December 28, 2006

Infertility and Possible Causes

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Infertility is the inability to naturally conceive a child or to carry a pregnancy to full term. There are many reasons why a couple may not be able to conceive, or may not be able to conceive without medical assistance.

The International Council on Infertility Information Dissemination (INCIID) considers a couple to be infertile if

they have not conceived after 12 months of unprotected intercourse, or after 6 months if the woman is over 35 years of age. The reduced duration for women over 35 is because there is a rapid decline in fertility after this age and help should be sought sooner.
there is incapability to carry a pregnancy to term.



The World Health Organization (WHO) estimates that approximately 8-10% of couples experience some form of infertility problem. On a worldwide scale, this means that 50-80 million people suffer from infertility. However, the incidence of infertility may vary from region to region.



Factors affecting conception
The chances of achieving pregnancy for a couple in a given cycle depend upon many factors, and the most important ones are:


The age of the woman: As age increase the number of eggs and their quality starts decreases. After puberty, women become less fertile as they age. Fertility declines sharply after the age of 35, then again between 37 and 40. If possible, women should start to build a family in their twenties or early thirties. In addition, fertility treatments tend to be more successful in younger women, so seek treatment as soon as infertility is suspected. Older women who are infertile can have success with donor eggs.


Frequency of intercourse: couples who have less frequent intercourse have diminished chance of conceiving. A couple is only fertile for about six days each month. Using the basal body temperature, vaginal secretions, and other fertility signs, a couple can be certain that they are having intercourse when the woman is most likely to conceive. Much is made of using the correct position and elevating the woman's pelvis, but during the most fertile times of the month, sperm are able to swim up to the uterus from any position. However, many consider the missionary position (man on top, face to face) the most successful because it allows deep penetration. The woman can elevate her pelvis with a pillow during intercourse and for about 15-20 minutes afterward so that gravity can assist the sperm in reaching their goal. After 20 minutes, all of the motile sperm will have made the trek. Any "leakage" won't reduce the likelihood of pregnancy.

Possible Causes of infertility

There are numerous causes of infertility. In men, these include environmental and hormonal factors that affect the production of healthy, motile sperm and normal semen, as well as blockages that affect the delivery of sperm. In women, the causes are more varied since she plays a greater role in reproduction. First, one of the organs involved in reproduction may be absent, mal-formed or non-functional such as damaged fallopian tubes. Less frequent causes include, for example, endometriosis and hyperprolactinemia.. Second, the organs may be normal, but the complex hormonal feedback system that is necessary to support follicular development, ovulation and implantation of the fertilized egg may be disrupted.

Other causes;

Body weight

Women who are significantly overweight or underweight can face difficulties in getting pregnant. Low weight or excessive weightloss can lead to decrease in important hormonal "messages" that the brain sends to the ovaries in women and testes in men. Gonardotropin releasing hormone(GnRH) is produced in the part of the brain called Hypothalamus. The release of GnRH leads to release of hormonal messangers LH and FSH by the pitutary glands. LH and FSH are critical for the development of eggs in ovaries and sperm in the testes.Similarly being overweight or obese can affect the hormonal signals to the ovaries and testes. Increased weight can also increase insulin levels in women which in turn may cause the ovaries to overproduce the male hormones and stop releasing eggs. Weight loss is the best plan of action in such cases supported with clomiphene or gonadotropins. Body fat plays a critical role in human reproduction. Both excess and deficiency of body fat lead to reproductive failure. Body weight disorders is one of the first potential causes of reproductive failure in both men and women. This is a problem that can be corrected by the affected individual and the infertile couple.


Diet & exercise

Foods rich in manganese (oats, wheat germ, rye bread and peas) promote the action of oestrogen, and vitamin B's (wholegrains such as brown rice, wheat germ, pulses oats and green vegetables), involved in oestrogen metabolism. Their deficiency can hamper pursuing pregnancy. Soya beans and wholemeal bread will provide magnesium.Infertility is associated with low vitamin D, and PMS can be completely reversed by addition of calcium, magnesium and vitamin D. Vitamin D supports production of estrogen in men and women. PMS has been completely reversed by addition of calcium, magnesium and vitamin D. Menstrual migraine is associated with low levels of vitamin D and calcium. Ten minutes of daily exposure of the arms and legs to sunlight will supply us with all the vitamin D that we need as humans can manufacture vitamin D from cholesterol by the action of sunlight on the skin.


Proper diet and exercise is essential to maintain a healthy weight. At the same time extreme exercise can lead to reduced sperm production in men and lack of ovulation in women by decreasing the brain message to the testes and ovaries. It is impossible to know how much exercise for a person is too much. Generally running more than 10 miles a week is considered too much when trying to conceive. Try bringing about modifications in your exercise routine in order to treat reproductive problems.

Smoking


Smoking is a known contributor to infertility problems in women and can lead to an increased rate of miscarriage. Women who smoke regularly also may enter menopause at an earlier age because of the damaging effect of tobacco smoke on ovaries. Men who smoke may have diminished sperm function.

Drugs and Alcohol

Alcohol is known to cause structural and developmental defects in a fetus. This group of disorders is termed the "Fetal Alcohol Syndrome." It is best to avoid drinking alcohol during the course of your infertility treatment or during pregnancy. Marijuana use in men leads to poor sperm counts that take many weeks to recover after exposure. Other recreational drugs can lead to other significant problems for pregnancy. At the same time it is desirable to limit the intake of tea, coffee, soft drinks which contains caffeine.


Women who take folic acid before they conceive reduce their risk of neural tube defects in the fetus by 50%. It is recommended that all women undergoing infertility treatment take at least 0.4 mg of folic acid (folate) before they conceive and during the course of their pregnancy. Some high potency vitamins may have a detrimental effect in pregnancy (i.e. too high level of vitamin A).


Regular medications of modern medicine in certain ailments like ulcer, high blood pressure etc, causes low sperm count & negative side effects that causes infertility problems in both man & woman.

STDs & PID

Pelvic inflammatory disease (PID) is a major cause of infertility in women. Any sexually transmitted disease (STD), such as gonorrhea or syphilis, may cause PID, which can lead to infertility. Prevent STDs by abstaining from sexual intercourse for unmarried or by being faithful to your partner if you are married.


Does stress cause infertility or does infertility cause stress? Most doctors agree that reducing stress won't ensure pregnancy, but it may help a couple cope with infertility and making treatment decisions.

Eating Disorders

The eating disorders anorexia and bulimia can have long lasting impacts (several years) on fertility. Women with these conditions may not ovulate even if they menstruate. Eggs may not develop properly. In these cases, treating the disease is essential to restoring fertility.
Adapted from WomenFitness