Infertility

Infertility is defined as trying to get pregnant (with frequent intercourse) for at least a year with no success. Infertility results from female factors about one third of the time and male factors about one-third of the time. The cause is either unknown or a combination of male and female factors in the remaining cases.

The courses of infertility in women:

  1. You need to ovulate
  2. You need to have regular intercourse
  3. You need to have open fallopian tubes and a normal uterus

Ovulation disorders:

Problems with the regulation of reproductive hormones by the hypothalamus or the pituitary gland, or problems in the ovary, can cause ovulation disorders.

The most frequent disorders are:

  • Polycystic ovary syndrome (PCOS). PCOS causes a hormone imbalance, which affects ovulation. PCOS is associated with insulin resistance and obesity, abnormal hair growth on the face or body, and acne. It's the most common cause of female infertility.
  • Hypothalamic dysfunction. Two hormones produced by the pituitary gland are responsible for stimulating ovulation each month — (FSH) and luteinizing hormone (LH). Excess physical or emotional stress, a very high or very low body weight, or a recent substantial weight gain or loss can disrupt production of these hormones and affect ovulation. Irregular or absent periods are the most common signs.
  • Premature ovarian failure. Also called primary ovarian insufficiency, this disorder is usually caused by an autoimmune response or by premature loss of eggs from your ovary (possibly from genetics or chemotherapy). The ovary no longer produces eggs, and it lowers estrogen production in women under the age of 40.
  • Excess production of prolactin. The pituitary gland may cause excess production of prolactin (hyperprolactinemia), which reduces estrogen production and may cause infertility. Usually related to a pituitary gland problem, this can also be caused by medications you're taking for another disease.
  • Factors from environment and life still :
    • Industrial chemicals (extended exposure to benzenes, toluene, xylene, pesticides, herbicides, organic solvents, painting materials and lead) may contribute to low sperm counts
    • Heavy metal exposure
    • Radiation or X-rays
    • Alcohol use
    • Tobacco smoking
    • Emotional stress
    • Weight ( obesity can impair fertility in several ways, including directly impacting sperm themselves as well as by causing hormone changes that reduce male fertility).

Male infertility

Signs and symptoms:

  1. Problems with sexual function — for example, difficulty with ejaculation or small volumes of fluid ejaculated, reduced sexual desire or difficulty maintaining an erection (erectile dysfunction)
  2. Pain, swelling or a lump in the testicle area
  3. Recurrent respiratory infections
  4. Inability to smell
  5. Abnormal breast growth (gynecomastia)
  6. Decreased facial or body hair or other signs of a chromosomal or hormonal abnormality
  7. Having a lower than normal sperm count (fewer than 15 million sperm per milliliter of semen or a total sperm count of less than 39 million per ejaculate)

Medical causes :

  • Varicocele. A varicocele is a swelling of the veins that drain the testicle. It's the most common reversible cause of male infertility. Varicoceles result in reduced quality of the sperm
  • Infection. Some infections can interfere with sperm production or sperm health or can cause scarring that blocks the passage of sperm. These include inflammation of the epididymis (epididymitis) or testicles (orchitis) and some sexually transmitted infections, including gonorrhea or HIV. Although some infections can result in permanent testicular damage, most often sperm can still be retrieved
  • Ejaculation issues
  • Antibodies that attack sperm
  • Tumors
  • Undescended testicles
  • Hormone imbalances. Infertility can result from disorders of the testicles themselves or an abnormality affecting other hormonal systems including the hypothalamus, pituitary, thyroid and adrenal glands. Low testosterone (male hypogonadism) and other hormonal problems have a number of possible underlying causes
  • Defects of tubules that transport sperm
  • Chromosome defects. Inherited disorders such as Klinefelter's syndrome — in which a male is born with two X chromosomes and one Y chromosome (instead of one X and one Y) — cause abnormal development of the male reproductive organs. Other genetic syndromes associated with infertility include cystic fibrosis, Kallmann's syndrome and Kartagener's syndrome
  • Problems with sexual intercourse. These can include trouble keeping or maintaining an erection sufficient for sex (erectile dysfunction), premature ejaculation, painful intercourse, anatomical abnormalities such as having a urethral opening beneath the penis (hypospadias), or psychological or relationship problems that interfere with sex
  • Certain medications. Testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), certain antifungal medications, some ulcer drugs and certain other medications can impair sperm production and decrease male fertility