Fertility problems, also known as infertility, refer to the inability to conceive or carry a pregnancy to full term after one year of regular, unprotected sexual intercourse. Infertility affects approximately 10-15% of couples globally. 

There are many potential causes of infertility in both men and women. This article will provide an in-depth overview of fertility problems, including the causes, risk factors, symptoms, diagnosis, and treatment provided by kapeefit Online Ayurvedic Consultation .

Causes of fertility problems

There are a variety of causes of infertility in both men and women. Here are some of the most common:

Ovulation disorders

Ovulation disorders account for infertility in approximately 25% of infertile couples. Some ovulation disorders include:

• Oligoovulation: Irregular or infrequent ovulation. This often manifests as irregular menstrual cycles.
• Anovulation: Lack of ovulation. No egg is released.
• Polycystic ovary syndrome (PCOS): A hormonal disorder characterized by irregular menstrual cycles, excess androgen levels, and ovarian cysts. This leads to irregular or lack of ovulation.
• Premature ovarian insufficiency: Diminished ovarian reserve and function before the age of 40.
• Ovulation factors: Problems with the release of the egg from the ovary or the pick-up of the egg by the fallopian tube.

Uterine or cervical causes

Problems with the uterus or cervix account for infertility in approximately 15% of infertile couples. Some uterine or cervical issues include:

• Uterine fibroids: Noncancerous growths in or on the uterine wall. It can interfere with implantation.
• Polyps in the uterus or cervix: Can block the fallopian tubes.
• Scarring in the uterus: From prior surgery, infection, or injury. It can prevent implantation.
• Congenital uterine abnormalities: Malformed or abnormal uterus present from birth.
• Cervical stenosis: Narrowing of the cervical opening.

Endometriosis

Endometriosis occurs when tissue similar to the uterine lining grows outside of the uterus, often on the ovaries, fallopian tubes, or pelvic surfaces. This can cause inflammation, scar tissue formation, and disruption of reproductive organ function. Endometriosis is responsible for infertility in up to 30-50% of women with infertility.

Tubal factor infertility

Blocked or damaged fallopian tubes account for approximately 25% of infertility cases. Some tubal causes include:

• Pelvic inflammatory disease (PID): Infection and inflammation of the reproductive organs, often due to a sexually transmitted infection like chlamydia or gonorrhea. This can cause scarring and blockage of the tubes.
• Previous sterilization procedures: Tubal ligation or clips can sometimes fail or recoalesce over time.
• Scar tissue or adhesions: From injury, infection or endometriosis.

Male factor infertility

Male factor issues cause infertility in approximately 30% of infertile couples. Some male fertility problems include:

• Varicocele: Dilated veins in the scrotum that can overheat the testicles and reduce sperm count and quality.
• Sperm abnormalities: Low sperm count, poor sperm motility, or abnormally shaped sperm.
• Chromosomal or genetic issues: Klinefelter syndrome, XX male syndrome, or other genetic issues.
• Undescended testes: Failure of the testes to descend into the scrotum at birth.
• Infections: Such as epididymitis or orchitis.
• Ejaculatory issues: Inability to ejaculate or problems with ejaculation.
• Immune or autoimmune issues: Antisperm antibodies or other issues.
• Testosterone deficiency: Low testosterone levels can impair sperm production.
• Environmental toxins: Pesticides, heavy metals, chemicals, radiation or medications.
• Varicocele: Abnormal enlargement of the veins in the scrotum.

Unexplained infertility

In approximately 15% of cases, no cause is found even after extensive testing. This is termed unexplained infertility. There may be subtle or undiscovered factors at play that cannot be identified.

Risk factors for infertility

Certain risk factors can increase the chances of infertility for both men and women. These include:

• Advanced age: Fertility starts to decline for women after age 35 and for men after age 40.
• Smoking: Smoking can harm sperm and egg quality. Exposure to secondhand smoke may also be a risk factor.
• Alcohol use: Heavy alcohol use may disrupt ovulation and sperm production and quality.
• Being overweight or underweight: Both increase risks for ovulation problems.
• Certain chronic illnesses: Poorly controlled diabetes, thyroid disease, Cushing’s syndrome, and autoimmune disorders can increase infertility risks.
• STIs: Chlamydia and gonorrhea can cause pelvic infections and damage reproductive organs.
• Past use of birth control pills: This may temporarily affect ovulation after stopping the pill.
• Strenuous athletic training: Excessively intense workouts and low body fat may disrupt ovulation.
• Environmental toxins: Pesticides, lead, chemicals, radiation, and medications may impact fertility.
• DES exposure: Women whose mothers took the drug DES may have uterine abnormalities.

