Infertility
The World Health Organisation (WHO) clinically define infertility “the inability of a sexually active, non-contracepting couple to achieve pregnancy in one year.”
15 percent of the western world population is considered infertile.
As fertility in women is known to decline steadily with age, some providers evaluate and treat women aged 35 years or older after 6 months of unprotected sex.
Why is infertility growing?
Infertility is increasing in modern communities.
In men, declines in sperm count due to toxic environments and possible evolutionary effects are amongst the most notable reasons.
In women, educational and career concerns have delayed marriage and conceiving to a later age, generally above the mid-thirties. As average menopausal age ranges between 48 and 52, and ovarian function diminishes several years prior to menopause, women are becoming more unable to bear children.
Fertility treatment is always determined by individual cases. Causes of infertility are usually a complex interplay of different factors and are attributable to men and women alike, therefore in general both partners are examined.
The following are amongst the most common causes:
Dysfunction with egg maturation
Hormone production and distribution are influenced by various factors. Stress, certain medications, weight or thyroid disorders could for instance have a negative impact on hormonal balance. If there is an imbalance in the body’s hormone levels, this has a significant influence on the natural process of a woman’s menstrual cycle. Egg maturation and subsequent ovulation may for instance be inhibited or not take place at all.
Infertility due to the fallopian tubes
After ovulation, the egg lands in the fallopian tube. In the fallopian tube the sperm then have the opportunity to fertilise the egg. In approximately one third of women, the fallopian tubes are damaged or obstructed, which causes involuntary childlessness.
Myomas
Benign growths in the uterine muscle can grow inside the uterus, in the uterine wall or outside the uterus. Depending on the position and size, these harmless tumours can have a negative influence on fertilisation and embryo implantation.
Abnormalities in the reproductive organs
The reproductive organs must be intact so that a sperm can fertilise the egg. In about 5% of women, abnormalities in the ovaries, fallopian tubes or uterus are the cause of infertility. The abnormalities are usually hereditary and can occur in different forms.
Antibodies against sperm
If the man’s sperm enter the woman’s body, they are sometimes initially perceived as undesirable foreign objects. Antibodies in the cervical mucus of the uterus then start fighting the sperm and slow them down. This process, which prevents fertilisation of the egg, is called an immunological issue.
Dysfunctional sperm maturation
The most common problem with fertility in men is insufficient production of normal, motile sperm in the testes. Semen quality is considered normal when the number of sperm cells is over 20 million per millilitre of semen. Of these, at least 15 percent should be normally formed and 25 percent should have good forward mobility. If these values are not achieved, the man’s fertility is reduced. However, even if the sperm count is normal, a functional problem could still prevent the sperm from penetrating the egg.
Inhibited sperm transport
In four per cent of cases, sufficient sperm is actually formed but these fail to penetrate the woman’s body during ejaculation because the seminal ducts are blocked. This situation is comparable to a blocked fallopian tube in the woman.
It could be caused by prior sterilisation, undeveloped epididymis or adhesions within as a result of an infection.
Other inhibitors of sperm motility
Further causes include hormonal problems, stress, environmental pollution, undescended testicles, tumours that have been operated on or genetic causes, such as chromosomal abnormality. Acute infections can also temporarily reduce sperm motility.
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