What are the causes of infertility and how to treat it

2024 Author: Malcolm Clapton | [email protected]. Last modified: 2023-12-17 03:44

One in five couples with this disorder will one day be able to become parents without any therapy.

What is infertility and how it happens

Infertility The definition of infertility is a disorder in which a couple cannot achieve pregnancy for at least a year, despite regular unprotected sex.

This phenomenon is not uncommon. According to the Statistics of Infertility in Russia and the World, about 15% of married couples in the Russian Federation suffer from infertility.

Doctors distinguish two types of infertility infertility:

• Primary - when pregnancy has never occurred.
• Secondary - when there was at least one conception in the past, but it is impossible to get pregnant again.

Determination of the type helps to suggest what exactly caused the anomaly: a certain congenital factor acquired during life or associated with a partner.

What are the causes of infertility

The possibility of pregnancy depends on many factors. What Is Fertility?:

• the quality of sperm, the amount of motile sperm in it;
• the body's ability to produce healthy eggs;
• patency of the fallopian tubes - "roads" along which sperm rush to the eggs;
• sperm health and their ability to fertilize an egg when they meet;
• the ability of a fertilized egg (embryo) to implant in the wall of the uterus;
• the health of the embryo - so that it can develop further.

Failure at any of the listed stages leads to the fact that pregnancy does not occur.

There is an opinion that only women have problems with conception. But, as can be seen from the list of factors above, the responsibility for the onset of pregnancy lies with both partners.

In only one third of Infertility cases, infertility is associated exclusively with women's health. And in the third - with the male.

Sometimes it is not at all possible to establish why infertility appears. And you also need to be ready for this.

Causes of infertility in women

Here are the most common Infertility.

1. Ovulation disorders

Ovulation is the process of the release of a mature egg from the ovary into the fallopian tube, where it is possible to meet with sperm. But sometimes the oocyte does not mature or cannot leave the ovary. In this case, conception is impossible.

Female infertility can lead to ovulation disorders:

• Diseases of the thyroid gland - hyper- or hypothyroidism.
• Polycystic ovary syndrome.
• Hyperprolactinemia. This is the name of a condition in which there is too much prolactin in a woman's body, a hormone that stimulates the production of breast milk. Hyperprolactinemia stops ovulation and is the reason why pregnancy may not occur in breastfeeding women.
• Excess weight.
• Excessive physical activity.
• Eating disorders - such as anorexia or bulimia.
• Alcohol or drug use.
• Severe stress.
• Tumors of the reproductive system.

2. Pathology of the uterus or cervix

Abnormal location (bend) of the cervix, polyps, benign tumors in the uterine wall (fibroids) - all of this can block the fallopian tubes or prevent a fertilized egg from implanting in its proper place.

3. Endometriosis

This is the name of the proliferation of the endometrium (the lining of the uterus) outside the organ. Endometriosis can impair the patency of the fallopian tubes and cause the ovaries to malfunction.

4. Obstruction of the fallopian tubes

This is a condition in which the oocyte cannot move from the ovary to the uterus. Most often, obstruction is the result of inflammatory processes in the pelvic organs. For example, caused by appendicitis or any of the sexually transmitted infections.

5. Early menopause

Usually, the ovaries stop producing eggs at about 45–55 years of age. But sometimes it happens much earlier - before the age of 40. In this case, doctors talk about early menopause. Diseases of the immune system, some genetic disorders, as well as chemotherapy and radiation therapy, which are used in the treatment of cancer, can stop the ovaries prematurely.

Causes of infertility in men

1. Poor quality semen

For example, there may be too few sperm in it (according to statistics, every twentieth Male infertility man faces such a problem). Or cells are inactive. Or maybe they are not completely healthy - and the embryo will not develop or will not be able to gain a foothold in the uterus.

Sperm Quality Impairs Infertility:

• Various diseases. For example, diabetes, mumps in childhood (mumps) or sexually transmitted infections (chlamydia, gonorrhea, HIV, and others).
• Dilated veins in the testes (varicocele).
• Undescended testicle.
• Smoking.
• Alcohol abuse.
• Taking certain medications - antibiotics, high blood pressure medications, antidepressants.
• Exposure to heat. For example, in a bath or sauna.
• Poisoning by chemicals - for example, pesticides.
• Exposure to radiation.

2. Problems with sperm delivery

Sometimes a man simply cannot fully ejaculate. For example, with retrograde ejaculation, sperm, instead of moving through the urethra to the exit, enters the bladder. These problems can be caused by injuries to the genitals, hormonal and autoimmune diseases (diabetes, multiple sclerosis), certain medications, or aging.

How to know if you are infertile

Remember the diagnostic period: 12 months (6 months for women over 35 years of age). If your unsuccessful attempts to conceive a child last less, it is too early to talk about infertility. If it is longer, then you really should see a doctor.

