INFERTILITY
Did you know that around the world, about 17.5% of the adult population are struggling with infertility? This means approximately 1 in 6 people worldwide experience infertility in their lifetime. If you have been struggling to make a baby, you should know that aren’t alone as millions of people in the world are dealing or have dealt with a similar problem. In this piece, we’ll be talking about infertility, what causes it and different treatment options that are available.
Infertility, as defined by WHO is a disease of the male and female reproductive tract characterized by the inability to conceive after 12 months or more of regular, unprotected sex.
Infertility can either be primary or secondary. A person can be said to have primary infertility if in their life, they have never conceived a child. In secondary infertility, there’s a past history of conception. A person who has secondary infertility has been pregnant before, the outcome of the pregnancy notwithstanding.
WHAT ARE SOME OF THE CAUSES OF INFERTILITY?
It can be caused by a number of things, however in about 25% of people, the cause is unknown.
CAUSES OF INFERTILITY IN WOMEN
OVULATION PROBLEMS
The process of ovulation causes the monthly release of eggs from the ovaries and eggs are required for fertilization to occur. Where there’s a problem that interferes with this cyclical release of an egg, the sperm has nothing to fertilize even if regular sex is being engaged in. This can be due to problems like polycystic ovarian syndrome or even an imbalance of the thyroid hormone.
FIBROIDS AND ENDOMETROISIS:
The presence of a fibroid mass within the womb can prevent the attachment of a fertilized egg to the wall of the uterus. Fibroids can also block fallopian tubes obstructing egg transport. In endometrioisis, tissues that are similar to those lining the inner part of the womb begins to grow in other sites like the fallopian tubes and ovaries. This can lead to damage of these structures, causing infertility.
PELVIC SURGERIES
Surgeries to the pelvic region can lead to the formation of scar tissues in these areas contributing to infertility.
INFECTIONS
Infections to the upper part of the female genital tract, known as pelvic inflammatory disease caused by sexually transmitted infections leads to damage and scarring to the fallopian tubes. This prevents movement of the egg into the womb.
HARSH CERVICAL ENVIRONMENT
During ovulation, the cervical mucus changes its consistency becoming thinner and watery to allow the sperm easily swim up the tract. If this change does not occur, it may be more difficult to conceive.
DRUGS
There are some medicines that makes it more difficult to conceive and some examples are cancer medications, some drugs used to manage psychiatric disorders, and even the popular over the counter medication, NSAIDS (e.g: Ibuprofen, aspirin).
CAUSES OF INFERTILITY IN MEN
The commonest cause of infertility in men is due to abnormalities with the semen. Semen is considered to be of poor quality if any of the following is detected. A low sperm count, problems with sperm movement, and an abnormal sperm shape. Other causes of infertility in men includes: Poor ejaculation, low testosterone levels, vasectomy, and testicular problems (e.g testicular cancer, infection, testicular injury and congenital problems like a poorly descended testes). Drugs like steroids and those used for chemotherapy can reduce sperm count and movement. Illicit drugs like cocaine and marijuana has also been shown to decrease the quality of semen.
WHAT ARE SOME OF THE RISK FACTORS?
In both men and women, many of the risk factors apply.
- Alcohol: Heavy alcohol use can contribute to infertility.
- Tobacco: The use of tobacco and other illegal drugs like marijuana can cause difficulty in getting pregnant.
- Age: The quality of eggs and semen decreases with age. In women, this decline is marked from the age of 37 while in men, it occurs from the age of 40.
- Unprotected sex: Multiple sexual partners and practice of unsafe sex increases risk of getting a sexually transmitted infection which can cause infertility in both men and women.
- Exercise: Studies have shown that both under and over exercising may contribute to infertility
- Weight: Being either underweight or overweight can increase likelihood of having fertility issues.
- Exposure to chemicals: Some industrial and environmental agents are toxic and can affect sperm quality.
- High Temperatures: There are some data that shows that high temperatures e.g in baths, steam rooms, etc can affect the movement of sperm and even its production.
WHEN TO BE CONCERNED.
If you have been struggling to get pregnant despite having regular sex for about a year, you may need to see a doctor if you have any of the following:
- History of multiple miscarriages.
- Painful menstruation
- History of fertility issues.
- Age greater or equal to 35, trying to conceive for about 6 months.
- You are older than 40 years.
- Received treatment for cancer.
- History of endometriosis or PID.
- Family history of infertility.
WHAT CAN BE DONE?
Your doctor will run a series of tests, including tests for STIs. Scans will be done to check the woman’s reproductive organs to rule out any condition that may make it difficult for pregnancy to occur, example blockage of the tubes. Fertility tests will be done for both the woman and man. Depending on the results from these tests, different treatment options will be offered. These may include: fertility pills, surgery to repair blocked tubes, assisted conception like IVF, intrauterine insemination, sperm and egg donation.
SUMMARY
Infertility is a burden to millions of people worldwide. In a number of people, the cause cannot be identified despite extensive tests. This group of people can benefit from IVF. You can decrease risk of infertility by modifying lifestyle habits like smoking, alcohol intake, manging your weight, managing stress and stopping the use of illegal drugs. Also, limit the use of medications that may affect your fertility by speaking to your doctor and avoid self-prescribed medications, including herbal formulations.