What is Infertility: Causes, Symptoms & Treatment

by | Apr 1, 2022 | Fertility

What is Infertility?

Infertility is a disease in the male or female reproductive system defined as the inability to conceive a child despite having regular, unprotected intercourse for at least one year, infertility may also be defined as the inability to carry a pregnancy to term, resulting in recurrent miscarriages. Infertility affects both men and women and can stem from various factors, including hormonal imbalances, physical abnormalities, and lifestyle choices.

 

How Common is Infertility?

Infertility is a significant concern in India, affecting approximately 10-14% of the population. The prevalence may vary depending on the region, socio-economic status, and cultural factors. With a large population and increasing awareness of infertility issues, there is a growing demand for infertility treatments and assisted reproductive techniques in the country. It is important to note that the actual number of individuals facing infertility may be higher, as many cases remain unreported due to social stigma and lack of access to healthcare services in some areas.

 

Types of Infertility:

There are two main types of infertility: primary and secondary.

Primary Infertility:

Primary infertility refers to the inability of a couple to conceive their first child. This type of infertility can be attributed to various factors, which can be broadly classified into female factors, male factors, and unexplained factors.

Female Infertility Factors:
  1. Ovulation disorders: Conditions such as polycystic ovary syndrome (PCOS), hypothalamic dysfunction, and premature ovarian failure can disrupt the ovulation process, making it difficult to conceive.
  2. Fallopian tube damage: Blockage or damage to the fallopian tubes can prevent sperm from reaching the egg or the fertilised egg from implanting in the uterus.
  3. Endometriosis: The growth of endometrial tissue outside the uterus can lead to scarring and adhesions, which can obstruct the fallopian tubes and interfere with implantation.
  4. Uterine or cervical abnormalities: Abnormalities in the uterus or cervix, such as polyps or fibroids, can hinder sperm from reaching the egg or prevent the embryo from implanting.
Male Infertility Factors:
  1. Sperm production: Low sperm count, poor sperm motility, or abnormal sperm morphology can reduce the chances of fertilisation.
  2. Varicocele: Enlarged veins in the scrotum can impair sperm production and quality.
  3. Ejaculation disorders: Conditions such as retrograde ejaculation or premature ejaculation can hinder the delivery of sperm to the egg.
  4. Immunological factors: The presence of anti-sperm antibodies in the male partner can impair sperm function.

 

Unexplained Infertility Factors:

In some cases, no identifiable cause can be found for a couple’s infertility. This is referred to as unexplained infertility, which may be due to subtle issues not detectable through conventional testing.

 

Secondary Infertility:

Secondary infertility is the inability of a couple to conceive or carry a pregnancy to term after successfully having at least one child. The causes of secondary infertility can be similar to those of primary infertility, including an age-related decline in fertility, lifestyle changes, or the development of new medical conditions.

Infertility is a complex and often an emotionally challenging issue for couples. Understanding the types of infertility and their underlying causes can help guide appropriate treatment options and facilitate the journey towards parenthood. It is crucial for couples experiencing difficulty conceiving to consult a healthcare professional to explore their options and receive appropriate support.

Also Read: Foods to Increase Sperm Count and Increase Male Fertility

Symptoms of Infertility:

Infertility can manifest in different ways for both men and women. In many cases, there are no obvious signs of infertility until a couple tries to conceive. However, some symptoms can signal potential issues with fertility.

 

General Symptoms of Infertility:

  1. Difficulty conceiving: The primary symptom of infertility is the inability to conceive after a year of regular, unprotected intercourse.
  2. Irregular menstrual cycles: In women, irregular or absent menstrual cycles may indicate problems with ovulation or hormone imbalances.
  3. Recurrent miscarriages: Experiencing multiple miscarriages can also be a sign of infertility issues.

 

Symptoms of Male Infertility:

  1. Erectile dysfunction: Difficulty achieving or maintaining an erection can be a sign of male infertility.
  2. Low libido: A decrease in sexual desire might suggest hormonal imbalances that can affect fertility.
  3. Pain or swelling in the testicles: Discomfort or swelling in the testicles may indicate an underlying condition affecting sperm production or function.

