Infertility

The World Health Organisation defines infertility as the failure to achieve a pregnancy after 12 months or more of regular unprotected sexual intercourse. Infertility can result from either female or male factors or both female and male factors. There is also unexplained infertility. 

Infertility is a global health issue affecting millions of people around the world. According to available data  one in six people experience infertility in their lifetime. 

Infertility can be primary and/or secondary.  

  • Primary infertility refers to couples or individuals who have never been able to conceive a pregnancy after a minimum of 1 year of trying through unprotected intercourse. 
  • Secondary infertility refers to couples or individuals who have had 1 or more pregnancies in the past, but are having difficulty conceiving again. 

 

Causes of female infertility

There are a number of factors that can cause infertility in females. Some of these common are: 

  • Endometriosis.
  • Polycystic ovary syndrome (PCOS).
  • Low ovarian reserve or poor egg quality.
  • Uterine fibroids or polyps.
  • Genetic or chromosomal disorders.
  • Sexual dysfunction.
  • Abnormalities of vagina, uterus or fallopian tubes.

Causes of male infertility

Same as female infertility, male infertility is caused by various factors. Some of these factors are:

  • problems with the sperm such as azoospermia – inability to produce sperm cells or oligospermia – production of low or poor quality sperm.
  • genetic diseases
  • malformed sperm
  • some medical conditions
  • varicoceles

Endometriosis infertility

Studies show that about 25 to 50% of infertile women have endometriosis, and 30 to 50% of women with endometriosis are infertile. The connection between endometriosis and infertility has been studied for some time, however no agreement has been reached about the exact mechanisms. 

Some ways in which endometriosis causes infertility include distorted pelvic anatomy, endocrine and ovulatory abnormalities, altered peritoneal function, and altered hormonal and cell-mediated functions in the endometrium.

The rate of fecundity in a normal couple is around 0.15 to 0.20 per month, while in women with endometriosis the monthly fecundity is about 0.02–0.1 per month. Moreover, endometriosis is associated with a lower live birth rate.