Infertility: causes and symptoms



If you and your partner are trying to have a child, you are not alone. 8-15% of couples of appropriate  age are infertile. Couple infertility is defined as the lack of getting pregnant after regular sexual activity and without using a contraceptive method within a year (WHO, 2013). This definition is based on the cumulative probability of pregnancy.

Infertility can be a problem of one of the partners or a combination of factors that influence the pregnancy. Fortunately, there are many safe and effective therapies that significantly improve your chances of getting pregnant.




Symptoms

The main symptom of infertility is that you do not get pregnant. There are no other obvious symptoms. Sometimes the infertile woman may have irregular or absent periods. Rarely, the infertile man may show some signs of hormonal problems, such as changes in hair growth or sexual function. Most couples will eventually conceive, with or without treatment.
When to go to the doctor

You probably don't need to go to the doctor about infertility unless you've been trying to conceive regularly for at least a year. Talk to your doctor early if you are a woman and:

  • You are 35-40 years old and in the last 6 months you have tried to conceive
  • You are over 40 years old
  • You have irregular or absent periods
  • Menstruation is very painful
  • You have known fertility problems
  • You have been diagnosed with endometriosis or pelvic inflammatory disease (PID)
  • You have several miscarriages
  • You have been treated for cancer


Talk to your doctor if you are a man and if:

  • Sperm counts are low or you have other sperm problems
  • You have a history of sexual, testicular or prostate problems
  • You have been treated for cancer
  • You have small testicles or varicocele (inflamed testicles in the scrotum)
  • You have relatives with infertility problems
  • causes


Sometimes the problems that cause infertility in couples are congenital (present at birth) and sometimes develop later in life.

The causes of infertility can affect one or both partners. In general:

  • In about a third of cases, it is a man's problem.
  • In about a third of cases, it is a woman's problem.
  • In all other cases, there are problems with both the man and the woman or a cause of infertility could not be identified.
  • Causes of male infertility


These can be:

  • Abnormal production of abnormal sperm function caused by unloaded testicles, genetic defects, health problems such as diabetes or infections such as chlamydia, gonorrhea, mumps or HIV. Varicose vein dilation of the testicles (varicocele) can also influence sperm quality.
  • Hormonal causes: the improper function of the endocrine system affects sperm production and fertilization capacity: thyroid disorders, changes in testosterone levels, FSH, LH, excess prolactin production (inhibits the production of gonadotropic hormones, LH and in response decreased testosterone levels).
  • Defects of the tubes that carry sperm - they can become blocked due to injuries that occur as a result of surgery, infections, trauma, or abnormal development (eg cystic fibrosis). These blockages can occur at any level: inside the testicle, in the epididymis, vas deferens, ejaculatory ducts.
  • Cryptorchidism (failure of the testes in the scrotum) - the failure of the testicles to descend from the abdomen to the scrotum during the fetus can benefit from surgical correction in the first two years of life and at the latest before adolescence so that fertility is not affected in the abdomen affects the ability to produce sperm).
  • Ejaculatory dysfunctions - retrograde ejaculation, premature ejaculation, inability to get/sustain an erection, lack of libido, pain during intercourse.
  • Overexposure to certain environmental factors, such as pesticides or other chemicals or radiation. Smoking, alcohol, or drugs, certain medications (antibiotics, antihypertensives, anabolic steroids, and others) can also influence fertility. Frequent exposure to heat, in saunas or hot baths, can raise the temperature of the testicles and can influence sperm production.
  • Adverse effects of cancer and cancer treatment, such as radiation therapy and chemotherapy. Cancer treatment can sometimes severely reduce sperm production.
  • Causes of female infertility


These can be:

