Infertility: Types, Causes, Symptoms, Diagnosis and Treatment

Have you ever heard about infertility? It is the condition when you can’t get pregnant even after a year of trying to conceive. Its risk increases as you get older. Hormonal imbalances such as low levels of testosterone or progesterone, low sperm count, ovulatory disorders, and endometriosis are some common causes of infertility. However, several treatment options can help you treat infertility. 

What is Infertility?

A reproductive disorder that causes the inability to reproduce is called infertility. This condition affects your reproductive system and you would fail to conceive. The basic factors affecting your ability to  conceive, include:

• Producing reproductive hormones through the brain is crucial to controlling ovarian function.
• Release of egg in the ovaries.
• Maturation of eggs in the ovary.
• Picking up eggs through a fallopian tube.
• Feasible transfer of sperm to the vagina through your fallopian tube and uterus.
• Fertilization of egg through sperm to create an embryo.
• The feasible transfer of the embryo to the uterus for implantation, through the fallopian tube.

If one of the these steps doesn’t occur, you can’t get conceived. 

In addition, age is another major factor in diagnosing infertility in anyone. If your age is less than 35 years, failure to get pregnant after one year of efforts to conceive can confirm your infertility. Unprotected sex is essential for getting pregnant. However, if your age is above 35 years, your infertility may be confirmed within 6 months of regular, unprotected sex.

Moreover, infertility is a common condition and many people are affected by it. The good thing is that there are many ways to treat infertility. These treatment options are the source of hope for individuals who are eager to expand their families.  

Types of Infertility

Based on failed steps in conceiving efforts, infertility can be divided into the following types:

Primary Infertility: If you don’t get pregnant, even having regular unprotected sexual intercourse for 12 months or more.

Secondary Infertility: If you would fail to conceive after one successful pregnancy.

Unexplained Infertility: When your healthcare provider doesn’t get any clear reason for your failure in conceiving and the pregnancy test does not give any data about the cause of your infertility.

Is Infertility a Common Condition?

Yes, infertility is a common condition and it affects both men and women equally. According to a survey report of 2022, women of age 120 to 50 are more likely to get pregnant and in the country, every 1 in 10 women is struggling with primary infertility and around 1 in 15 women are living with secondary infertility. The report also claimed that around 56 million couples are living with unexplained infertility around the world. 

Symptoms and Causes

Symptoms of Infertility

Being unable to get pregnant after six months to twelve months of irregular, unprotected sexual intercourse, is considered the main symptom of infertility. Sometimes, you may not find any prominent symptoms of infertility but certain physical symptoms indicate that you are unable to get pregnant, such as:

• Issues with ejaculation due to a penile disorder.
• Irregular periods, no periods, or irregular vaginal bleeding.
• Abdominal or pelvic pain. 

Causes of Infertility

Sometimes, it is not easy to answer why you are not getting pregnant even after regular unprotected sex. But sometimes, your heart care provider concludes a certain cause of your infertility after performing a thorough examination and doing some reproductive tests. Studies show that the variable causes of infertility include:

• One-third percent of infertile individuals are found  with problems in uterus and ovaries.
• Next one third infertile individuals are found with problems in penis and testicles.
• The last one-third infertile population involves unexplained infertility in both partners.

According to studies, around 30% of infertile couples have more than one cause of infertility. Some of these causes often come after just one partner, while others can affect both partners. Common risk factors of infertility include:

• Eating Habits: Bulimia and Anorexia Nervosa are the eating disorders that cause infertility.
• Over-exercising.
• Chemotherapy or radiation therapy.
• Age: is a major factor in causing infertility. Especially individuals with age between 40 and 50 have a higher risk of infertility.
• Excessive consumption of alcohol.
• Use of tobacco products such as smoking.
• Exposure to environmental pollutants containing pesticides and lead.
• Sexually transmitted infections are known as STIs.
• Obesity or being underweight.
• Chronic conditions and diseases.
• Imbalance production of hormones.
• Substance abuse.

