Infertility:
It is the inability to conceive after a year or more of marriage, and because it is known that fertility among women decreases with age, doctors evaluate and treat women aged 35 years and over after 6 months of marriage.
Impairment of fertility:
It is related to infertility, which is the inability of a woman to conceive or complete a pregnancy to term.
Pregnancy occurs as a result of several steps:
- One of the ovaries in a woman's body must release a single ovum, ready for fertilization.
- The fusion of the man's sperm with the ovum, for fertilization to occur.
- The fertilized ovum passes through the fallopian tube to reach the uterus.
- Germination of the ovule inside the lining of the uterus.
Infertility occurs as a result of a problem with one of these steps
Causes of infertility in women:
- Occurrence of a defect in ovulation (production of ova): A woman’s menstrual cycle occurs on average every 28 days, and the cycle is regular if it occurs between 24 to 32 days. If the menstrual cycle is irregular, ovulation often does not occur. Ovulation can be confirmed by examining blood by measuring the progesterone level on the 21st day of her menstrual cycle and measuring the ovulation-stimulating hormone on the 3rd to 5th day of the menstrual cycle, and also using a transvaginal ultrasound.
- Ovarian cysts: It is a condition that causes ovulation to not occur or to occur irregularly. Some women with ovarian cysts have an increase in testosterone, which causes acne and excessive hair growth. Ovarian cysts are the most common cause.
- Functional amenorrhea: It occurs due to the practice of violent sports, excessive stress, and severe tension, and is sometimes associated with eating disorders (e.g.: anorexia).
- Imbalance in the function of the pituitary gland: The pituitary gland produces hormones to maintain regular ovulation, and when a defect occurs, ovulation is interrupted (e.g.: increased prolactin).
- Fallopian tube obstruction: Risk factors for fallopian tube obstruction include previous pelvic infection, previous infection with gonorrhea and chlamydia, or any abdominal surgery.
- Abnormal uterine circumference: It is diagnosed by transvaginal ultrasound (sonar) to detect the presence of fibroids inside the uterus or any defects in the uterus.
Risk factors for female infertility:
- Advance age reduces a woman's chances of having children due to the decrease in the number of ovules with age and the lack of efficiency of the ovule for fertilization, and with age, women are more susceptible to problems of infertility and miscarriage.
- Excessive weight gain or extreme weight loss.
- Smoking and drinking alcohol.
- Physical and mental stress and severe stress that causes menopause.
Causes of male infertility:
- Male infertility can be caused by various factors and is usually evaluated by a semen analysis, a semen analysis in which sperm count, motility and shape are evaluated by a specialist.
- Varicose veins: a condition in which the veins on a man's testicles are large and cause a rise in temperature, and the temperature may affect the number or shape of sperm.
- Unhealthy habits: e.g. drinking alcohol, smoking, anabolic steroid use and drug use.
- Cancer treatment: This includes the use of certain types of chemotherapy, radiation, or surgery to remove one or both testicles.
- Medical conditions: For example, diabetes, cystic fibrosis, certain types of autoimmune disorders, and certain infections may cause testicular failure.
- Hormonal imbalance: An imbalance occurs in the pituitary gland, which produces hormones that maintain the normal function of the testicles.
- Genetic disorders: For example, Klinefelter syndrome and other genetic disorders that may cause no sperm production, or a small number of them.
Risk factors for male infertility:
- Age: Although age plays an important role in the occurrence of infertility in women, men after the age of forty are more susceptible to infertility problems.
- Overweight and obesity
- Smoking and drinking alcohol
- Marijuana use
- Exposure to testosterone. This may occur when a doctor prescribes testosterone injections or topical gels for low testosterone, or when a man illegally takes testosterone or similar drugs in order to increase his muscle mass.
- Exposure to radiation
- Frequent exposure of the testicles to high temperatures (such as: what may happen to men in a wheelchair, or through frequent use of a sauna or hot tub).
- Exposure to environmental toxins, including exposure to pesticides, lead, cadmium, or mercury.
How long should couples try to conceive before seeing a doctor:
At least one year for women under the age of 35, and for women who are 35 years of age or older, couples should visit a doctor after 6 months of unsuccessfully trying, as a woman’s chances of having a child decrease every year after the age of thirty.
Some health problems also increase the risk of infertility, so couples who suffer from the following signs and symptoms should not delay in seeing a doctor when trying to conceive:
- No or irregular menstruation.
- Severe pain during menstruation.
- Occurrence of endometriosis.
- Previous pelvic infection.
- Multiple abortions.
- When there is suspicion that there is a reason for infertility in the husband (e.g.: previous trauma to the testicles or previous hernia surgery).
Treatment:
Infertility is treated based on its cause either through medication, surgery, intrauterine insemination or assisted reproductive technology and is done by a doctor.