Infertility is the inability of a couple to achieve a pregnancy after 1 year of regular, unprotected sexual intercourse. It affects about 10 – 15 % of couples. The cause of infertility may lie in the female, her partner or both. It is a cause of significant grief and anxiety in most families. A significant factor in infertility is female age above 35 years.
FEMALE INFERTILITY
Female infertility accounts for about 30 – 40 % of cases of infertility. For a woman to get pregnant she has to release eggs of good quality and quantity regularly and the eggs will travel through the fallopian tube for fertilization by the sperm. Challenges with ovulation, fallopian tube damage, scarring of the endometrium or cervical stenosis could result in female factor infertility.
Causes of female infertility include:
- Damaged Fallopian Tube
Damage to the fallopian tube will prevent the sperm from reaching the eggs for fertilization. It could be caused by Pelvic Inflammatory Disease, Adhesions from previous surgery, Pelvic Tuberculosis or Endometriosis.
- Anovulation [Failure to Ovulate]
Conditions that prevent women from ovulating will result in infertility. They include polycystic ovarian syndrome, obesity, excessive weight loss, hyperprolactinemia, premature ovarian failure and the use of cytotoxic drugs which destroys the ovaries. Surgical removal of the ovaries could lead to failure to ovulate.
- Local Factors
Conditions within the cervix and uterine linings such as adhesion formation, endometrial fibroids, cervical stenosis, and endometrial polyps within the fallopian tube could all increase the chances of infertility.
- Recreational Drugs
Cigarette smoking has been known to damage the ovaries and increases a woman’s chances of early menopause.
MALE INFERTILITY
Male infertility accounts for about 30 – 35 % of cases of infertility. For a man to impregnate a woman he needs to have an erection, penetrate her long enough and ejaculate sperm of good volume and quality. Challenges with erection, poor sperm production, blockage of sperm ducts, use of recreational drugs and chronic medical illnesses could affect the male partner’s chances of impregnating the female.
Causes of male infertility include:
- Erectile Dysfunction
All conditions that make it difficult to initiate and maintain an erection could cause male factor infertility.
- Medical Conditions
Conditions such as:
- Varicocoele could increase the temperature of the testis and impair sperm production
- Undescended testis goes unnoticed causing testicular damage
- Infection with sexually transmitted infection leading to damage of the tubules which transport sperm cells
- Chronic medical diseases such as cancers, diabetes mellitus, hypertension and drugs used for their treatment could lead to erectile dysfunction and low sperm production.
- Recreational Drugs
Recreational drugs such as alcohol consumption, cigarette smoking, and the use of anabolic steroids are all causes of male infertility through damage to sperm production.
- Previous Surgery
Surgery for the repair of inguinal hernias may damage the ducts which carry certain components of semen. Other surgical procedures include prostate surgery, testicular surgeries, and vasectomy.
- Environmental Factors
Men get exposed to a lot of environmental factors at work. Prolonged exposure to some of these agents is responsible for diminished sperm counts.
The use of laptops on the thigh over a long period could increase the testicular temperature and damage sperm production. Long-distance truck drivers who sit on the engines of the vehicles may be prone to overheating the scrotal sac. Exposure to heavy metals and radioactive substances will also lead to a low sperm count.
