Infertility is a very common problem among both men and women and it refers to the inability to conceive even after regular unprotected sex. The causes of this can be varied and some of the most prominent ones are:

Causes in Women:

1. Polycystic ovarian syndrome

PCOS is a medical condition in women in which they do not ovulate. It is a major cause of infertility in most women. It can often result in irregular menstruation and an increase in the release of male hormones in the female body. This causes male symptoms like the growth of a beard, hoarse voice etc. in females. The probable causes of this condition comprise being over or under weight, thyroid imbalance etc. It is possible to treat this condition with medical aid and weight management can also prove to be helpful.

2. Lack of sufficient healthy eggs

As you grow in age, the number and health of your eggs decline significantly. This could be a possible reason for your infertility. In this condition, optimizing egg health by maintaining a healthy weight and quitting alcohol and cigarettes can help you get rid of your infertility.

3. Blockage of the fallopian tubes

Blockage of or damage to the fallopian tubes causes the tubal factor that is responsible for infertility in women. The tubal factor can also be a result of endometriosis or any sexually transmitted disease like Chlamydia etc.

Causes in Men:

1. Ejaculatory disorders

Retrograde ejaculation, premature ejaculation, and other issues associated with ejaculation may cause infertility in men. In retrograde ejaculation, the semen enters the bladder instead of emerging out of the penis during orgasm. In premature ejaculation, the ejaculation occurs before the vagina is prepared to receive the semen.

2. Chromosome defects

Disorders like Klinefelter's syndrome can cause abnormal growth of the male reproductive organs resulting in infertility. Other such syndromes include Kallmann's syndrome, Karatagener's syndrome, cystic fibrosis etc. These conditions are mostly genetic.

3. Hormonal imbalance

Male infertility can also be a result of hormonal imbalances like hypogonadism (low testosterone levels), disorders of the testicles, abnormal functioning of the pituitary, thyroid, adrenal and the other glands as well.

6 Common Causes of Infertility That are also Curable

There are some commonest misconceptions about infertility and these misconceptions should be eliminated as soon as possible so that the actual facts can be known. There are many online sites where you can find detailed information on the scientific explanations regarding infertility and you can follow them.

List of myths and facts regarding infertility

1. Myth: The menstrual cycle of a woman is for 28 days.
Fact: Normal cycle ranges between 21 to 36 days.

2. Myth: A woman can have pregnancy on the day one of menstrual cycle.
Fact: The released eggs remain viable for almost 12-14 hours and a woman can get pregnant after an intercourse done two days after ovulation and five days before ovulation.

3. Myth: Infertility occurs due to stress.
Fact: Ovulation can surely get delayed due to hormone suppression, but infertility does not occur due to stress.

4. Myth: Sperms stay active for few hours.
Fact: Sperms stay alive at least for five days.

5. Myth: Men with a higher sexual drive will have a normal sperm count.
Fact: There is no relation in between fertility and virility. Sometimes, it has been found that men having a higher sex drive do not produce sperms.

6. Myth: Women have to wait for three months to conceive after stopping the usage of contraceptive pills.
Fact: As soon as a woman stops pill usage, hormonal levels go back to normal condition, as a result of which ovulation begins immediately.

7. Myth: Only females have infertility troubles.
Fact: Both women and men suffer from infertility troubles as per the current scientific studies.

8. Myth: Ovulation occurs in a woman on the 14th day of menstrual cycle.
Fact: Ovulation can be calculated by counting 14 days backwards from the past menstrual cycle's last day.

9. Myth: Daily sex can increase conceiving chances.
Fact: During ovulation, having sex each day, especially in between 12 to 16th day of the cycle can be the best timing.

10. Myth: Fertility troubles occur at 35.
Fact: Peak fertility timing in a woman's life is 20 and this might continue until late 30s. Fertility troubles might even arrive at a younger age. With age, conception chances get declined, especially after 35.

Myths & Facts About Infertility

Almost every man and woman craves to have a child they can call their own. This makes an inability to procreate one of the most dreaded situations. Infertility can be defined as the inability to conceive a child within 12 months of biologically appropriately timed intercourse. Infertility exacts a huge psychological toll on the person.

