When a couple is enjoying regular unprotected sex, and they are not able to conceive, it means there is a problem of infertility. It may be that because one partner cannot contribute to conception or the woman is unable to carry pregnancy full term.
Infertility can occur if there is no conception after regular unprotected sexual intercourse without the use of birth control.
About 8 – 12% of couples worldwide experience fertility problems. 45 – 50% infertility cases in couples are said to stem from factors that affect the man and treatment is often available.
Causes Of Infertility In Men
The causes of infertility in men which are common include:
Semen and Sperm Issues
Semen is the milky fluid that is released from a man’s penis during an orgasm. Semen consists of fluid and sperm. The fluid is released from the prostate gland, the seminal vesicle, and other sex glands while the sperm is produced in the testicles.
During an orgasm, when a man releases semen through the penis, the semen which contains the sperm is transported towards the egg to enable fertilization. If the sperm is unable to reach the egg, fertilization will not happen, and there will be no pregnancy.
The following are possible problems that could make the sperm not to get to the egg for fertilization
Low sperm count
This is when the man ejaculates a small amount of sperm. A sperm count of below 15 million is low. About 3 in every 10 couples have difficulty in conceiving because of a low sperm count.
Low sperm motility or mobility
This is when the sperm cannot move or swim as well as they should to be able to reach the egg.
Abnormal sperm
Abnormal sperm has an unusual shape making it difficult for it to get to the egg and fertilize it.
If the sperm lacks the right shape and cannot travel accurately and quickly towards the egg, conception may not occur. About 2% of men are said to have suboptimal sperm.
Another cause of infertility in men is when the semen is unable to transport the sperm effectively, and this could result from the following:
A medical condition
Medical conditions that affect the semen include cancer, testicular infection or post-surgery.
Over-heated testicles
This could be caused by undescended testicles, a varicocele or varicose vein in the scrotum. Wearing tight clothes, working in hot environments, and the use of saunas or hot tubs could also cause the testicles to be over-heated.
Ejaculation disorders
A blocked ejaculatory duct can cause the semen to be ejaculated into the bladder.
Hormonal imbalance
Imbalance in the hormonal level can affect the semen; for example; hypogonadism can lead to a deficiency in testosterone.
Other Causes of Infertility in Men
Genetic factors
In Klinefelter’s syndrome, a man has 2 X chromosomes and a Y chromosome instead of an X and Y chromosome. The testicles develop abnormally leading to low testosterone level, low sperm count or no sperm.
Mumps
If mumps develops after puberty, it leads to the inflammation of the testicles that affects the production of sperm.
Hypospadias
In hypospadias, the opening of the penis is under instead of its tip. This makes it difficult for the sperm to get into the cervix of the woman. It can be corrected surgically in infancy.
Cystic fibrosis
It is a chronic disease that leads to the production of a sticky mucous. The mucous affects the lungs, but in men, it also blocks the vas deferens. It is the vas deference that transports sperm from the epididymis to the ejaculatory duct and urethra.
Radiation therapy
Radiation therapy can affect the production of sperm. The severity of the effect of radiation therapy depends on how close the testicles is to the area of the body the therapy is aimed at.
Some diseases
Diseases like anemia, diabetes, and thyroid gland disorder in men can sometimes affect fertility in men.
Medications That Increase The Risk Of Infertility In Men
Medications, conditions, and therapies that increase the risk of men having fertility problems include
- Chemotherapy
- Sulfasalazine
- Age
- Exposure to chemicals
- Anabolic steroids
- Overweight or obesity
- Mental stress
- Illegal drugs
- Excess alcohol consumption
- Different Walk-in clinics in London have indicated that the long-term intake of acetaminophen during pregnancy could affect the fertility of men by lowering their testosterone production, so women are advised not to take acetaminophen more than once in a day.
Causes Of Infertility In Women
Infertility in women is caused by several factors. The risk factors for infertility in women are listed below.
Risk Factors for Infertility in Women
- Age
- Alcohol consumption
- Smoking
- Overweight or obesity
- Eating disorders
- Unbalanced diet
- Exercise
- Sexually transmitted infections (STIs)
- Mental stress
- Exposure to some chemicals
Medical Conditions That Affect Fertility In Women
The medical conditions that affect fertility in women include
Ovulation Disorders
This is the most common cause of infertility in women. Ovulation is the release of an egg in a woman’s monthly cycle. In some cases, an egg is never released while in some others the egg is not released in all cycles.