The specialist will identify the cause of infertility and prescribe treatment. But first, both partners need to be examined so that the doctor can make an accurate diagnosis.

What examinations a woman needs to undergo

Your doctor is a gynecologist. He will listen to complaints, clarify how often you have sex, what medications you take, whether you have had pregnancies in the past, and will examine you on a chair.

In addition, you will need to do:

• Blood and urine tests. This will help determine if you are ovulating.
• Hysterosalpingography. This is the name of an x-ray examination, which helps to identify obstruction of the fallopian tubes.
• Transvaginal ultrasound. The doctor will insert a probe into the vagina and use it to find out the state of the uterus and ovaries.
• Hormone tests. They will reveal the level of hormones on which ovulation and other reproductive processes depend.

There are other, more specific studies. For example, an endometrial biopsy or a Pap smear (Pap test), which is used to diagnose cervical cancer. But which tests you need, only the doctor decides.

What examinations a man needs to undergo

Your doctor is a urologist. He will also start by asking questions about the regularity of sexual activity, past illnesses, medications taken, and also examines the genitals.

Then you will get directions to:

• Semen analysis. Several seed samples may be needed to get an accurate result.
• Blood test for hormone levels.
• Analysis of urine after ejaculation.

In addition, you may need to do an ultrasound of the scrotum and a transrectal ultrasound of the prostate - they will help determine if there are growths in the testicles and blockages in the vas deferens. The doctor may send you for other tests: genetic test on a semen sample, testicular biopsy, tests for STDs (sexually transmitted diseases).

How to treat infertility

Treatment depends on:

• the reason that caused the abnormal condition;
• type of infertility (primary or secondary);
• the age of both partners;
• financial capabilities and preferences of the couple.

The good news is that most Infertility people who receive therapy eventually conceive a child.

And one in five couples diagnosed with infertility once become parents without any treatment.

But some people, despite all the efforts and medical tricks, remain childless. Although it's definitely worth trying.

Today there are three types of infertility treatment: medical, surgical and assisted reproductive technologies.

Taking medication

For a woman, a doctor may prescribe medications that induce or regulate ovulation. For a man, medications that improve testicular function and sperm quality.

Surgical methods

The operation is necessary if the fallopian tubes in a woman or the vas deferens in a man are injured or blocked. Expansion of the veins in the testicles also requires the help of a surgeon.

Assisted reproductive technologies (ART)

They are used when the first two treatments fail and the couple is unable to conceive naturally. There are many types of Assisted Reproductive Technology (ART) - Infertility Treatment of ART, here are the most common.

1. IVF (in vitro fertilization)

Sex cells - eggs and sperm - are taken from the couple and combined in the laboratory. The resulting embryos are given several days to develop, the healthiest ones are left and placed in the uterus.

2. ICSI (intracytoplasmic sperm injection - intracytoplasmic sperm injection)

Sometimes standard IVF fails and fertilization does not occur when oocytes and sperm are combined. Then they resort to the ICSI method: the sperm is injected into the egg with a thin glass needle.

3. GIFT (gamete intrafallopian transfer - transfer of the gamete into the fallopian tube)

The eggs and sperm are pooled and inserted into the fallopian tube through a small incision. Fertilization itself takes place inside the body.

4. IUI (intrauterine insemination)

On the day of ovulation, sperm are artificially injected directly into the uterus. This method is good when the sperm cannot naturally reach the egg.

5. FET (freezing embryo transfer)

Used in conjunction with one of the previous methods. For example, during IVF, several healthy embryos were obtained at once. If the couple wants to have more children, the "extra" ones can be frozen and used later.

6. Egg donation

If the oocytes are unhealthy, you can use someone else's. In accordance with the Federal Law, Federal Law No. 323-FZ of November 21, 2011 (as amended on July 31, 2020) "On the Fundamentals of Health Protection of Citizens in the Russian Federation" (as amended and supplemented, entered into force on August 11, 2020) … Article 55. The use of assisted reproductive technologies "On the basics of protecting the health of citizens in the Russian Federation" a donor can be a person aged 18–35 who does not have physical or mental illnesses, as well as who has undergone a medical and genetic examination.

7. Sperm donation

The requirements for a sperm donor are the same as above.

8. Surrogacy

The egg is fertilized using IVF or ICSI, but the pregnancy is not carried by the biological mother, but by the surrogate mother. This is a good solution for women who are physically unable to bear a baby: for example, they have no uterus or the risk of dying during childbirth is too high. In Russia, surrogate motherhood is officially permitted by the Federal Law "On the Fundamentals of Health Protection of Citizens in the Russian Federation" dated November 21, 2011 No. 323-FZ (last edition).