Infertility

For years, infertility has been considered a woman’s problem but the statistics show that this is not the case. In fact, in 40% of infertility cases, the problem is solely associated with the man with an equal 40% being attributed to the woman. In another 10% of the cases, the problem is mutual and the remaining 10% is due to unknown causes. Overall, 1 out of every 6 Australian couples suffer from infertility.

Infertility is defined as the inability to conceive a child after engaging in 12 consecutive months of unprotected sexual intercourse. This definition has also been expanded to include women who have not been able to carry a pregnancy to full term and to men who are unable to aid in the conception process.

The causes of infertility vary from person to person but many times the cause can be diagnosed and treated. Other times the cause will never be determined. However, prior to figuring out the cause, the type of infertility must be determined. There are two basic types of infertility: structural infertility and functional infertility. Structural infertility is when either a man or woman is infertile as a result of the structural integrity of the reproductive organs. This type of infertility could be a result of congenital (birth) defects, injury, or surgery. Functional infertility, on the other hand, is infertility that results from the improper functioning of the reproductive organs and often occurs later in life as a result of injury, scar tissue, infections, or sexually transmitted diseases. Below is a brief overview of the different types of infertility problems according to gender.

Male Structural Infertility
Obstructive Azoospermia — More simply, this is just a blockage of the male tubes that transport the sperm. If the sperm is blocked from leaving the body, it can’t possibly reach the egg to fertilize it.

CAVD — Short for congenital absence of vas deferens, this is a birth defect in which a man is born without the vas deferens. Despite the normally functioning testicles, the lack of this particular organ means that the sperm cannot join the ejaculate and leave the body.

Undescended Testicles — This is another birth defect in which the testicles do not descend from the abdomen to the scrotum prior to birth.

Hypospadias — Yet another birth defect that results in the opening to the urethra being located somewhere other than the tip of the penis. Approximately 1 in 500 males will suffer from this type of structural infertility.

Male Functional Infertility
Impotence — Also commonly referred to as erectile dysfunction, this is the inability for a man to get or maintain an erection.

Sperm Motility — Sometimes a man’s sperm doesn’t move appropriately or there isn’t enough sperm to reach the egg.

Hormonal Imbalances — The process of sexual appetite and performance requires a delicate balance of hormones and if these hormones are not perfectly balanced, infertility can occur.

Female Structural Infertility
Typically structural infertility in women is diagnosed and categorized based on the reproductive organ affected. The most common include:
Fallopian Tubes — A blockage of these or scar tissue formed on the fallopian tubes can be a major problem.
Ovaries — The most common medical condition associated with the ovaries and infertility are ovarian cysts.
Uterus — Fibroid tumors are extremely common on, in or around the uterus.
Congenital Defects — Just like men, women can also be born with defects of their reproductive organs such as a double uterus or a uterus that has only formed on one side.

Female Functional Infertility
Hormonal Imbalances — Just like men, women need to maintain a delicate balance of hormones to effectively reproduce and if these hormones are not present, infertility is the result.

Irregular Menstrual Cycles — A woman must have regular menstrual cycles in order to ovulate and produce mature eggs, if the cycles are irregular, infertility follows. Many times, irregular menstrual cycles are a result of a bigger problem, even a structural problem.

Although there is a laundry list of problems and conditions that can render a man or woman infertile, the good news is that most of these conditions can be treated, leading to eventual conception. For congenital defects, surgery is usually required. However, for functional problems simple lifestyle changes or medications will often times correct the problem. Of course, there are always exceptions and some conditions cannot be treated. One example of this is men who suffer from CAVD. Luckily, a man with this condition can still aid in the conception process, not just naturally. Laboratory procedures such as IVF can really help in this situation.

If you or your partner fear you may be suffering from infertility, there are a myriad of tests and diagnostic procedures that can be performed to come to a definitive conclusion. Tests for women include urinalysis to determine hormone levels and to see if ovulation is occurring, taking a small tissue sample of the uterus to ensure that the lining has developed properly, an ultrasound to pinpoint any possible blockages or growths, and/or any other tests that your doctor may recommend. Some of the tests performed on men include a semen analysis to determine sperm count, motility, and quality, an ultrasound to determine any blockages or growths, genetic and/or hormone testing, and a biopsy of the testicles. Unfortunately, a couple can endure all of these invasive and sometimes painful tests only to be told that the cause of their infertility is unknown. Almost 10% of couples suffering from infertility receive this diagnosis.

All hope is not lost though. There are many advances in fertility treatments that can help a couple conceive. In fact, there have been almost 5 million technology assisted births as of March 2009. Some of the more common treatments include acupuncture, hormone therapy, assisted reproductive technology (ART), artificial insemination, in vitro fertilization, tubal embryo transfer, fertility drugs, gamete intrafallopian transfer, and even donor sperm or eggs can be utilized when other options fail.