Infertility
From ArticleWorld
Infertility, medically-defined, is the inability of a couple to produce a pregnancy after one year of unprotected intercourse or the inability to carry a pregnancy to the point of viability. This condition affects up to 10% of men or women who are considered to be of the reproductive age. Most available research points to the condition of infertility as being due to female infertility in about 1/3 of cases, to male infertility in another 1/3, to mixed infertility in about 15% and to “unexplained” causes in the rest. Some couples have “primary infertility” when they have never conceived a child or carried one to maturity. Others are able to conceive at least once but become infertile after that—a condition known as “secondary infertility”.
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Female causes
Females can be infertile due to hormonal or medical factors that inhibit ovulation. Some chronic illnesses, ovarian diseases, psychological factors and hormonal conditions can each lead to the inability to ovulate or “anovulation”. In other cases, ovulation occurs normally but there is a problem with one or more Fallopian tubes so that the egg cannot be fertilized. Scar tissue and some pelvic infections (such as with Chlamydia) can cause the failure of the Fallopian tubes to be patent enough (or open) for the egg to pass. The uterus, too, can be a cause of female infertility if it is congenitally malformed or contains uterine fibroids. Finally, more obscure causes of female infertility include cervical blockage, anti-sperm antibodies, vaginal obstruction, a lack of lubrication and some genetic conditions.
Male causes
Male infertility usually affects the testicle in some way so that it can’t make or transport sperm. Hormonal problems, psychological issues, conditions which raise the temperature of the testes (varicoceles or hydroceles) and chronic medical conditions, such as diabetes or hypothyroidism, can all result in testicular malfunction. Blockage of the vas deferens, the tube that transports the sperm cells from the testicle to the urethra, causes infertility even though the testicles are functioning normally. Rare conditions, like Keinefelter’s Syndrome (a chromosomal problem), other genetic conditions and previous exposure to mumps can render a man infertile.
Mixed conditions
In some cases, both members of a couple have some degree of infertility. In some cases, the infertility may not be absolute. For example, a man may produce less than normal numbers of sperm cells and be paired with a woman who has only one Fallopian tube or who ovulates sporadically.
Evaluation
A basic fertility evaluation involves an examination of the man’s sperm and an assessment of the woman’s menstrual cycle through the use of body temperature monitoring or hormonal measurements. Generally, these two tests will together direct the physician toward more specific testing on the male, on the female or on both.