Causes of Infertility for Women

In women, ovulation disorders are the major cause of infertility. Through the ovulation procedure, the ovaries release an egg to be fertilized with a sperm. 

More factors contributing to female infertility are:

• Autoimmune diseases such as lupus or celiac disease.
• Pelvic inflammatory disease.
• Endometriosis.
• Kidney disease.
• Primary ovarian insufficiency.
• Thyroid diseases.
• Structural disorders of fallopian tubes, vagina, or uterus.
• Hypothalamic and pituitary gland disorders.
• Absent or infrequent menstrual periods.
• Polycystic ovary syndrome.
• Congenital or surgical absence of ovaries.
• Genetic or chromosomal disorders.
• Sickle cell anemia.
• Sexual dysfunction.
• Tubal ligation or salpingectomy.
• Uterine polyps and uterine fibroids.

Causes of Infertility in Male

Problems involving the amount, shape, and mobility of sperm are the main causes of infertility in males.

More causes of male infertility include:

• Prior surgical sterilization.
• High heat exposure to testicles due to ho; ding heating pads or laptops near your testes, frequent use of hot tubs, and tight clothing.
• Genetic disorders such as cystic fibrosis.
• Lower levels of testosterone hormone.
• Congenital or surgical absence of testes.
• Undescended testicles.
• Enlarged veins are found in the scrotum, the sac holding your testicles.
• Injury to the testicles or scrotum.
• Chromosomal disorders.
• Previous radiation therapy or chemotherapy. 
• Sexual dysfunction, like erectile dysfunction, retrograde ejaculation, and premature ejaculation.
• Misuse of anabolic steroids.

Diagnosis and Tests

Diagnosis of Female Infertility

After examining your complete sexual and medical history, your healthcare provider will go for some tests. But first, you should know the procedure of fertility. Your brain sends hormonal signals to your ovary to release an egg. The egg travels to your uterine lining through your fallopian tubes. The first fertility test involves detecting an issue with any of these procedures.

Following tests may help diagnose the actual cause of infertility:

Laparoscopy: A thin tube with a camera is called a laparoscope. The doctor inserted the laparoscope into a small abdominal incision. This device helps identify problems like scar tissue, uterine fibroids, and endometriosis.

Pelvic Exam: Examination of any structural problem in your pelvic area helps identify the symptoms of infertility.

Blood Tests: Blood tests help check hormonal imbalances creating hindrance in ovulation.

X-ray (HSG): X-ray uses an injectable dye to check any blockage in your fallopian tubes.

Transvaginal Ultrasound: Doctors insert an ultrasound wand into your vagina to check for any issue in your reproductive system.

Hysteroscopy: Insertion of a thin, lighted tube called hysteroscope into the vagina helps examine your vagina.

Saline Sonohysterogram: The doctor fills your uterus with a saline fluid and conducts a transvaginal ultrasound to detect the problem causing infertility.

Diagnosis of Male Infertility

Ejaculation of unhealthy sports is linked with male infertility. More infertility issues can be diagnosed through the conduction of tests including:

Scrotal Ultrasound: An ultrasound of your scrotum helps identify testicular problems such as varicoceles.

Blood Test: Thyroid or other hormonal imbalance problems are detected through a blood test. Chromosomal abnormalities in males are also diagnosed with the help of genetic blood tests.

Semen Analysis: This test is used to check poor sperm motility or low sperm count. Sometimes Needle biopsy is done to remove sperm from testicles for further testing. 

Treatment and Management

Treatment of Infertility

The cause of infertility decides the option of treatment. Some other factors such as your age, the duration for whom you are trying to conceive and your personal preferences also affect the treatment procedures. Sometimes, treatment involves just one person while sometimes both partners need treatment.

In addition, infertile couples mostly can have a pregnancy with small efforts. In such cases, SM, all surgeries, assisted reproductive technology and medications can help. Moreover, your timing of intercourse and some lifestyle changes can help improve the chances of pregnancy. This means a combination of methods is used for the treatment of infertility.

Treatment of Infertility for Females

The infertility treatment options for females include:

Surgery: This is done to open the blocked fallopian tubes and remove fibroids, polyps, or scar tissues.

