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  Infertility - Why does it happen? Her problem? Or His problem? Download

INFERTILITY-Why does it happen? Her problem? Or His problem? It should be remembered that not only the wife is responsible for infertility, but also the husband. In most cases, however, it is necessary to include the wife in the course of treatment, even when the husband is the affected party. What could be her problem? Disturbance in ovulation (1 in 5 infertile couples) She may have problem in producing normal and mature egg. This can be caused by hormonal imbalance due to stress, excessive overweight, excessive weight loss, extreme physical exertion, or some types of endocrine disorders. Tubal damage (1 in 5 infertile couples) Fallopian tube is the organ where the sperm meets the egg, and a new life starts. The tube can be damaged due to infection, endometriosis, previous ectopic pregnancy or previous pelvic operation. Sometimes pelvis infection is silent and she may not be aware of its existence at all until investigation is performed. Endometriosis (1 in 5-15 infertile couples) This means growth of endometrial tissue beyond its normal boundary. It may cause adhesions between pelvic organs. She may feel pain during menstruation or sexual intercourse, or she may feel nothing abnormal. Mucus defects (1 in 25 infertile couples) Around the time of ovulation, her cervix will produce thin mucus in abundant amount. However, if her cervical mucus contains antibodies against his sperms, the sperms will be difficult to enter the womb. Malformation of female genital tract (1 in 100 infertile couples) Embryo implantation may be affected if she is born with a malformation of her womb. Externally, she looks normal. The abnormality can only be identified by pelvic examination and investigations.
What could be his problem? Sperm defects / dysfunction (1 in 4 infertile couples) Even if he is fertile, most of his sperms are imperfect and many cannot swim properly, but at least one-third of the sperms should be normally formed and half of the sperms are freely mobile. The most frequent problem resulting in male fertility is insufficient production of normal and freely mobile sperms. Sometimes, the motile sperm is functionally abnormal in such a way that while it can swim towards the egg, it cannot penetrate the egg and therefore fails to start a new life. Why can't he produce sufficient number of healthy sperms? Mumps infection in childhood, varicose vein in his testicles, undescended testes, hormonal disturbances, stress, smoking, environmental factors, or hereditary factors may lead to poor sperm quality. Disturbances of sperm transport (1 in 25 infertile couples) Sperm is produced in the testes and transported to the penis via the vas deferens. If his vas deferens is blocked due to previous sterilization, infection, or underdevelopment, no sperm can be found in his ejaculate.
Other factors Coital failure (1 in 15 infertile couples) During sexual intercourse, he may have erection or ejaculation failure and she may have spasm of vagina. Most of the cases are due to psychological problem. Unexplained (1 in 4 infertile couples) If a detailed history and examination followed by complete investigation still fail to give a clear-cut explanation, this is called 'unexplained infertility'. "If a cause for infertility cannot be found, does it mean that they have no chance to get pregnant?" In unexplained infertility, two main factors determining the chance of pregnancy are the duration of infertility and the women's age. In young women with unexplained infertility, it is observed that 6 out of 10 may spontaneously conceive in 3 years. Thereafter, the chance of pregnancy drops significantly to less than 10% per year. The prognosis is getting worse in older women.
 
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Last revision date: 01 September 2006