 

Symptoms of Female Infertility:

  1. Painful or heavy periods: Endometriosis, a condition affecting female fertility, can cause pain during menstruation.
  2. Pelvic pain: Chronic pelvic pain may signal problems with the reproductive organs, such as fibroids or endometriosis.
  3. Excessive hair growth or acne: These symptoms can be associated with polycystic ovary syndrome (PCOS), a common cause of female infertility.

 

Causes of Infertility:

Infertility can result from a variety of factors, including genetic, hormonal, and environmental causes. Some of the common causes of infertility include:

  1. Age: As individuals age, their fertility naturally declines, with a more significant decrease after the age of 35 for women and 40 for men.
  2. Hormonal imbalances: Conditions such as PCOS, thyroid disorders, and pituitary gland problems can disrupt the hormonal balance needed for fertility.
  3. Lifestyle factors: Poor diet, lack of exercise, smoking, and excessive alcohol consumption can contribute to infertility.
  4. Exposure to toxins: Exposure to environmental toxins, such as pesticides or heavy metals, can negatively impact fertility.
  5. Stress: High-stress levels can affect hormone production, potentially leading to infertility.
Causes of Infertility

Causes of Infertility

Causes of Male Infertility:

Male infertility causes by issues related to sperm production, function, or delivery. Some common causes include:

  1. Varicocele: Enlarged veins in the scrotum can impair sperm production and quality.
  2. Infections: Infections such as epididymitis, orchitis, or sexually transmitted infections can reduce sperm count or cause scarring that blocks the passage of sperm.
  3. Ejaculation issues: Retrograde ejaculation, premature ejaculation, or erectile dysfunction can prevent sperm from reaching the egg.
  4. Immunological factors: Anti-sperm antibodies can impair sperm function and lead to infertility.
  5. Chromosomal abnormalities: Genetic disorders, such as Klinefelter syndrome, can affect sperm production and function.

 

Causes of Female Infertility:

Female infertility can be attributed to problems with ovulation, reproductive organs, or hormonal imbalances. Some common causes include:

  1. Ovulation disorders: PCOS, hypothalamic dysfunction, and premature ovarian failure can interfere with ovulation and make it difficult to conceive.
  2. Blocked Fallopian tube: Damage or blockage of the fallopian tubes can prevent sperm from reaching the egg or the fertilised egg from implanting in the uterus.
  3. Endometriosis: The growth of endometrial tissue outside the uterus can cause scarring and adhesions, which can obstruct the fallopian tubes and interfere with implantation.
  4. Uterine or cervical abnormalities: Abnormalities in the uterus or cervix, such as polyps, fibroids, or an abnormally shaped uterus, can hinder sperm from reaching the egg or prevent the embryo from implanting.
  5. Pelvic inflammatory disease (PID): PID, often resulting from untreated sexually transmitted infections, can cause damage to the fallopian tubes, uterus, and surrounding tissues, leading to infertility.
  6. Early menopause: Some women experience early menopause, also known as premature ovarian failure, which results in the depletion of ovarian follicles and cessation of menstruation before the age of 40. This condition can lead to infertility.
  7. Thyroid problems: Both hyperthyroidism and hypothyroidism can interfere with ovulation and impact fertility.

Infertility is a complex issue with various symptoms and causes. The causes of male and female infertility can be multifactorial and may involve genetic, hormonal, and environmental factors. It is essential for individuals experiencing infertility symptoms or having difficulty conceiving to consult a healthcare professional. Timely intervention and appropriate treatments can improve the chances of conceiving and help couples achieve their dream of parenthood.

 

Prevention of Infertility:

While not all cases of infertility can be prevented, there are steps that individuals and couples can take to reduce the risk of fertility issues and improve their overall reproductive health. Some general prevention strategies apply to both men and women, while others are more gender-specific.

