Dr Richa Sharma & Dr Amit Basnotra
Infertility- Is inability to conceive due to either explained or unexplained reasons-which we can know only after in depth evaluation
The main symptom of infertility is not getting pregnant. There may be no other obvious symptoms. Sometimes, an infertile woman may have irregular or absent menstrual periods. Rarely, an infertile man may have some signs of hormonal problems, such as changes in hair growth or sexual function.
All of the steps during ovulation and fertilization need to happen correctly in order to get pregnant. Sometimes the issues that cause infertility in couples are present at birth, and sometimes they develop later in life.
Infertility causes can affect one or both partners. In general:
* In about one-third of cases, there is an issue with the male.
* In about one-third of cases, there is an issue with the female.
* In the remaining cases, there are issues with both the male and female, or no cause can be identified.
Predisposing Factors-(Red Alert !!)
Various factors can increase risk of infertility issues like-
* Advancing age-especially of female but male age also can have impact somehow as per latest studies
* Lifestyle Modifications- Changing lifestyle adding to greed and ambition adds to stress ,Smoking and alcohol intake which can affect the health of not only individual but of the prospective baby also
* Obesity Epidemic- As we see with new high tech modalities we are getting high tech problems also which are mostly self and man made- obesity and overweight are one but there can be extreme end of underweight also esp in figure conscious generation.Definitely its not something which we recommend while planning a baby.
Causes of female infertility
Causes of female infertility may include:
* Ovulation disorders, which affect the release of eggs from the ovaries. These include hormonal disorders such as polycystic ovary syndrome.
* Uterine factor-including fibroids, polyps in the uterus or the shape of the uterus. More often, fibroids interfere with implantation of the fertilized egg.
* Fallopian tube damage(Tubal factor)
* Endometriosis, which occurs when endometrial tissue grows outside of the uterus, may affect the function of the ovaries, uterus and fallopian tubes.
* Primary ovarian insufficiency (early menopause)- certain factors are associated with early menopause, including immune system diseases, certain genetic conditions such as Turner syndrome or carriers of Fragile X syndrome, radiation or chemotherapy treatment, and smoking.
* Pelvic adhesions, bands of scar tissue that bind organs after pelvic infection, appendicitis, or abdominal or pelvic surgery.
Causes of male infertility
These may include:
* Abnormal sperm production or function due to undescended testicles, genetic defects, health problems such as diabetes or infections such as chlamydia, gonorrhea, mumps or HIV. Enlarged veins in the testes (varicocele) can also affect the quality of sperm.
* Problems with the delivery of sperm due to sexual problems, such as premature ejaculation; certain genetic diseases, such as cystic fibrosis; structural problems, such as a blockage in the testicle; or damage or injury to the reproductive organs.
* Overexposure to certain environmental factors, such as pesticides and other chemicals, and radiation. Cigarette smoking, alcohol, marijuana or taking certain medications, such as select antibiotics, antihypertensives, anabolic steroids or others, can also affect fertility. Frequent exposure to heat, such as in saunas or hot tubs, can raise the core body temperature and may affect sperm production.
* Damage related to cancer and its treatment, including radiation or chemotherapy. Treatment for cancer can impair sperm production, sometimes severely.
(The authors are Senior IVF Consultant Delhi, and Senior Gastroentrologist Delhi)
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