Ovulation disorders causes
- Premature ovarian failure
- Polycystic ovary syndrome (PCOS)
- Poor egg quality
- Thyroid gland disorders
- Hyperprolactinemia
- Chronic conditions like AIDS or cancer
Problems in the Uterus or Fallopian Tubes
Certain problems could happen in the uterus that prevents the egg from traveling from the ovaries to the uterus. If the egg doesn’t travel to the uterus, it could make conception more difficult.
These problems could be caused by any of the following:
- Surgery
- Submucosal fibroids
- Previous sterilization
- Endometriosis
Medications, Treatments, and Drugs that Affect Fertility in Women
The following drugs, medications, and treatment affects fertility in women
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Chemotherapy
- Radiation therapy
- Illegal drugs
Cholesterol
A recent study has shown that high cholesterol levels in the blood can adversely affect fertility in women.
Treatment
The treatment of infertility depends on several factors which include age, duration of infertility, personal preference, and the general state of health of the person seeking treatment.
Generally, the possible treatment includes:
Frequency of Intercourse
The doctor at a walk-in clinic will advise the couple to increase the frequency of sexual intercourse around the time of ovulation. The sperm can survive in a woman’s body for up to 5 days while the egg can be fertilized 24 hours after ovulation. Conception on any of the six days before and during ovulation is possible.
However, conception will most likely occur two days before ovulation and on the day of ovulation. Some people suggest that the frequency of sexual intercourse should be reduced to increase the supply of sperm, but this does not make any difference.
Fertility Treatment in Men
The treatment for fertility in men depends on the underlying cause of infertility. Treatments include:
- Medication, behavioral approach or both for erectile dysfunction
- Surgical removal of the varicose vein in the scrotum in varicocele
- Invitro collection of sperm from the bladder and injection into the egg in retrograde ejaculation and blockage of ejaculatory duct
- Surgical correction of blockage of the epididymis
Fertility Treatment for Women
Several options are available for the treatment of infertility in women. They include
Medications for ovulation
The following medications can be used to either induce or regulate ovulation
- Clomifene (Clomid, Serophene)
- Human menopausal gonadotropin (hMG) or Repronex
- Human chronic gonadotropin (Ovidrel, Pregnyl)
- Follicle-stimulating hormone (Gonal- F, Bravelle)
- Bromocriptine (Parlodel)
- Gonadotropin-releasing hormone (Gn-RH) analogs
Other available fertility treatments in women include reducing the risk of multiple pregnancy and surgical procedures.
Assisted Conception Methods
The following methods are available to assist conception
- Intrauterine insemination (IUI)
- In-vitro fertilization
- Assisted hatching
- Surgical sperm aspiration
- Electric or vibratory stimulation to achieve ejaculation
- Intracytoplasmic sperm injection (ICSI)
Diagnosis
It’s usually better for a couple to see the doctor together to find out the cause of their infertility. If the woman is above 35 years, the couple should try to see the doctor early because female fertility starts to decrease when a woman is in her 30s. To diagnose the cause of infertility, the doctor will require several assessments because most of them do not reveal a specific cause.
Infertility Test in Men
The doctor may ask the man to perform the following investigations
- Blood tests
- Semen analysis
- Ultrasound
- STI screening
Infertility Tests in Women
A physical exam will be carried out by the doctor on the woman and recommend the following investigations
- Laparoscopy
- Blood test
- Hysterosalpingography
- Thyroid function test
- Pelvic ultrasound
- Genetic testing
- Ovarian reserve testing
- STI screening
Types Of Infertility
Infertility can be secondary or primary.
In primary infertility, a couple has not conceived after at least 12 months of unprotected and regular sexual intercourse without using birth control while in secondary infertility, the couple has conceived previously but are no longer able to conceive.
Complications
Some complications can result from the treatment of infertility, the most common complications include
Ovarian Hyperstimulation Syndrome
In this condition, the ovaries may swell and leak excess fluid into the body or produce too many follicles. It usually results from taking medications that stimulate the ovaries like clomifene and gonadotropins. Symptoms include:
- Bloating
- Constipation
- Dark urine
- Diarrhea
- Vomiting
- Abdominal pain
- Nausea
In rare cases, blood clotting in the veins, arteries, liber or kidneys may occur, and respiratory distress may develop.
Ectopic Pregnancy
In an ectopic pregnancy, the fertilized eggs get implanted and develop outside the womb in the fallopian tube. This requires immediate surgery to remove it because it can lead to the loss of the fallopian tube.
You can get treatment for infertility in both men and women at our Walk in Clinic in Harley Street, London. Call us today on 02070968853 or email us at info@walkinclinic.london.