What is Infertility?

Infertility is defined as the failure to conceive after a year of unprotected and unrestricted intercourse. In women over 35, the period is defined as six months. Primary infertility is when a couple has never had children, whereas secondary infertility refers to couples who have had children together but are at present unable to conceive.

infertilityImage Credit: GoodStudio/Shutterstock.com

Causes of infertility

The causes of infertility are equally split between male, female and unknown causes.

Male causes

  • Oligospermia/azoospermia
  • Varicocele
  • Prostatic infection
  • The majority of sperms are inactive or non-motile
  • Blockage of the reproductive tract, following surgery or injury

Reduction in sperm quality or quantity may be idiopathic, or a result of conditions such as:

  • Congenital – Klinefelter’s syndrome
  • Acquired:
    • Infections of the male reproductive tract
    • Alcohol or drug abuse
    • Exposure to environmental pollutants
    • Smoking
    • Following mumps orchitis
    • Chronic illnesses such as kidney disease
    • Testosterone underproduction
    • Medications
    • Chemotherapy/ radiation
    • Heat exposure to the testes, such as overly warm tubs, use of a laptop on the lap for long periods, varicoceles.
    • Impotence or premature ejaculation

Female causes

  • Anovulation
    • Polycystic ovarian syndrome, a metabolic disease in which infertility is often associated with diabetes and obesity.
    • Primary ovarian failure
  • Blockage of the fallopian tubes, due to endometriosis, pelvic inflammatory disease, ectopic pregnancy, or surgery.
  • Uterine developmental abnormalities, fibroids, or adhesions.

Anovulation may be due to many factors, including:

  • Age
  • Smoking
  • Alcohol abuse
  • Stress
  • Obesity
  • Malnutrition

Diagnosis of the cause of infertility

In men, testing starts with semen analysis, and hormonal assays if indicated, as when sperm counts are very low.  

In women, ovulation is tested for, either at home, using means such as basal body temperature or cervical mucus tests, or in hospital, with an ultrasound or blood tests.

If ovulation is present, tests may be performed to rule out tubal or uterine blockages and assure normal uterine anatomy.

If ovulation is absent, hormonal levels are checked, as well as metabolic parameters.

Treatment of infertility

Treatment is based on:

  • The couple’s age
  • The period of infertility
  • The test results, showing any abnormalities if present
  • The health of the couple

Treatment includes:

  • Medication for obvious problems, such as anovulation or infection
  • Surgery for blockages or for varicoceles
  • Impotence or premature ejaculation requires behavioral and medical therapy
  • Other modes of treatment such as:
    • Artificial insemination
    • Assisted reproductive technologies, such as in vitro fertilization, intracytoplasmic sperm injection, or gamete intra-fallopian transfer.

ART is costly, time-consuming and carries a relatively higher risk of certain birth defects, such as heart, digestive and cleft lip/palate problems.

More modern choices include the use of a surrogate mother or a gestational carrier.

References

Further Reading

Last Updated: Apr 15, 2021

Dr. Liji Thomas

Written by

Dr. Liji Thomas

Dr. Liji Thomas is an OB-GYN, who graduated from the Government Medical College, University of Calicut, Kerala, in 2001. Liji practiced as a full-time consultant in obstetrics/gynecology in a private hospital for a few years following her graduation. She has counseled hundreds of patients facing issues from pregnancy-related problems and infertility, and has been in charge of over 2,000 deliveries, striving always to achieve a normal delivery rather than operative.

Citations

Please use one of the following formats to cite this article in your essay, paper or report:

  • APA

    Thomas, Liji. (2021, April 15). What is Infertility?. News-Medical. Retrieved on September 25, 2021 from https://www.news-medical.net/health/What-is-Infertility.aspx.

  • MLA

    Thomas, Liji. "What is Infertility?". News-Medical. 25 September 2021. <https://www.news-medical.net/health/What-is-Infertility.aspx>.

  • Chicago

    Thomas, Liji. "What is Infertility?". News-Medical. https://www.news-medical.net/health/What-is-Infertility.aspx. (accessed September 25, 2021).

  • Harvard

    Thomas, Liji. 2021. What is Infertility?. News-Medical, viewed 25 September 2021, https://www.news-medical.net/health/What-is-Infertility.aspx.

Comments

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
You might also like... ×
Active management strategy helps women with early, nonviable pregnancies of unknown location