Infertility often triggers depression in a person. This may be acute and result from specific events such as the holidays, family celebrations of the news of a someone else having conceived a child or could be cyclic and coincide with phases of their fertility cycle. This depression could lead to problems at work and communication with the spouse.

Infertility can also make a person feel helpless and affect their self esteem. Infertility accompanied by depression can trigger the feeling of having lost control over one s life and can make people withdraw into themselves.

An infertile person may also often feel guilty and make them blame themselves and their prior actions for the condition. This leads them to question their worthiness of being a good spouse and potential parent. A woman who has suffered from an STD earlier or has undergone an abortion earlier can become obsessed with blaming herself for being infertile. 

This affects their daily lives and ability to work. An infertile person may also feel guilty for having robbed their partner of the chance to become a parent. This can put a strain on their relationship and in many cases lead to a broken marriage.

When they find themselves unable to conceive a child, a couple may try to time their intercourse with ovulation tools, such as an ovulation thermometer etc. and may try different positions, some of which may be fairly uncomfortable. They may also end up having intercourse more often than desired. In order to prevent sperm from leaking out of the vagina, a woman may also find herself lying in an awkward supine position after intercourse. A combination of all these factors makes the act a chore and with time can lead to a loss of libido.

Infertility can also trigger anger against life for having been treated unfairly or towards other parents. This may also be displaced towards their family and friends leading to situations where they feel ostracized and unsupported.

When dealing with infertility, it is important to understand that neither partner is to blame. Infertility is a physiological condition and can be treated in most cases. It is important for both partners to support each other during this process and if need be consult a counselor.

Infertility - Its Impact on a Person's Mental Health

Female infertility is considered as the inability of conceiving. As per WHO it is described as the inability to be pregnant, maintain and carry forward a pregnancy to its full term. It is often of two types:

    Primary Infertility: This is the inability to give birth to a baby either due to the inability to become pregnant or maintain a pregnancy, which includes stillborn and miscarriage.
    Secondary Infertility: This refers to the inability to give birth when there is already a live birth or the woman was pregnant.

The causes of infertility can vary from being acquired or genetic. However, following factors are largely responsible for infertility:

    Genetic: Some genes can lead to mutation leading to infertility like, in case of BMP15 gene there is a hypergonadotrophic ovarian failure which causes infertility.
    Acquired: This is caused by factors like age, smoking, sexually transmitted diseases, obesity, body weight, eating disorders, diseases like diabetes, thrombophilia and also radiation and chemotherapy.

The treatment for infertility usually depends on the cause, age, duration of time for which a person has been infertile and preference of the patient. Infertility is believed to be a complex disorder and the treatment involves a huge amount of physical, financial and psychological commitments. All this also requires a lot of time. Some women might need just a minimum of two therapies to attain fertility while others might require different treatment before they can conceive.

Treatment is largely aimed to restore the fertility either by means of medication and surgery or help in reproduction with the help of some procedures.

Fertility Restoration through medication

This is the main treatment for women who are infertile because of ovulation disorders. These drugs include:

    Gonadotropins: These are injected to stimulate the ovaries. Drugs like Menopur, Repronex, Follistim AQ, Gonal-F, Bravelle restore the production of eggs, while Ovidrel and Pregnyl are used for maturing the eggs and for their release.
    Clomiphene citrate: This is taken orally and stimulates ovulation by releasing more Follicle Stimulating Hormone and Luteinizing Hormone from the pituitary gland.
    Metformin: This is used in females who have PCOS and also when insulin resistance plays a major role in infertility.
    Bromocriptine: Used when the infertility is caused due to excess prolactin production.
    Letrozole: This also induces ovulation

Fertility Restoration through surgery

Surgical procedures can amend the problem of infertility. However, these treatments are very rare these days owing to the success of other fertility treatments. These include:

    Tubal ligation reversal surgery: In case a tubal ligation has been performed it can be reversed by reconnecting the tubes again through surgery.
    Hysteroscopic surgery: This corrects or removes the abnormalities that cause infertility. This surgery can correct the shape of the uterus, remove endometrial polyps and improve chance of getting pregnant.
    Tubal surgeries: In case of blocked fallopian tubes laproscopic surgery can be performed to dilate the tubes, removed blockages or create a new opening.