  • Ovulation disorders, which influence the release of the egg, such as polycystic ovary syndrome (PCOS). Hyperprolactinemia, a condition in which you have too much prolactin - the hormone that stimulates milk production - can also influence ovulation.
  • Too many thyroid hormones (hyperthyroidism) or too few (hypothyroidism) can influence the menstrual cycle or cause infertility. Other causes may include strenuous exercise, eating disorders, trauma, or tumors.
  • Diseases of the uterus: uterine malformations, fibroids, polyps, endometrial infections, adhesions in the uterine cavity (synechiae that may occur after a curettage), use of an intrauterine device for contraception (IUD).
  • Diseases of the vagina or cervix: malformations, infections, immunological causes (formation of antisemitic antibodies in the cervical mucus).
  • Damage or blockage/blockage of the fallopian tubes, often caused by inflammation of the fallopian tubes (salpingitis), which is caused by pelvic inflammatory disease (PID), usually caused by a sexually transmitted infection (STI) or surgery.
  • Endometriosis, which occurs when endometrial tissue grows outside the uterus and can affect the function of the ovaries, uterus, and fallopian tubes.
  • Primary ovarian failure (early menopause), when the ovaries stop functioning and menstruation end before the age of 40. Although the cause is generally unknown, certain factors are associated with early menopause, including immune system diseases, certain genetic conditions such as Turner syndrome or carriers of Fragile X syndrome, but also radiotherapy and chemotherapy, and smoking.
  • Pelvic adhesions (fibrous scar tissue formed between pelvic organs) that can be after infections, surgery, or endometriosis.


Other causes in women include:

Cancer and cancer treatment. Certain cancers - especially of the female reproductive organs - often severely affect a woman's fertility. Both radiotherapy and chemotherapy can affect fertility.
Other conditions. Medical problems associated with delayed puberty or absence of menstruation (amenorrhea), celiac disease, poorly controlled diabetes, and certain autoimmune diseases such as lupus can affect a woman's fertility. Genetic abnormalities can also make conception and pregnancy unlikely.






Female infertility is on the rise in the past 10 years.

Risk factors

Most risk factors for both men and women are the same and may include:

  • Age: A woman's fertility gradually decreases with age, especially in the mid-1930s, and suddenly decreases after 37 years. Infertility in older women can be determined by the number and quality of eggs or health problems that affect fertility. Men over the age of 40 may be less fertile than younger ones and may be at higher risk for children.
  • Smoking: This harmful habit reduces the possibility of pregnancy. Smoking also reduces the potential benefits of fertility treatment. Spontaneous abortions are more common among women who smoke. In men, smoking may increase the risk of erectile dysfunction and low sperm count.
  • Alcohol consumption: In women, there is no safe level of alcohol consumption during conception or pregnancy. Avoid alcohol if you are planning to become pregnant. Alcohol increases the risk of birth defects and can contribute to infertility. In men, heavy alcohol consumption can reduce sperm count and motility.
  • Excess weight: A sedentary lifestyle and being overweight can increase the risk of infertility in women. And in men, being overweight can affect sperm count.
  • Weight below average: Women at risk for fertility problems are those who suffer from eating disorders such as anorexia and bulimia, but also women who have a restrictive or very low-calorie diet.
  • Exercise: Insufficient physical exercise promotes obesity, which increases the risk of infertility. Uncommonly, ovulation problems may be associated with frequent and intense exercise in women who are not overweight.
  • Prevention - for couples, for men, for women


Some types of infertility cannot be prevented, but a number of strategies can increase the chances of pregnancy.

For couples

Have regular sexual intercourse a few times around the ovulation period - for increased chances of having a pregnancy. Ovulation usually occurs in the middle of the cycle - halfway through menstruation - in most women with menstrual cycles of about 28 days.
For men

For men, although most types of infertility cannot be prevented, these strategies can help you:

  • Avoid smoking and excessive alcohol consumption, which can contribute to male infertility.
  • Avoid high temperatures, as they can affect sperm production and sperm motility. Although this effect is usually temporary, avoid hot baths and steam baths.
  • Avoid exposure to industrial or environmental toxins, which influence sperm production.
  • It limits the administration of drugs with an effect on fertility, both prescription and OTC. Talk to your doctor about the medications you take regularly, but do not stop taking your prescription medications without seeking medical advice.
  • Exercise in moderation. Regular exercise can improve sperm quality and increase your chances of conceiving.

For women


For women, a number of strategies can increase their chances of getting pregnant:

  • Quit smoking. Tobacco has many negative effects on fertility, not to mention the general health and health of the fetus. If you smoke and are considering pregnancy, quit now.
  • Avoid alcohol and recreational drugs. These substances can reduce the ability to conceive and have a healthy pregnancy. Do not drink alcohol or use recreational drugs such as marijuana or cocaine.
  • Limit caffeine. Women trying to get pregnant should limit caffeine consumption. Seek medical advice about safe consumption.
  • Exercise in moderation. Regular exercise is important, but intense exercise that causes menstruation to become irregular or absent can affect your fertility.
  • Avoid extreme weight. And if you are overweight, underweight also influences your hormone production and can cause infertility.

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