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What do you understand by the term ‘Fertility’? Fertility is the ability to conceive and have children. Right? Well yes, but the definition further expands when seen in terms of fertility in men and fertility in women. While for a woman, fertility is the ability to become pregnant using her own eggs, for a man, it is the ability to have a child using his own sperms.
What happens is that in each monthly menstrual cycle (till a woman reaches menopause), an egg is released from the ovaries. Egg or ovum moves down the fallopian tube where the sperm contacts it in the uterine cavity and fertilizes it to form the embryo. Men produce approximately 300 million sperm in one ejaculation. If one sperm mates the egg, you get pregnant with a single child, but when more than one sperm fertilize the egg, you get twins, triplets, etc.
Studies reveal that around 85% of couples get pregnant within the first year of consummation. Half of the remaining couples conceive a baby within two years. And the other half of these remaining couples get pregnant within three years of marriage. Chances of getting pregnant decrease with age in women as they move closer to menopause, and hence, fertility ideally drops at around 35 to 40 years of age in women. However, you should also know that if you try to conceive at too early an age, then chances of miscarriages are higher. In early 20’s, around 13% of pregnancies may end in a miscarriage. Hence, the best bet is to conceive at an age when your body is ready to take the physical demand of a baby developing inside you.
Female Fertility Problems
According to the WHO, female fertility issues have been identified as the cause of one-third of infertility problems in couples. Some of the major issues that give rise to infertility in females are:
Over-age: Women above the age of 35 often face issues in conceiving owing to infertility
Ovulation Problems: At least 25 percent of female infertility issues are due to under-ovulation
Abnormal Hormone Levels: Combination of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH) is the only factor responsible for ovulation. If these hormones aren't at the required level, then ovulation will be irregular. Ageing, stress, sudden weight gain/loss, or health issues like diabetes and hypertension are majorly responsible for hormonal fluctuation, and thus infertility.
Polycystic Ovarian Syndrome: It causes overproduction of androgens, which is a very common cause of infertility in females. However, if attended to in time, Polycystic Ovarian Syndrome is very much curable.
Damaged Fallopian Tubes: The damage to fallopian tubes may happen due to a previous surgery, prior ectopic pregnancy (a pregnancy in which a fertilized egg implants in the fallopian tube), scarring caused by an STI, or any other reasons such as Pelvic Inflammatory Disease (PID), which is a major cause of tubal infertility.
Endometriosis: This is another major cause of infertility in women, which is basically an abnormal growth of the uterine lining that affects conception.
Other Uterine Problems like fibroids, tumors, irregular uterine shape, or even previous dilation and curettage (D&C).
Cervical Problems like cervical stenosis where the uterine opening becomes narrowed or blocked. This can be either genetic or due to any damage to the cervix. It makes it difficult for the sperm to reach the egg, thereby giving rise to infertility issues in women.
Besides, there are certain biological factors (like chromosomal problems) and external factors (like exposure to toxins via chemotherapy or radiation) as well that can hamper fertility in general.
Male Fertility Problems
About two-thirds of the fertility problems in men is mainly owing to the issues with sperms in the testes. The problem arises either because of low production of sperms or due to the inappropriate functioning of the sperms. Besides, it has been also found that about one in every five infertile men, including those who have had a vasectomy but now wish to have more children, suffer from sperm transport problems. At times, the problem also arises because of blockages in male tubes, which causes complete lack of sperms in the ejaculated semen.
The major known factors that have been identified to impact fertility in males are:
Sperm Production Problems that are mainly due to:
Chromosomal or genetic causes
Undescended testis (failure of the testis to descend at birth)
Torsion (twisting of the testis in scrotum)
Varicocele (varicose veins of the testis)
Blockage of sperm transport which is owing to:
Absence of vas deferens
Sexual Problems find their cause as below:
Retrograde and premature ejaculation
Failure of ejaculation
Spinal cord injury
Damage to nerves
Hormonal problems caused by:
Congenital lack of LH/FSH (pituitary problem from birth)
Anabolic (androgenic) steroid abuse
Injury or infection in the epididymis