Infertility can be broadly clubbed under two categories-
When the female is not able to conceive even after one year of unprotected sex.
Where the female has been able to get pregnant once, but is not able to do so now.
For Pregnancy to happen - First a woman must release an egg from one of her ovaries (ovulation) and then that egg must be fertilized by the male sperm. It
then travels through a fallopian tube into the uterus i.e the womb, where it attaches to the wall of the uterus and grows. As for the man, he must produce
enough sperm, and the sperm must be motile enough to fertilize the egg along the way, at the proper time. Finally the fertilized egg must then be able to
attach to the inside of the uterus. If any of these fail to happen, it leads to infertility.
About 30% of infertility cases are due to male related factors and 30% are due to problems with the female factors. Other cases
are due to a combination of male and female factors (10%) or due to unknown causes (25-30%).
Some of the reasons for males are as follows:
- - Low sperm count (oligospermia)
- - No sperms (azoospermia)
- - Decreased motility/abnormal sperms
- - Sexual dysfunction
- - Hormonal or endocrine problems
- - Cancer treatments, including chemotherapy and radiation
- - Age, male fertility decreases with age
- - Birth defect, such as absence of the tubes that carry the sperm (Vas deferens)
- - Exposure to excessive heat
- - Genetic/chromosomal problems
- - Antisperm antibody
- - Retrograde ejaculation (sperm goes back into the bladder)
- - Varicoceles, spematoceles, or tumors of the testicles.
- - Lifestyle factors such as: Alcohol and drugs & environmental toxins, including pesticides and lead, may cause some cases of infertility in men.
It requires examination of both the partners. In males, the tests include:
- - Physical examination
- - Sperm/semen Testing
- - Blood hormone level testing
- - Testicular biopsy
Treatment plan completely depends upon the problem identified and might just require a lifestyle modification (stopping drinks,
drugs and smoking) or counselling or medications, however in other cases a surgical intervention might be required.
Last but not the least, ovulation occurs about 2 weeks before the next menstrual cycle (period) starts. If a woman gets her
period every 28 days, the couple should have sex between the 10th and 18th day after the period starts, to maximize chances of
- - Surgery may be needed in a man, as in Vericocele, obstruction
- - Intrauterine insemination (IUI) of sperm, timed with ovulation.
- - IVF - In Vitro Fertilization