What is infertility?
Infertility means unable to conceive even after one year of unprotected sex. Many couples take several months to conceive. The probability of conception in one menstrual cycle is roughly 17% and about 80% of couples conceive within a year of trying.
How pregnancy occurs?
To conceive, an ovum (egg) from the woman has to combine with a sperm from the man. An ovum is released from an ovary when a woman ovulates. This usually occurs once a month between 12 and 16 days from the start of your last period if you have a regular monthly cycle of 28-30 days.
Sperm lie next to the cervix (neck of the uterus) when a man ejaculates ('comes') during sex. The sperm travel up past the cervix to get into the main part of the uterus, and into the fallopian tubes. If there are sperm in the fallopian tube then one may combine with (fertilise) the ovum to make an embryo. The tiny embryo travels down into the uterus and attaches to the lining of the uterus. The embryo then grows and matures into a baby.
What can cause fertility problems?
Ovulation problems
Failure of the woman to ovulate is the cause in about 30% couples with infertility. In some women this is a permanent problem. In some women it is intermittent: some months ovulation occurs, and some months it doesn't. There are various reasons for this anovulation they are Polycystic ovarian syndrome (PCOD),Hormonal problems, Premature menopause ,obesity etc.
Fallopian tube, cervix or uterine problems
These are the cause in about 20% couples with infertility, and include the following:
- Endometriosis: It is a disease where tissue that lines the uterus (endometrium) is found outside of the uterus. It is 'trapped' in the pelvic area and can affect the ovaries, uterus, and nearby structures. It often causes lower abdominal pain and/or painful periods.
- Pelvic inflammatory disease(PID): Previous infection of the uterus and fallopian tubes is another common cause. Previous surgery to the fallopian tubes, cervix or uterus can cause scarring.
- Large fibroids may also cause problems, although this is debated by some experts.
Male problems
These occur in about 40-50 % cases. The most common reason for male infertility is a problem with sperm due to an unknown cause. The sperm may be reduced in number, less mobile (less able to swim), and/or be abnormal in shape. Some men are born with testes that do not make any sperm, or very few sperm. Some are born without testes or without a vas deferens.
Unexplained Infertility
No cause can be found in about 10% couples with infertility.
Age and stress can be a factor
Older women tend to be less fertile than younger women. The 'fall off' of fertility seems to be greatest once you are past your middle 30s. For women aged 35-39, the chance of conceiving is about half that of women aged 19-26. Some studies have shown that stress at work may reduce the chance of a woman conceiving. If the male or the female partner is stressed, this can affect libido and how often the couples have sex.