Signs and symptoms of fertility problems

• Irregular, absent, or abnormal periods: This signals ovulation problems.
• Difficulty getting pregnant: After one year of regular, unprotected intercourse. Six months if the woman is over 35.
• Repeated miscarriages: Having two or more consecutive miscarriages may indicate underlying problems.
• Genetic issues or congenital disabilities in past pregnancies.
• Pain during sexual intercourse: Potential sign of endometriosis or pelvic infection.
• Erectile dysfunction or ejaculation issues in men.
• Known risk factors: STIs, chronic illnesses, hormone disorders, etc.
• Family history of fertility issues.

In some cases, there may be no obvious symptoms of infertility until difficulty getting pregnant occurs. Consulting a doctor after 6 months to 1 year of trying or earlier if risk factors are present is recommended.

Diagnosis of fertility problems

If fertility problems are suspected, both partners will undergo an evaluation. Diagnostic testing may include:

For women:

• Medical and gynecological history
• Physical exam
• Ovulation testing: Using ovulation predictor kits, blood tests, or ultrasound
• Ovarian reserve testing: To assess the number and quality of remaining eggs. Blood tests check FSH, estradiol and AMH levels.
• HSG: Hysterosalpingogram examines the uterus and fallopian tubes. Dye is injected, and an X-ray is taken.
• Laparoscopy: A camera is inserted through a small incision to examine the pelvic organs.
• Imaging tests: Pelvic ultrasound, MRI, or CT scan of the pelvis.
• Genetic testing: Karyotype test or genetic disorder screening.
• Thyroid testing: Overactive or underactive thyroid can cause ovulation problems.

For men:

• Medical and reproductive history
• Physical exam and genital exam
• Semen analysis: Examines sperm count, concentration, motility and morphology.
• Blood tests: To assess hormones like testosterone, LH and FSH. Genetic testing may also be done.
• Imaging: Scrotal ultrasound may be done to look for varicoceles or other issues.

Depending on test results, further evaluation may be needed to pinpoint the specific cause of infertility. In 15% of cases, all tests are normal, and unexplained infertility is diagnosed.

Treatments for fertility problems

Kapeefit Online Ayurvedic Consultation for fertility problems will depend on the underlying cause of infertility. Some options include:

Ovulation induction medications

Medications like clomiphene and gonadotropins can stimulate ovulation in women who are not ovulating regularly on their own. This may be used along with intrauterine insemination (IUI).

Surgery

Surgery may be done to repair uterine abnormalities, remove fibroids or polyps, open blocked fallopian tubes, or treat endometriosis. Varicocele repair can help male factor infertility.

Intrauterine insemination (IUI)

Sperm is directly inserted into the uterus around the time of ovulation. This brings a higher concentration of motile sperm closer to the fallopian tubes.

Assisted reproductive technology (ART)

ART includes procedures like in vitro fertilization (IVF), where eggs are retrieved and fertilized with sperm outside the body, then transferred into the uterus. Gamete intrafallopian transfer (GIFT) and zygote intrafallopian transfer (ZIFT) are similar procedures.

Donor eggs or sperm

Donor eggs or sperm may be used if there are issues with the quality or number of eggs or sperm. The partner’s or a donor’s eggs or sperm are fertilized and transferred.

Surrogacy

If the uterus is unable to carry a pregnancy, a gestational carrier may be used to carry the pregnancy. The eggs and sperm can be from the couple or donors.

Adoption

If treatments are unsuccessful or not an option, adoption may be considered for building a family.

Natural methods

Some couples use natural methods like lifestyle changes, supplements, acupuncture or herbs to try to improve fertility before doing medical treatments. Discuss these with your doctor.

Acceptance

If treatments fail or are not possible, counseling and support groups can help with the grief and transition to accepting infertility.

The chances of success depend on the cause and severity of infertility and the treatment used. Infertility treatments like IVF have about a 10-15% chance of leading to a live birth per cycle. After 3-4 cycles, most couples will conceive or explore other options.

Coping with fertility problems

Dealing with fertility struggles can be extremely difficult emotionally. Seeking support is important, as well as practicing self-care:

• Seek counseling or join infertility support groups.
• Confide in trusted loved ones for support.
• Practice relaxation techniques like meditation, yoga and deep breathing.
• Maintain healthy habits like regular exercise, proper sleep and nutrition.
• Make time for enjoyable hobbies and activities unrelated to fertility.
• Seek understanding from your faith or community.
• Stay optimistic but set realistic expectations. Success is not guaranteed.
• Be kind and patient with yourself and your partner. This is no one’s fault.
• Avoid unnecessary stressors and excessive exposure to pregnancy news if this is painful.
• Consider taking time off from fertility treatments if needed.

The infertility journey is filled with grief, hope, resilience and strength. Seeking support and allowing yourself grace on this rollercoaster is so important. With various medical options and alternative paths to parenthood, most couples will eventually find the right solution for building their family.