A growing phenomenon, in not just cities, today infertility is gripping the rural dwellers too. Infertility is the inability of sexually active couples to conceive even after 12 months of regular unprotected sex. Infertility can be of two types – namely primary and secondary infertility. Primary infertility is a condition in which the woman has never conceived. On the other hand, secondary infertility is a condition in which the female had conceived at least once earlier, but is currently unable to conceive. Either or both the partners might be responsible for infertility.
Causes of female infertility
In females, infertility can be due to defects in production, reception, or transportation of the egg. It may also be the result of the inability of the sperms to enter the female reproductive system.
- Ovulation disorders:- It is necessary for a female to ovulate regularly to conceive. There are various conditions like polycystic ovarian syndrome, hypothalamic insufficiency, premature ovarian failure, and hyperprolactinemia, which affect the regular ovulatory cycle. Due to irregular or complete absence of ovulation, it becomes difficult for a woman to conceive.
- Tubal defects:- Fallopian tubes play an important role in conception as the egg is transported via these tubes to the uterine cavity for implantation. Any damage to these tubes due to infection, inflammation, previous surgery, or scar formation can lead to infertility.
- Endometriosis:- This is a condition in which cells from the uterine lining are deposited outside the uterine cavity, e.g., on the uterus, fallopian tubes, ovaries, and other areas. Because it is the uterine tissue, it also bleeds and sheds tissue during the regular menstrual cycle irritating the surrounding tissues. Continuous irritation leads to scar formation, adhesions, and pelvic discomfort. When deposited on ovaries, it hampers ovulation; on fallopian tubes, it impedes the movement of the egg to the uterus, making it difficult to conceive.
- Uterine or cervical issues:- Uterine fibroids or benign polyps in the uterus can hamper implantation. Sometimes these are positioned such that they block the fallopian tubes, thus reducing the chances of conception. Congenital disabilities such as unusually shaped uterus make it difficult to achieve or sustain a pregnancy. Many times, cervical secretions are not favourable for the survival and motility of sperms. Cervical stenosis or damage to the cervix can prevent conception.
- Lifestyle factors:- Drinking, smoking, drugs, obesity, and prolonged stress also adversely affect fertility.
Causes of male infertility
Male infertility can be due to poor sperm quality, quantity, and mobility. Both the male and female reproductive system affect the transportation of the sperm to the uterus.
- Medical disorders:- In males, disorders like varicocele, undescended testes, infection, tumours, genetic disorders, erectile dysfunction, retrograde ejaculation, hormonal imbalance, auto-antibodies, prior surgeries, and certain medications can lead to infertility.
- Environmental factors:- Exposure to heavy metals, industrial chemicals, and radiations can cause infertility. Exposing testicles to high temperatures can also affect the production and quality of sperms.
- Lifestyle factors:- Drinking alcohol causes erectile dysfunction and lowers testosterone levels and sperm production. Smoking may decrease the sperm count. Using anabolic steroids for bodybuilding can shrink the testicles and reduce sperm production. Cocaine and marijuana also have short-term effects on the quality and quantity of the sperms produced. Prolonged stress can disrupt sperm production by causing hormonal imbalance.
Unexplained infertility: In some couples, the exact cause of infertility cannot be determined. It can be a conglomeration of minor problems leading to infertility. There is a possibility that the issue resolves on its own.