General Prevention Strategies:

  1. Maintain a healthy lifestyle: Eating a balanced diet, exercising regularly, and managing stress can contribute to better reproductive health and hormonal balance.
  2. Avoid smoking and excessive alcohol consumption: Smoking and excessive alcohol intake can negatively impact fertility in both men and women.
  3. Maintain a healthy body weight: Being underweight or overweight can disrupt hormonal balance and affect fertility. Aim for a body mass index (BMI) within the normal body range.
  4. Minimise exposure to environmental toxins: Limit exposure to harmful chemicals, such as pesticides, heavy metals, and industrial pollutants, as they can affect fertility.
  5. Practice safe sex: Engage in safe sex practices to reduce the risk of sexually transmitted infections (STIs), which can cause fertility issues if left untreated.

Prevention of Male Infertility:

In addition to the general prevention strategies, men can take specific steps to protect their fertility:

  1. Keep testicles cool: Prolonged exposure to heat can harm sperm production. Avoid hot tubs, saunas, and tight clothing, and consider using a laptop on a desk instead of on the lap.
  2. Protect against injury: Wear protective gear during sports and other physical activities to prevent injuries to the testicles, which can affect fertility.
  3. Manage stress: Chronic stress can negatively impact sperm production and overall fertility. Find healthy ways to cope with stress, such as exercise, meditation, or counselling.
  4. Limit exposure to radiation: Prolonged or frequent exposure to radiation from sources like X-rays or electronic devices can reduce sperm count and quality.
  5. Review medications: Some medications can affect male fertility. Consult your healthcare professional if you have concerns about the impact of a particular drug on your fertility.

 

Prevention of Female Infertility:

Women can take the following steps to help protect their fertility:

  1. Track menstrual cycles: Keeping track of menstrual cycles can help identify irregularities or potential ovulation issues, allowing for timely intervention if necessary.
  2. Schedule regular check-ups: Regular gynaecological check-ups can help detect and address potential issues that may affect fertility, such as fibroids, endometriosis, or STIs.
  3. Avoid excessive exercise: Over-exercising can disrupt the hormonal balance needed for regular ovulation. Aim for a moderate exercise routine that supports overall health without causing hormonal imbalances.
  4. Limit caffeine intake: High caffeine consumption has been associated with an increased risk of infertility. Limit caffeine intake to no more than 200 mg per day (equivalent to about two cups of coffee).
  5. Consider age-related fertility decline: Women’s fertility naturally declines with age, especially after 35 years. If you are planning to have children, consider this age-related decline when making family planning decisions.

While it is not always possible to prevent infertility, adopting healthy lifestyle habits and taking proactive measures can help reduce the risk of fertility issues for both men and women. Monitoring reproductive health and addressing any concerns with a healthcare professional can further support overall fertility and increase the chances of successful conception.

 Also Read: Infertility Meaning in Hindi

Diagnosis of Infertility:

Diagnosing infertility involves evaluating both partners to identify potential causes and guide appropriate treatment. A thorough medical history, physical examination, and specific tests can help healthcare professionals determine the underlying issues contributing to infertility.

Tests for Male Infertility:

Male infertility is typically assessed through a combination of medical history, physical examination, and laboratory tests. Some common tests include:

  1. Semen analysis: This test evaluates sperm count, motility, and morphology by examining a semen sample under a microscope. It is the primary test for diagnosing male infertility.
  2. Hormone testing: Blood tests can be used to measure hormone levels, including testosterone, follicle-stimulating hormone (FSH), and luteinising hormone (LH). Imbalances in these hormones can affect sperm production and function.
  3. Genetic testing: Genetic tests can identify chromosomal abnormalities or gene mutations that might be causing infertility, such as Klinefelter syndrome or cystic fibrosis.
  4. Imaging tests: Scrotal ultrasound, transrectal ultrasound, or magnetic resonance imaging (MRI) can help visualise the reproductive organs and detect any structural abnormalities, such as varicoceles or obstructions.
  5. Post-ejaculation urinalysis: This test checks for the presence of sperm in the urine, which can indicate retrograde ejaculation.
  6. Antisperm antibody test: This test detects the presence of antibodies that can attack and impair sperm function.