Assistance in Reproduction through techniques

The most common used techniques for reproduction assistance are:

    Intrauterine insemination or IUI: In this about million healthy sperms are put in the uterus at the time of ovulation.
    Assisted reproductive technology: In this mature eggs are retrieved from a woman and this is then fertilized with sperms in a dish in the lab. Once the fertilization is done the embryo is placed in the uterus for further development. IVF is the most common and effective assisted reproductive technology. This procedure takes place over weeks with several blood tests and hormone injections.

Dealing with infertility is not easy and can be emotionally and physically draining. To cope with the various tests and treatments of infertility one should be fully prepared, eat a healthy diet, exercise reach out for help and support of family and friends and look for other options like a donor egg, adoption or no children.

Treatments of Infertility

One of the most important decisions a couple takes is to start a family. It fills them with hope and joy of new future, but if the attempts have been unsuccessful for more than six months, it can take a toll on the relationship and the mental health of the couple. This is the time to seek fertility specialist who will be appropriate to analyze the situation and provide proper guidance. Read on to find out the exact indications to see a fertility specialist:

1. If a woman who is under the age of 35 is unable to get pregnant even after a year of having regular unprotected sex
2. A woman who has had more than three miscarriages
3. Someone who has suffered from blocked fallopian tubes and is in need of surgery
4. One who experiences irregular ovulation
5. A couple who has suffered from genital infections
6. A pregnant woman who has consumed an estrogen derivative
7. A man who has been diagnosed with low semen count, also known as poor motility
8. A couple who has not been diagnosed with any irregularity but is infertile

Which specialist should you visit?

If you or your partner or both have shown signs of infertility, then visiting the following specialists can be helpful:

Specialists for men

Urologists and Andrologists are specialists who treat men for infertility. Urologists conduct an analysis of semen quality, semen count, hormone levels, reproductive organs and abnormalities in bladder and kidneys. Andrologists are medical professionals who specialize in hormonal conditions and physiology of male infertility.

Specialists for women

Hormonal imbalance is one of the potent obstacles to pregnancy. If a general obstetrician/gynecologist has not been able to successfully treat a woman then she can visit a reproductive endocrinologist who specializes in hormonal disorders. Depending upon the nature of the problem, she can also visit a reproductive surgeon who deals with uterine abnormalities, endometriosis, and reproductive organ surgery.

When Should a Couple See a Fertility Specialist?

There are two types of abortion, namely medical and surgical. In case of medical abortion, pills are taken to terminate the pregnancy; whereas, surgical abortion is done if the pregnancy has reached an advanced stage when pills are ineffective. While generally there are no health risks or negative effects of abortion on fertility, there are rare cases of complications, which can give rise to severe symptoms post abortion. Following is the information you need to know about abortion and its effects on fertility:

When to seek medical assistance
It is advisable to seek medical help if you have the following symptoms post abortion:
1. Persistent pain in the lower abdomen, which lingers even after taking medication
2. Excessive bleeding
3. A high temperature

Possible effects of surgical abortion on fertility
1. Infection after abortion: infections post abortion like pelvic inflammatory disease (pid), if left untreated for long can spread and harm your reproductive organs, thereby impacting your fertility. It can cause complications like infertility or ectopic pregnancy.

2. Damage to the cervix during abortion: damage to the cervix during an abortion can cause cervical incompetence and consequently increase the risk of miscarriage.

3. Damage to the womb during abortion: there are chances of damage of the womb (uterus) during abortion, resulting in scarring, which can cause fertility issues if not corrected. This is more likely in case you had multiple abortions.

Apart from the above mentioned complications there are a number of other complications, which can happen due to abortion, preterm birth, vaginal bleeding during pregnancy and low birth rate, etc. Further, infertility can also be a possible side effect of abortion pills, which happens due to scarring of the uterus during the procedure of forcible elimination of the fetus. In all such cases it is advisable to schedule regular check up with your gynaecologist.

Can Abortion Affect Fertility?

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