Infertility

Article

12. 08. 2019

Both infertility and sterility are classified as a clinical condition. It is primarily defined as an individual's inability to conceive after one year of unprotected intercourse, and therefore, infertility can occur in both men and women. The share of female infertility among infertile couples is about 40%, and in about 25% of infertility cases, both partners have conditions that prevent them from conceiving.
Infertility also refers to when a woman cannot carry a baby throughout the whole course of pregnancy. 
 
The most common cause is a genetic defect in the foetus (chromosomal abnormality) - most commonly is the wrong number of chromosomes, or damaged chromosomes. Humans have 46 chromosomes (out of which two are sex chromosomes) that carry genetic information in the form of DNA. They are present in every cell in our body, and their presence is integral for all cellular activities. When the number of these chromosomes changes, some of the information that the cell contains is either missing, or in excess. This is, in most cases, incompatible with life. 
 
Maternal age is the most significant factor influencing chromosomal abnormalities. With increasing maternal age, the likelihood of DNA (chromosomal) damage increases distinctly. 

 

Types and causes of infertility
 
The WHO (World Health Organisation) classifies infertility into the following categories:
  • Primary infertility
Complete absence of conception despite regular unprotected sexual intercourse over the course of one year. 
  • Secondary infertility
Inability to conceive with regular unprotected intercourse over the course of one year, despite a previously successful conception.
  • Recurrent, spontaneous miscarriage/ infant mortality
Death within the first 5 years of a child's life.
  • Unexplained infertility
Absence of conception due to factors such as breastfeeding (lactation), contraception, reduced sexual activity, or unknown factors.

 

Infertility or reduced fertility in women
  • Ovarian factor infertility - ovaries do not produce fertilisable eggs
  • Anatomical causes - damage or obstruction to the fallopian tubes
  • Chromosomal abnormalities- genetic disorders
  • Hormonal causes - disorder of the production or function of sex hormones
  • Endometriosis - presence of uterine tissue outside of the uterus
  • Immunological causes - female immune response to male sperm
  • Implantation problems - inability for the fertilised egg to be implanted into the uterine wall
  • Early menopause- ovarian failure 

 

Infertility or reduced fertility in men
  • Reduced sperm quality- low sperm count, azoospermia, poor sperm motility, failed penetration of the ovum.
  • Chromosomal abnormalities
  • Immunological causes - autoimmune reaction to own sperm
  • Anatomical causes - epididymal blockage of the vas deferens (blockage of sperm flow caused by infection. 
  • Kartagener syndrome - immobile flagella syndrome, or in other words, a disorder of the sperms tail, affecting it’s mobility. A very rare, genetic disorder. 
  • Sexual performance disorders - impotence, ejaculatory disorder, retrograde ejaculation
  • Vasectomy - male sterilisation via surgery
  • Medication - chemotherapy, anabolic steroids, spironolactone, sulfasalazine… 

 

What else contributes to infertility? 
Other factors that play a major role in the cause of infertility, are mostly linked to our societies current lifestyle. Factors such as increasing age at which women decide to have children, easily accessible contraception, stress, nutritional disorders, smoking as well as alcohol, drug and medication use, but also sexually transmitted infections (e.g. chlamydia), as well as environmental pollution. All of these factors contribute to the problem of infertility, as well as the increasing incidence of congenital defects, and they need to be addressed thoroughly during therapy. 
 
If you need a consultation regarding (in)fertility, please arrange an appointment by contacting our callcenter at: +420235360133

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