 

Tests for Female Infertility:

Female infertility is evaluated through a combination of medical history, physical examination, and laboratory tests. Some common tests include:

  1. Ovulation testing: Blood tests can measure hormone levels, such as progesterone, FSH, and LH, to determine if a woman is ovulating. Over-the-counter ovulation predictor kits can also detect the surge of LH that precedes ovulation.
  2. Hysterosalpingography (HSG): This X-ray test involves injecting a contrast dye into the uterus and fallopian tubes to evaluate their shape and check for blockages.
  3. Transvaginal ultrasound: This imaging test uses a specialised ultrasound probe inserted into the vagina to visualise the ovaries, uterus, and fallopian tubes, helping to identify conditions such as polycystic ovary syndrome (PCOS), fibroids, or ovarian cysts.
  4. Laparoscopy: This minimally invasive surgical procedure involves inserting a thin, lighted camera through a small incision in the abdomen to examine the reproductive organs and diagnose conditions such as endometriosis or tubal damage.
  5. Hysteroscopy: This procedure uses a thin, lighted camera inserted through the cervix to examine the inside of the uterus and diagnose conditions such as polyps or intrauterine adhesions.
  6. Endometrial biopsy: This test involves taking a small sample of the endometrium (the uterine lining) to check for abnormalities or inflammation that might be affecting fertility.

Diagnosing infertility requires a comprehensive evaluation of both partners to identify the underlying causes and guide appropriate treatment. A range of tests, including hormonal assessments, imaging studies, and minimally invasive procedures, can help healthcare professionals determine the factors contributing to a couple’s infertility. Early diagnosis and intervention can improve the chances of successful conception and help couples achieve their dream of parenthood.

 

Treatment of Infertility:

Treatment options for infertility depend on the underlying causes, the couple’s individual circumstances, and personal preferences. A combination of lifestyle changes, medications, assisted reproductive techniques (ART), and surgical interventions may be considered to help couples achieve successful conception.

 

Treatment of Male Infertility:

Treatment for male infertility focuses on addressing the specific factors contributing to fertility issues. Depending on the diagnosis, the following treatments may be recommended:

  1. Lifestyle changes: Adopting a healthier lifestyle, including a balanced diet, regular exercise, stress management, and avoiding smoking and excessive alcohol consumption, can improve overall fertility.
  2. Medications: Hormone replacement therapy or medications that regulate hormone levels can be used to address hormonal imbalances affecting sperm production and function. Antibiotics may be prescribed to treat infections that impact fertility.
  3. Surgery: Surgical procedures may be performed to correct structural issues, such as varicocele repair, vasectomy reversal, or the removal of obstructions in the reproductive tract.
  4. Assisted reproductive techniques (ART): Intrauterine insemination (IUI) or in vitro fertilisation (IVF) can help couples achieve pregnancy when other treatments have not been successful. Intracytoplasmic sperm injection (ICSI), where a single sperm is injected directly into an egg, can be particularly helpful for men with low sperm count or poor sperm quality.

 

Treatment of Female Infertility:

Female infertility treatment aims to address the specific factors contributing to fertility issues. Depending on the diagnosis, the following treatments may be recommended:

  1. Lifestyle changes: Adopting a healthier lifestyle, including a balanced diet, regular exercise, stress management, and maintaining healthy body weight, can improve overall fertility.
  2. Medications: Fertility drugs, such as clomiphene citrate or gonadotropins, can stimulate ovulation in women with ovulation disorders. Hormone replacement therapy or medications that regulate hormone levels can also be used to address hormonal imbalances.
  3. Surgery: Surgical procedures may be performed to correct structural issues, such as removing fibroids, endometrial polyps, or adhesions, or repairing blocked fallopian tubes. Laparoscopic or hysteroscopic surgery can be used to treat endometriosis or other conditions affecting the reproductive organs.
  4. Assisted reproductive techniques (ART): ART, such as IUI or IVF, can be used to help couples achieve pregnancy when other treatments have not been successful. ICSI, preimplantation genetic testing (PGT), or using donor eggs or sperm can also be considered in certain cases.

Infertility treatment depends on the underlying causes and individual circumstances. Couples experiencing infertility should consult a healthcare professional to determine the most appropriate course of action based on their specific situation. A combination of lifestyle changes, medications, ART, and surgical interventions can help improve fertility and increase the chances of successful conception. Support from healthcare professionals, counsellors, and support groups can help couples navigate the challenges of infertility and make informed decisions about their treatment options.

