Fertility
What is Fertility?
Fertility refers to the capability of giving life. It is measured by fertility rate, which is the number of children born per couple. The male or female who are able to conclude a successful pregnancy are termed to be fertile.
It has been found that while men remain fertile almost all the time, women fertility is at peak two days before and two days after the ovulation date. Thus, it is obvious that female fertility is related to the menstrual cycle.
In female, the ovule is usually fertilizable, after its release from the ovary, for up to 48 hours. However, male sperm can survive 48-72 hours inside the uterus.
Usually, unprotected sex between a fertile man and a fertile woman would lead to pregnancy but if any one of the partners is infertile, even frequent, unprotected sex would not result in pregnancy.
Symptoms of Infertility
The most obvious symptom of infertility is inability to conceive even after unprotected, frequent sex. There are other symptoms of infertility too, but these are negligible.
Abnormal menstrual periods may also be a symptom of infertility. In case of men, there may be hormonal problems, such as change in the hair growth or sexual dysfunction.
Diagnosis of Infertility
The diagnosis of infertility is made through different tests for men and women.
For men:
1. Physical examination: The doctor may inspect the medical history, symptoms and complications. A test of the genitals may also be undertaken.
2. Analysis of the semen: The semen may be tested for sperm count, sperm motility and various other factors. The semen may also be checked for its color, quantity and presence of infection or blood.
3. Hormone tests: A test of blood sample for the testosterone levels is also quite common.
4. Ultarsound: Ultrasounds may be performed to test ejaculatory duct obstruction and retrograde ejaculation.
For women:
1. Ovulation testing: A blood test to check the levels of hormone may be undertaken.
2. Laparoscopy: Laparoscopy is usually performed to detect endometriosis and scarring. The test uses a fiber optic telescope inserted to pelvic cavity. It may be also used to detect irregularities in the fallopian tube and uterus.
3. Ovarian reserve testing: This test is performed to test effectiveness of the egg after ovulation.
4. Ultrasound: the pelvic ultrasound may be performed to test fallopian tube and uterus disorders.
Apart from these tests, hormonal and genetic testing may also be undertaken to test the hormonal levels and the structures of chromosomes respectively.
Causes of Infertility
Various reasons may be associated with infertility. However, it is worthwhile to discuss infertility issues by dividing them into male and female sections.
Causes of Male Infertility
A host of factors may be associated to male infertility. The major causes are as follows;
1. If the shape or function of the sperm is impaired it may not penetrate into the egg. This may occur due to a change in the morphology of the sperm, its speed and properties.
2. Lower sperm concentration may also lead to infertility. An amount of 10 million sperms or low, in a milliliter of semen is considered to be low. Lower amounts of sperm may not impregnate the egg successfully.
3. Infertility may also arise due to vericoocele. Vericocele refers to the presence of a varicose vein in the scrotum. The presence of varicose vein may prevent the natural cooling process of the testicle leading to lesser sperm production.
4. Undescended testicles, which occurs when testicle (s) fail to descend from the abdomen into the scrotum, may also be a reason for male infertility,
5. Hypogonadism, the deficiency of the male hormone, may also lead to male infertility. This may occur due to abnormal functioning of pituitary or hypothalamus gland.
6. Klinefelter’s syndrome, a genetic defect in which the male has two X chromosomes and a Y chromosome instead of one X and one Y chromosome may also lead to abnormal fertility or infertility.
7. Infections in any of the sexual organs may impair fertility among men. Chlamydia and gonorrhea are often found to hamper male fertility. Infections or inflammations, due to mumps or other reasons of the urethra or the epididymis may affect the sperm motility and result in infertility.
Causes of Female Infertility:
1. A damage or blockage in the fallopian tube may restrict fertility in a woman. Damage may take place due to inflammation or other injuries. Tubal infection may also lead to infertility. Chlamydia, a sexually transmitted disease, may also be responsible for fallopian tube dysfunction.
2. Various ovulation disorders may also be responsible. Usually, troubles in the part of the brain which produces luteinizing hormone and follicle-stimulating hormone may result in abnormal or unsuccessful ovulation, leading to infertility.
3. Elevated levels of prolactin, a hormone that controls breast milk production, may also be responsible for infertility in women.
4. Early menopause, which is marked by early depletion of ovarian follicles and absence of menstruation, may also lead to female infertility.
5. Various other conditions, such as polycystic ovary syndrome (PCOS), benign uterine fibroids and Pelvic adhesions may also contribute to female infertility.
Apart from the causes mentioned above, some medications, thyroid problems and cancer and its treatments may also lead to infertility. Some medical conditions, such as delayed puberty or amenorrhea, Cushing’s disease, HIV/AIDS, sickle cell disease, kidney disease and diabetes may also contribute to infertility.
Types of Infertility
There are no special types of infertility. It can only be considered different depending upon gender i.e.-male or female.
Treatment of infertility
The treatment options for males and females are different. While for men, the treatments are made primarily to correct the sexual problems and restore the properties of the sperm, for women there are various choices to rectify the reproductive system. It has also been observed that increasing the frequency of intercourse can also, sometimes, rectify problems related to infertility. However, too much intercourse can lead to deteriorate the quality of sperm.
Usually, for men, identifying the base of the problems, such as impotency and premature ejaculation can help a lot in diminishing infertility. For lack of sperm a hormonal treatment or a surgery can solve the problem.
For women, however, the treatment may be a little bit complex. One of the first approaches includes use of fertility drugs for stimulating ovulation. These drugs may include Clomiphene citrate, Human menopausal gonadotropin, Follicle-stimulating hormone and human chorionic gonadotropin. Other drugs used for the same trouble may be Letrozole (Femara), Metformin (Glucophage) and Bromocriptine. However, use of fertility drugs should be closely monitored as these drugs increase the chances of multiple births.
If oral drugs and medications cannot solve the problems, surgery may be an option. Laparoscopic techniques used in surgery provide relief from problems such as fallopian tube disorders and blockages. Infertility due to endometrosis can be complicated to solve and the doctor might use ovulation therapy.
Artificial means of reproduction, known as assisted reproductive technology (ART) is nowadays a very popular method. The major types of ART include In vitro fertilization, electrical or vibratory stimulations, surgical sperm aspirations, intracytoplasmic sperm injection and assisted hatching. In in-vitro fertilization the egg and sperm are obtained from individuals and are fertilized in laboratory conditions. Later, the embryo is placed in the uterus. Electrical and vibratory stimulations and surgical sperm aspirations are means of achieving the sperm if it’s biologically impossible for any reason. In Intracytoplasmic sperm injection, a single sperm is inserted directly into an egg while in assisted hatching; the embryo is implanted into the linings of uterus.
Living with Infertility
Infertility can have serious effects in the sociological contexts. Nowadays, various medications, surgeries and therapies have been in use and the problem has been adequately addressed. Methods such as in vitro fertilization and sperm injections are quite helpful in providing solutions for infertile couples. Individuals suffering from infertility can look for surgical help too. With the newer technologies and medications, treating infertility has become a reality.
Prevention of Infertility
Since infertility is a internal problem including sexual habits, genetic modes and biological processes, it is impossible to prevent infertility. However, there are many ways to treat the condition and provide help regarding reproduction, both manually and through laboratory applications.