Lifestyle Modifications: Improving your health by losing or gaining weight, eating a healthy diet, and quitting smoking or drug abuse can help you get pregnant.

Medications: Medicines used for improving the chances of pregnancy help to stimulate your ovaries to ovulate more eggs which confirms the increase in chances of getting pregnant.

Healthcare providers also make suggestions to improve your odds of conceiving. These suggestions are:

• Use a home ovulation kit to help predict pregnancy. You can buy this kit from a drugstore.
• Track your ovulation track with the help of your basal body temperature. Noting the texture of your cervical mucus can also help you get pregnant.

Treatment of Infertility for Males

Male can have the following treatment options for their infertility:

Surgery: Blockages in the tubes that carry sperm can cause infertility in males. These blockages are opened through surgery and also repair structural problems. Another type of surgery, varicocele surgery is done to improve the odds of conception and health of sperm.

Medications: Medicines are used to raise the reproductive hormone levels in males. The Most important hormone testosterone is also increased through drugs or medications. Some medications also help treat erectile dysfunction during sex.

Common Treatment Options for Both Male and Female

Assisted reproductive technology (ART) is the most common treatment option that helps a couple more effective ways to treat infertility. This treatment option involves a healthcare provider handling the egg or sperm and adding medications to increase the chances of pregnancy. The medications help stimulate ovulation. Other options for couple infertility treatment include:

Third-Party ART: In this treatment procedure, donor eggs, donor sperm, or donor embryos are used. This means the infertile couple hires a gestational carrier or a surrogate.

In Vitro Fertilization (IVF): This option involves retrieving eggs from your ovary and placing them with sperm in a lab dish. The sperm fertilizes the egg and the embryo is implanted into the uterus of a female.

Assisted Hatching: This process is used to open the outer layer of the embryo so that it may be implanted easily in the uterine lining of the female partner.

Intracytoplasmic Sperm Injection: This is the part of IVF procedure and involves the injection of a single sperm directly into the eggs. Then one of the embryos is transferred to the female’s uterus.

Intrauterine Insemination: A long, thin tube is inserted directly into the female’s uterus. This is also known as artificial insemination.

Complications of Infertility Treatment

Common complications of infertility treatments include:

Failed Cycles: When you go through infertility treatment and it doesn’t end in pregnancy, you have a failed cycle.

Higher Chances of Multiples: Infertility treatment options involve the production of multiple eggs and the transfer of more than one embryo. This may increase the risk of getting pregnant with more than one fetus. This can result in higher risks of complications such as neonatal death, premature birth, long-term health complications, miscarriages, and low birth weight. 

Ectopic Pregnancy: Ectopic pregnancy risk can be increased due to IVF.

Ovarian Hyper-stimulation Syndrome: This condition leads to swollen and painful ovaries due to excessive use of medications. Sometimes, the condition gets worse and needs immediate medical assistance. 

Prevention of Infertility

When trying to conceive, take these steps to protect your fertility:

• Avoid delayed conception until an advanced age.
• Eat a well-balanced diet and maintain your weight.
• Undergo fertility preservation procedures such as freezing sperm or eggs.
• Quit smoking and avoid drinking alcohol and misuse of drugs.
• Avoid exposure to environmental toxins.
• Don’t over-exercise but stay physically active.
• Get treated for STIs.

Conclusion

If you want to start your relationship with an expansion of your family, pregnancy is a great way to achieve your goal. Best infertility is a bitter reality of life that poses many challenges and makes you feel soul-crushing and helpless. Infertility affects your relationship and is injurious to your emotional well-being. Treatment procedures for infertility are not only expensive but also cause unbreakable pains.  

Therefore, it is suggested that if you are not successful in getting pregnant despite having regular and unprotected sexual intercourse, contact your healthcare provider to discuss possible treatment options. A stitch in time saves nine. Similarly, your precautionary steps can save you and your partner from the painful feelings of infertility. With the help of the best treatments, you may get pregnant. In case of failure, you may turn to reproductive technologies.