight: Being Overweight or obese (having a BMI of 30 or more)
- Sexually transmitted infections (STIs)
- Smoking
- Alcohol
- Environmental factors
- Stress (1).
Diagnosis
Diagnosis typically involves an extensive medical history, physical examination, and a series of tests to evaluate the reproductive organs and determine the cause of infertility. These tests may include the following:
- Blood tests
- Sperm analysis
- Ultrasound
- Hysterosalpingography (HSG): a test that uses X-rays to examine the uterus and fallopian tubes.
Treatment Options
There are 3 typical types of infertility treatment depending on the underlying cause:
- Medications
- Surgery
- Assisted reproductive technologies (ART).
Medications
When treating infertility using medications, the expert can recommend, such as clomifene, stimulating ovulation in women who do not ovulate regularly or at all. Gonadotrophins
also stimulate ovulation in women and may improve fertility in men too.
Some medications can cause side effects like headaches, hot flashes, nausea, and vomiting. Ensure that you speak with your healthcare provider when you experience any side effects.
Surgery
Different surgical procedures can be used to assess fertility problems and help with fertility. Examples of surgical procedures are:
- Fallopian tube surgery: is performed to repair fallopian tubes that have become blocked or scarred.
- PCOS, endometriosis, and fibroids: Laparoscopic surgery is usually used to treat endometriosis and may be used to remove submucosal fibroids.
- Correcting an epididymal block and surgery to retrieve sperm; Sometimes, the epididymis becomes blocked, preventing sperm from ejaculating normally. If it causes infertility, surgery can be used to correct the blockage.
Assisted Reproductive Technologies (ART)
With more breakthroughs in research, couples struggling to conceive can try other methods, such as:
- Artificial insemination (AI) and intrauterine insemination (IUI)
- Invitro fertilization (IVF)
- Natural cycle IVF
- Donor eggs
- Surrogacy
- Egg freezing
In Conclusion
Infertility is a growing problem in society, affecting millions of couples around the globe. It is essential to note that the cause of infertility is unknown in many cases. In such cases, it may take multiple tests and evaluations to determine the underlying cause. If you are struggling with infertility, you must speak with your doctor to discuss your options and choose the best course of action.
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