Introduction:-
Infertility (L.in-not, fertilis-fruitful) is the failure to conceive even after 1-2 years of regular, unprotected sex. The term is not synonymous with sterility; which means complete inability to produce offspring. Infertility best be defined as relative sterility.
It is of two types- primary and secondary. Primary infertility is the infertility found in patients who have never conceived. Secondary infertility is found in patients who have previously conceived. Infertility can be caused by defects found in males or females.
Infertility in Males
Semen of a fertile male is 2.5 to 5 ml per ejaculation with a sperm count of over 200-300 million, mostly motile, having proper fructose content and fluidity which is deposited high in the vagina
Any defect in sperm count, sperm structure, sperm motility of seminal fluid can lead to infertility. Low sperm count is called asthenozoospermia while defective sperm morphology is termed as teratozoospermia. Various causes infertility in males include:
1. Cryptorchidism or failure of testes to descend into scrotum.
2. Absence or blockage of vasa deferentia.
3. Hyperthermia or higher scrotal temperature due to varicocele (varicose veins), hydrocele or filariasis, undergarment or working in hot environment causes oligospermia or depressed spermatogenesis.
4. Infections like mumps after puberty (orchitis or inflammation of testes), bronchiectasis (chronic dilation of bronchioles), infection of seminal vesicles or prostate result in oligospermia. Infections of Chlamydia trachomatis and T. mycoplasma (= Ureoplasma) also cause oligospermia.
Some other causes of infertility in males:-
Infertility in males is a complex condition often stem from various causes such as hormonal imbalances, genetic factors, lifestyle choices, and environmental exposures.
Sperm quality and quantity are critical indicators, with abnormalities in these areas leading to reduced fertility.
Common issues include low sperm count, poor motility, and abnormal morphology.
Early diagnosis and intervention, including lifestyle changes, medical treatments, or assisted reproductive technologies, can significantly improve the chances of conception.
Understanding and addressing male infertility requires a holistic approach, emphasizing both physical and emotional well-being.
Infertility in Females:-
A fertile woman is the one who regularly ovulates once every cycle, passes the egg down the reproductive tract which develops conditions for smooth passage of sperms and implantation of fertilized egg. The various causes of infertility in females are as follows:
1. Anovulation (nonovulation) and oligoovulation (deficient ovulation) are caused by deficient functioning of hypothalamo- pituitary complex or secondarily by thyroid and adrenal dysfunction.
2. Inadequate growth and functioning of corpus luteum resulting in reduced progesterone secretion and deficient secretory changes in endometrium. It is called luteal phase defect. It inhibits implantation
3. The ovum is not liberated but remains trapped inside the follicle due to to hyperprolactinaemia.
4. Fallopian tube may fail to pick up ovum, have impaired motility, loss of cilia and blocked lumen. The defects may be caused by infection or endometriosis
General nature causes of infertility in females:-
Infertility in females is a versatile issue influenced by a range of factors, including hormonal imbalances, ovulatory disorders, fallopian tube damage, and uterine or cervical abnormalities.
Conditions such as polycystic ovary syndrome (PCOS), endometriosis, and early menopause often contribute to difficulties in conceiving.
Lifestyle factors, age, and underlying health conditions also play significant roles
Diagnosis typically involves a combination of medical history review, physical examinations, and specialized tests.
Treatment options vary from lifestyle modifications and medications to surgical interventions and assisted reproductive technologies.
Addressing female infertility requires a comprehensive approach, considering both medical and emotional aspects to support women through their fertility journey.
In males, infertility often results from issues like low sperm count, poor sperm motility, or abnormal sperm morphology. In females, common causes include ovulatory disorders, fallopian tube damage, endometriosis, and hormonal imbalances.
Infertility diagnosis involves a thorough medical history review, physical examinations, and various tests. For males, semen analysis is common, while females might undergo blood tests, ultrasound, and hysterosalpingography to assess reproductive health.