24-Aug-2020 - 2 min read
Don't mind the unfamiliar word. It simply means Infertility. Yes infertility. Mind you it is not a word only for women as it is commonly believed to be in this part of the world. The woman is often pointed as the culprit in a childless affair however this is not always the case. We have heard stories of men blame their wife for not bearing fruit and leave the woman to have extramarital affairs which is said to have yielded fruit(s) only to find out years later the child is not theirs and he was never able to father a child all along.....paternity fraud (a topic for another day). I would like to enlighten us as to what infertility is and the various common causes in male and female.
Infertility is the inability to get pregnant within 1year of regular (adequate) unprotected intercourse. Adequate intercourse is sex every 2-3 days. Infertility can be either Primary or Secondary (if an individual has had a child before or not).
Male Infertility account for 30% of infertility cases, female infertility account for 30% also, Mixed Infertility accounts for 20% and Unexplained causes account for 20%.
To understand the common causes, knowledge of the structure or component of the reproductive system is important. Basically, the man produces sperm from the testes which is stored up and later deposited into the female vagina during intercourse while the woman's reproductive system journey begins from the vagina heading upwards to the neck of the womb (cervix), then to the womb itself (uterus), then to the left and right tubes connecting to the womb (fallopian tubes) both linking up with the left and right ovaries (where the eggs come from).
Male Infertility can be due to abnormal/damaged or insufficient sperm, varicocele, retrogade ejaculation, infection (STD), diabetes, premature ejaculation, emotional stress, undescended testes, tumours etc.
Female infertility are due to the following
> Insufficient egg (also known as insufficient/low ovarian reserve) often seen as female progress in age. Female have a limited number of eggs from birth and this number does not increase further once born. This total number of eggs begin to reduce drastically from the age menses begin (menarche) hence it is generally stated that a woman's fertility starts to reduce in her early 30s and by age 40 her chance is reduced to about 5% per cycle.
> Absence of ovulation (Anovulation) : this is the failure of a woman to ovulate in a given cycle and is often seen in patients that have a condition called Polycystic Ovarian Syndrome (PCOS) which is characterized by facial hair, acne, irregular periods and high BMI. Anovulation is also seen in cases of Hypothalamic amenorrhea (no menses) which is often due to psychological stress, extreme diet, extreme exercise, low BMI, Chronic disease state. Hormonal disorders such as Hyprothyroidism and hyperprolactinemia (features are breastmilk lactatation in non pregnant state, no menses, reduced libido, recurrent headaches, high levels of prolactin) are also implicated in anovulation.
> Abnormalities of structure of the reproductive system such as Fibroids, polyps, adhesions (often following unsafe abortions, STI) etc
> Tubular problems such as blockage following Sexually Transmitted Infection (STI),Pelvic Inflammatory Disease (PID) etc
Its important to look out for these signs and symptoms & talk to your Doctor. Several tests/investigations can be done to ascertain the cause of Infertility and subsequently appropriate treatment is commenced.
Note that the journey from Infertility to fertility is to be embarked upon by both the female and her male counterpart. This helps psycologically to ease the tension on just the woman as the burden is shared equally. This also helps to make appropriate diagnosis as both party would be duly tested.