Infertility is one of the deepest concerns of many men and women around the world. Although we may find ourselves ready to settle down and raise a family, the hidden threat of infertility may, in fact, prevent us from having children. But what is infertility, and how can we treat it?
Statistical data and epidemiology: myths and truths about infertility
To properly be defined as infertile, a couple should be unable to conceive a baby is having regular unprotected sex for at least 12 consecutive months (one year). A very small percentage of couples (less than 20%) is able to conceive after just one month of unprotected sex: over 80% of couples may require up to one year to achieve pregnancy. Although they could be considered infertile after that period, many couples will still be able to conceive just by keep trying. Up to 95% of infertile couples can still be able to achieve pregnancy within 24 months (2 years) of regular unprotected intercourses. However, even that 5% of remaining couples can still improve their chances of success by just improving their dietary habits and follow a healthier lifestyle.
A quite common myth about infertility is thinking that this problem is mostly associated with women. Although technically there’s a smaller difference between male and female infertility that show a higher percentage of infertile women, the reason lies just on how these numbers are obtained. Statistical data show that infertile women represent about 35-45% of total sterile individuals, males represent about 20-30% while couples where both partners are infertile cover the remaining 30-40%. However, the definition of women infertility also includes all those women who aren’t able to carry a pregnancy to full term, not just those who aren’t able to conceive children, thus skewing the data a little bit. A woman who suffered from repeated miscarriages during her life, in fact, is still considered “infertile,” even if she manages to give birth to a baby at a later time.
The main reasons for infertility – common causes of infertility
Some risk factors that may lead to infertility are common for both men and women and include bad lifestyle habits (smoking, high alcohol consumption, unhealthy diet, sedentary life), older age, obesity, anxiety and medication use. Some simple lifestyle improvements may significantly increase the chance of solving an infertility problem, for example, just a moderate amount of everyday physical exercise can reduce several risk factors at the same time. It will increase tissues oxygenation ameliorating general health, will reduce excess body weight, and will also decrease anxiety and mental stress. A better dietary plan with lots of fruits and vegetables can also reduce overweight while providing a supplementation of essential nutritional elements required for fertility such as zinc, iron, folic acid, Vitamin, A, B-12 and D. Other risk factors such as age show slight differences between men and women. While male fertility slowly reduces itself after the age of 40, women’s one progressively decreases after she’s just 30-32 years old, especially if she never got pregnant before that time.
The main reasons for Infertility – Male infertility
Some other causes of infertility, however, are specifically related to gender. Male sperm quality is of paramount importance. Too little sperm cells inside the seminal liquid may lead to oligospermia or even azoospermia (absence of sperm cells), preventing fertilization of the eggs within the fallopian tubes. Oligospermia is often caused by varicocele, a condition where an abnormally swollen vein in the testicles may reduce sperm production. Prostatitis, an inflammation of the prostate, may also decrease the lifespan of sperm cells when they reach the woman’s uterus. Lastly, anxiety and stress may be the cause of erectile dysfunction problems that may negatively affect sexual intercourses.
The main reasons for infertility – Female infertility
To achieve conception, every single woman’s hormone must be stable both before and after fertilization. Irregular ovulation and hormonal imbalances are thus the main reasons for female infertility, especially when women are over 30 years of age. Knowing one’s own body is the first step in assessing a woman’s fertility, and, for this reason, many pregnancy and ovulation tests may help have a proper understanding of one’s hormonal levels. Other conditions such as polycystic ovary syndrome (PCOS), luteal phase defects or endometriosis many also led to female infertility. However, these conditions are much less frequent. After conception, the mother’s hormonal levels still need to be stable to let pregnancy reach its full term, and the fetus needs to live in an appropriate physiological environment. Any congenital malformation of the mother’s womb (uterus, placenta, etc.) can also increase the risk of abortion.
Treatment and solutions
Other than the critical changes of lifestyle and habits we already addressed, there are still some options available for those couples who can’t still achieve conception. These solutions may solve about 85-90% of total infertility cases. Professional couples counseling may help address any unvoiced psychological issue. Surgery may remove a varicose scrotum vein and solve varicocele, or remove scar tissue from blocked fallopian tubes. Pharmacological treatments include Clomiphene or Follicle-stimulating Hormone (FSH) to induce regular ovulation and Metformin and Bromocriptine to treat hyperprolactinemia or PCOS. Several herb remedies help to treat infertility with mixed results, including soybeans, Tribulus Terrestris, Maca, black cohosh and red clover. Anyhow, even if everything else fails, assisted reproductive technologies can still help infertile couples. Intrauterine insemination (IUI), in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), can still provide a definitive solution to infertility.
This article was written by Dr. Claudio Butticè
- Fritz MA, Speroff L (2011). “Induction of ovulation.” In Clinical Gynecologic Endocrinology and Infertility, 8th ed., pp. 1293–1330. Philadelphia: Lippincott Williams and Wilkins.
- William R. Keye (1995). “Infertility: Evaluation and Treatment.” Saunders. ISBN 9780721639703.
- World Health Organization (WHO). “WHO| Infertility”. who.int. Retrieved2015-12-01.
- Centers for Disease Control and Prevention. “Infertility| Reproductive Health | CDC”.cdc.gov. Retrieved 2015-12-01.