Causes of male and female infertility
Infertility is defined as the inability of a couple to get pregnant
after trying to do so for at least one year. About 20 percent
of the couples in the United States have to deal with the problem
of infertility. About 40 percent of infertility cases are due
to a problem with the sperm of the male. About another 40 percent
of the causes of infertility are due to a problem with the female.
These causes include ovulation problems, tubal problems, endometriosis,
and cervical factors. About 20 percent of the infertility cases
are due to problems in both the male and female or of unknown
The infertility problems in men can be caused by problems in
their sperm. Some men have a low sperm count. The normal sperm
count in one milliliter of semen is over 20 million. A man with
a sperm count of 5 to 20 million is considered subfertile. A man
with a sperm count of less than 5 million is considered infertile.
Sperm that do not swim well (sperm motility) and do not have normal
structures may also cause problems. Some sperm may be immature
or have abnormalities in their head or tail. A semen sample has
to contain less than 25 percent of these types of sperm to be
considered normal. An abnormal volume of semen can also decrease
the chances of successful fertilization.
There are many conditions that can adversely affect your sperm
such as having only one testicle, testicles that are smaller than
normal, or abnormally large veins (varicocele) in the testicles.
There are things that might affect the formation of sperm (spermatogenesis)
including exposure to various toxins, alcohol abuse, drug use,
anabolic steroid use, diabetes and thyroid or other endocrine
diseases. There are treatments that might help with male infertility.
Your doctor can improve your sperm motility by injecting small
doses of testosterone. You can get rid of varicoceles through
surgery. There is also a procedure called artificial insemination
that might help. Artificial insemination is a mechanical means
of depositing the male's most motile sperm or donor sperm into
the uterus of the female.
Ovulatory problems account for most cases of female infertility.
If there are ovulatory problems, there may be no eggs to be fertilized.
Problems with the thyroid and pituitary glands can be responsible
for ovulatory problems since they release hormones that help regulate
the menstrual cycle. There are medications that can stimulate
fertility such as Clomid and Pergonal. You can check to see that
you do not have an ovulatory problem by making sure that an ovum
is produced each month, your morning body temperature is slightly
higher around the time of ovulation and luteinizing hormones are
released just before ovulation.
Pelvic adhesions are fibrous scars that prevent sperm from reaching
the egg or interfere with fertilization. These scars can be caused
by previous surgeries, abortions,
prior births, or pelvic inflammatory disease. Endometriosis can
lead to pelvic adhesions. Endometriosis is a disorder in which
the uterine tissue is located outside of the uterus. The bleeding
from the uterine tissue during the menstrual period can cause
irritation within the pelvis, which can lead to scarring. Pelvic
adhesions can also block a fallopian tube. This may prevent the
ovum and sperm from meeting in the fallopian tube.
A hysterosalpingogram is an x-ray exam that can show if a fallopian
tube is blocked. This exam checks to see if dye material can travel
through the tube. Some women have become pregnant after this exam
because the dye material has helped removed the obstruction in
the fallopian tube. A doctor can determine if you have scarring
by doing a laparoscopy. This procedure uses a scope that is inserted
into the abdomen through an incision near the naval. During the
laparoscopy, the doctor can treat pelvic adhesions by cutting
them with special instruments. There are also medications that
can treat endometriosis. In addition, surgery may be required
if there is an obstruction caused by pelvic adhesions.
Problems with the cervix can also cause infertility. The cervix
is the opening from the vagina to the uterus. The cervix produces
mucus, which helps transport the sperm into the uterus. Occasionally,
the mucus is too thick and will prevent the sperm from getting
into the uterus. There are some situations where there is a smaller
amount of mucus because of an injury that reduces the number of
glands in the cervix. Also, if surgery or infection caused scarring
of the cervix, the cervical opening may get smaller; this makes
it more difficult for the sperm to get through. If there is an
infection, you can use antibiotics to treat it. If mucus is the
problem, you can use artificial insemination to bypass the mucus.