The Facts About Infertility
Male and female fertility issues
Although the process of sperm-meets-egg is natural and easy for most couples, some couples who want to conceive a child struggle with infertility. Approximately 6.1 million American women and their partners (which is about 10 percent of the people in the reproductive age bracket) are affected by infertility.
Infertility is the inability to conceive after a year of unprotected intercourse, or the inability to carry a pregnancy to a live birth.
The reasons for this heartache are many and uncertain. Some feel that the age of free sex in the 1960s passed around sexually transmitted diseases that now years later cause both male and female reproductive problems. Others point to the environmental toxins caused by the breakdown of certain pesticides and plastics that are linked to reduced sperm count, endometriosis, and fibroids. Abortions have caused many scarred fallopian tubes, which blocks the sperm from meeting up with the egg. And the increasing numbers of women who postpone having children until their 30s or 40s, when their eggs are no longer top quality, naturally reduces the fertility pool.
Medical Reasons for Infertility in Females
In many cases the cause of infertility in females is rooted in a treatable medical condition. The top two reasons for female infertility are (1) tubal factors (such as damaged fallopian tubes) and (2) ovulatory disorders (such as an irregular or absent menstrual cycle). A smaller percentage of women suffer from endometriosis (a condition in which tissue from inside the uterus grows outside the uterus), which can cause infertility if left untreated.
Some women who do get pregnant but then repeatedly miscarry the baby might also have a medical problem that can be corrected. Similar to other types of infertility, repeat miscarriages might be caused by hormonal problems, ovulatory problems, or structural problems in which the uterus won't support a pregnancy. In a few rare cases, an abnormality of the chromosomes might be the cause. But unfortunately, in the majority of cases, the reason for repeat miscarriages is unknown.
Reasons for Infertility in Males
Infertility in males is due to problems with their sperm. The number of sperm might be low (viability), the sperm might be abnormally shaped (morphology), or the sperm might move too slowly or sluggishly (motility).
Although the causes of these problems are many and varied, the most common reasons are as follows:
- Varicocele, or varicose veins of the testicles, cause a dilation of the veins and an increased volume of blood in the testicles. Blood retained around the testes leads to an increase in temperature, which can damage sperm, causing low sperm counts and misshaped sperm. It might also interfere with testosterone levels.
- Infections in the reproductive organs can cause reduced sperm production. Sometimes it's only a temporary reduction and can be treated with antibiotics before any physical damage occurs; other times the damage is permanent. Some infections are caused by various venereal diseases, especially gonorrhea, which can scar the delicate tubes through which sperm are transported. Tuberculosis or mumps might also invade the reproductive organs and cause physical damage. Viral diseases such as mononucleosis and hepatitis and any other illness that causes a persistent high fever can temporarily but dramatically depress sperm production.
- Anatomical problems can make it difficult or impossible for sperm to do their job. These include irregularities in the male reproductive system that either prevent the testicles from producing sperm or block the sperm from being ejaculated.
- Hormonal factors can cause an imbalance of "sex" hormones that can result in a number of infertility problems in a male.
- Other factors include the side effects of testicular cancer treatment, a hypothalamic or pituitary disorder, problems with the cells that produce sperm, the inability to effectively reverse a vasectomy, and age (yes, the count and quality of a man's sperm can decline as he gets older).
Excerpted from The Complete Idiot's Guide to Pregnancy and Childbirth © 2004 by Michele Isaac Gliksman, M.D. and Theresa Foy DiGeronimo. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.
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