 Also Read: How to Get Pregnant Fast

Risk Factors of Infertility:

Risk factors of Infertility

Risk factors of Infertility

Several factors can increase the risk of infertility for both men and women. Some of these risk factors include:

  1. Age: Women’s fertility naturally declines with age, particularly after the age of 35. Men’s fertility may also decline with age, although at a slower rate.
  2. Tobacco and alcohol use: Smoking and excessive alcohol consumption can negatively impact fertility in both men and women.
  3. Weight: Being underweight or overweight can disrupt hormonal balance and affect fertility in both genders.
  4. Sexually transmitted infections (STIs): Untreated STIs can cause damage to the reproductive organs and lead to fertility issues.
  5. Exposure to environmental toxins: Prolonged exposure to harmful chemicals, such as pesticides, heavy metals, and industrial pollutants, can affect fertility in both men and women.
  6. Medical conditions: Certain medical conditions, such as polycystic ovary syndrome (PCOS) in women and varicoceles in men, can impact fertility.
  7. Previous cancer treatment: Radiation therapy, chemotherapy, and some surgeries can impair fertility in both men and women.

 

When Should You Seek Help for Infertility?

Couples are generally advised to seek help for infertility if they have been trying to conceive for one year without success. Women over the age of 35 should consider seeking help after six months of trying to conceive without success. Additionally, individuals with a known fertility issue or a history of recurrent miscarriages should consult a healthcare professional sooner.

 

Does Insurance Cover Infertility Treatment?

In India, insurance coverage for infertility treatment varies depending on the specific policy and insurance provider. Traditionally, most health insurance policies in India have not covered infertility treatments, such as in vitro fertilisation (IVF) or intrauterine insemination (IUI). However, in recent years, some insurance companies have started offering plans that cover certain infertility treatments or provide limited coverage through riders or add-on benefits.

It is essential to carefully review the terms and conditions of your insurance policy and consult with your insurance provider to determine the extent of coverage for infertility treatments. Keep in mind that coverage may be subject to specific conditions, limitations, waiting periods, or exclusions.

If your current insurance plan does not cover infertility treatments, you may want to explore options for additional coverage or consider switching to a plan that offers more comprehensive coverage for these treatments.

In other countries, private insurance plans may offer coverage for infertility treatments, but the extent of coverage can differ significantly between plans. Some policies may cover diagnostic tests and consultations, while others may also include coverage for specific treatments, such as intrauterine insemination (IUI) or in vitro fertilisation (IVF). It is essential to review your insurance policy and consult with your insurance provider to determine the extent of coverage for infertility treatments.

 

Diet to Increase Fertility:

A healthy diet can play a vital role in increasing fertility and supporting reproductive health. Some dietary recommendations for enhancing fertility include:

  1. Consume a balanced diet: Focus on consuming a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats. A well-balanced diet can help support hormonal balance and overall reproductive health.
  2. Opt for complex carbohydrates: Choose complex carbohydrates, such as whole grains, legumes, and vegetables, over refined carbohydrates. Complex carbohydrates can help maintain stable blood sugar levels and support regular ovulation.
  3. Include healthy fats: Incorporate healthy fats, such as those found in avocados, nuts, seeds, and oily fish, into your diet. These fats can help improve hormonal balance and support fertility.
  4. Prioritise lean protein sources: Opt for lean protein sources, such as fish, poultry, legumes, and tofu, which can provide essential nutrients for reproductive health.
  5. Incorporate antioxidant-rich foods: Antioxidant-rich foods, such as berries, dark chocolate, and green leafy vegetables, can help protect the reproductive system from damage caused by free radicals and support overall fertility.
  6. Ensure adequate vitamin and mineral intake: Ensure sufficient intake of essential vitamins and minerals, such as folic acid, vitamin D, zinc, and selenium, which play crucial roles in reproductive health.

