Unlike some traditional beliefs, both men and women can face fertility problems.
According to the World Health Organization (WHO), millions of people experience fertility problems that affect families and communities. One in every six individuals of reproductive age experiences fertility issues worldwide.
Causes of female fertility problems
Women often bear the responsibility for bearing children, especially in Asia, where patriarchal and male dominance cultures are more prevalent.
Women are frequently blamed if the couple cannot conceive for any reason. Here are some causes of female fertility problems:
- Pelvic inflammatory disease and sexually transmitted diseases can lead to blockages in the fallopian tubes.
- Conditions such as endometriosis, endometrial polyps, fibroids, and previous uterine surgery can cause changes and scarring in the uterine cavity.
- Congenital abnormalities like a bicornuate uterus can lead to implantation failure.
- Ovarian causes such as premature ovarian failure and polycystic ovarian disease result in cycles without ovulation.
- Menstrual disturbances like irregular periods and heavy menstrual bleeding can make it difficult for women to conceive.
- Autoimmune disorders like systemic lupus erythematosus, Hashimoto's thyroiditis, or rheumatoid arthritis can cause inflammation in the reproductive system as the host's immune system attacks its own tissues.
Causes of male infertility
Various factors can cause male fertility problems. Some of them include:
- Hormonal disturbances - the hypothalamus and pituitary gland produce hormones that control testicular function. Hormonal imbalances leading to abnormal hormone production can affect sperm production, causing male infertility.
- Obstructions in the sperm transport system can cause male infertility. Blockages are typically due to injury or recurrent infections in the genital tract.
- Male infertility can also result from primary testicular failure, which can be congenital or iatrogenic. Iatrogenic causes include side effects after radiation/chemotherapy and testicular varicocele (abnormal enlargement of spermatic veins).
- Genetic disorders like Klinefelter syndrome, myotonic dystrophy, and microdeletions can contribute to male infertility.
- Testicular injuries like testicular rupture, testicular torsion, or repeated testicular infections can damage the testes, causing infertility.
- Certain medications, recreational drugs, and behaviors such as alcohol and smoking can damage sperm production. Excessive pressure on the testicles, such as wearing tight clothing or frequent sauna or steam room visits, can impair spermatogenesis.
- Medical conditions like metabolic syndrome (high blood pressure, diabetes, and hypercholesterolemia) and autoimmune diseases can also lead to male infertility.
- Environmental pollution and toxins such as insecticides, lead, and certain chemicals can be toxic to sperm, resulting in lower sperm counts and poor sperm quality.
Men also experience increased stress levels due to work, family, or the pressure to meet their own expectations.
All these factors can lead to erectile dysfunction, negatively impacting marital life. Stress can also release steroid hormones that affect sperm quality and quantity.
Age-related factors
Men and women are biologically different, especially regarding fertility. It is a fact that as women age, their egg production decreases.
Additionally, the chances of having eggs with abnormal chromosomes are higher in older women, increasing the risk of having children with genetic diseases.
On the other hand, men continue to produce sperm throughout their lives, and the quality of sperm remains consistent.
An older man can still become a father if he can maintain sexual desire and erections despite experiencing andropause.
Why men find it difficult to seek fertility treatment
In reality, men often face the fertility issues they encounter without blaming their partners.
Fertility treatment can begin after appropriate assessment and investigation.
- First and foremost, a comprehensive history, physical examination, and external genital examination are required. Testicular ultrasound or hormone testing may be necessary. It is crucial to exclude any further medical issues that may affect sperm production. Semen analysis is essential to determine their quantity, motility, and morphology.
- Lifestyle changes, such as avoiding tight clothing or trousers, quitting smoking, alcohol consumption, or drug abuse, can make a difference. Promoting a healthy lifestyle involving a balanced diet, weight loss, and regular exercise can help overcome minor subfertility issues. The sperm count can be increased with dietary supplements.
After trying all the mentioned approaches without success, one should consider intrauterine insemination (IUI), in vitro fertilization (IVF), or intracytoplasmic sperm injection (ICSI).
Pregnancy rates vary from 50 to 80 percent worldwide. However, the rate of live births can be much lower because some women may experience miscarriages.
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