 

Conclusion

Infertility is a complex issue that affects many couples worldwide, including in India. Understanding the risk factors, symptoms, causes, prevention strategies, diagnostic tests, and treatments for infertility can help couples make informed decisions about their reproductive health. It is essential for couples experiencing fertility issues to seek help from healthcare professionals who can guide them through the process of diagnosis and treatment. Insurance coverage for infertility treatment in India varies, and it is crucial for individuals to review their policies and consult their insurance providers to determine the extent of coverage available. By adopting a healthy lifestyle, including a balanced diet and regular exercise, couples can improve their chances of successful conception and increase their overall reproductive health. Support from healthcare professionals, counsellors, and support groups can help couples navigate the challenges of infertility and make informed decisions about their treatment options.

Also Read: Boost Fertility Naturally

F.A.Q:

Q: What causes infertility?

A: Infertility can be caused by a variety of factors, including hormonal imbalances, structural issues, genetic abnormalities, lifestyle factors, and certain medical conditions affecting the reproductive system.

Q: What are the types of infertility?

A: There are two main types of infertility: primary infertility, where a couple has never conceived, and secondary infertility, where a couple has difficulty conceiving after a previous successful pregnancy.

Q: What are the causes of infertility in females?

A: Female infertility can be caused by ovulation disorders, fallopian tube damage or blockage, endometriosis, uterine or cervical abnormalities, and polycystic ovary syndrome (PCOS).

Q: Can infertility be cured?

A: In some cases, infertility can be treated or reversed through lifestyle changes, medications, surgical interventions, or assisted reproductive techniques (ART) such as IVF or IUI. However, some causes of infertility may not be treatable, and treatment success varies based on individual circumstances.

Q: How do I check my fertility?

A: Fertility can be assessed through a combination of medical history, physical examination, and specific tests, such as hormone tests, semen analysis, and imaging studies. Consult a healthcare professional for a comprehensive fertility evaluation.

Q: What is the most significant cause of infertility?

A: There is no single cause of infertility that is most significant, as multiple factors can contribute to fertility issues. However, age is a crucial factor, as fertility naturally declines with age in both men and women.

Q: Who is most at risk for infertility?

A: Individuals with known risk factors, such as advanced age, unhealthy lifestyle habits, certain medical conditions, or a history of reproductive system issues, are at higher risk for infertility.

Q: Can stress cause infertility?

A: Chronic stress can negatively impact fertility by causing hormonal imbalances and affecting overall reproductive health.

Q: What are 3 ways to prevent infertility?

A: Three ways to prevent infertility include maintaining a healthy lifestyle, practising safe sex to avoid STIs, and seeking timely medical help for any known reproductive health issues.

Q: How can I check my fertility at home?

A: Home fertility tests, such as ovulation predictor kits for women and sperm count tests for men, can provide limited information about fertility. However, these tests cannot provide a comprehensive assessment, and it is essential to consult a healthcare professional for a thorough evaluation.

Q: How to increase fertility?

A: Fertility can be improved by adopting a healthy lifestyle, including a balanced diet, regular exercise, stress management, maintaining healthy body weight, and avoiding smoking and excessive alcohol consumption.

Q: At what age can a woman be infertile?

A: There is no specific age at which a woman becomes infertile, but fertility declines with age, particularly after the age of 35. The likelihood of infertility increases as a woman approaches menopause, which typically occurs between ages 45 and 55.

Q: Can you have a baby if you’re infertile?

A: In some cases, individuals diagnosed with infertility can still have a baby with the help of treatments, such as medications, surgical interventions, or assisted reproductive techniques like IVF or IUI.

Q: Is infertility a bad thing?

A: Infertility can be emotionally challenging for couples who desire to have a baby. However, many couples can find successful treatments or alternative options for building a family, such as adoption or surrogacy. Support from healthcare professionals, counsellors, and support groups can help couples navigate the challenges of infertility and make informed decisions about their options.

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    Dr Mona Dahiya

    Dr Mona Dahiya

    IVF Specialist & Consultant

    Dr Mona Dahiya has performed over 5,000+ IVF cycles and is considered a global expert in IVF, ICSI, IUI and male fertility treatment. She is an eminent writer on Infertility Treatment and has over 100 Publications in both International and National Journals. Dr Mona Dahiya has immensely contributed to the field of infertility through her Research and articles.

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