Causes of infertility
Last reviewed: 23.04.2024
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[Male infertility
Some time passed, problems were solved that did not allow you to think about the birth of a child: a career was made, the material situation stabilized, housing problems were solved. It's time to have a baby. But ... Unfortunately, it often happens that many successful, loving couples face the problem of infertility.
When they talk about infertility, they usually have in mind female infertility, forgetting that the male infertility in this sad statistics is slightly less than 50%.
Given that the male reproductive system is no less vulnerable than the female one, many factors can adversely affect it. This is the environment (more precisely, its unfavorable factors), and various diseases, and bad habits, and stresses. And the barren man, as a rule, does not experience any unpleasant sensations, he considers himself completely healthy and is extremely surprised when the doctor suggests that he make an analysis of the spermogram.
The fact is that in most cases male infertility is caused by a violation of spermatogenesis (maturation of spermatozoa). This is secretion infertility. The most frequent cause of it (about 50%) is a circulatory disturbance in the testicles, associated with the expansion of the veins of the spermatic cord - varicocele. Another 35% of cases of male infertility "provide" infectious and inflammatory diseases of the genital organs. Significantly less often occurs autoimmune infertility associated with the fact that the immune system of one's own organism damages the tissue of the testicles and spermatozoa. And very rarely infertility is due to genetic diseases.
Thus, male infertility is manifested by inability to fertilize, regardless of the possibility of sexual intercourse. Causes: absence of spermatozoa (azoospermia), absence of ejaculate (aspermia), decrease in the proportion of live spermatozoa in sperm (necrospermia). It is established that if the mobility of spermatozoa is less than 75% (of their total mass), then we can talk about male infertility.
Marriage is considered infertile if pregnancy does not occur within one year of regular sexual activity in persons of childbearing age without the use of contraceptives. A survey of both partners is necessary. "Peak" fertility, both in men and women, accounted for 24 years. Therefore, men older than 35 years of the survey should start, without wasting time.
Modern methods of diagnosis and treatment provide a favorable prognosis. But even if a disappointing diagnosis is made, you should not lose hope. Methods of effective treatment of the most severe cases of male infertility have now been developed.
Female infertility
Female infertility is primary and secondary. Primary infertility is characterized by a lack of pregnancy in the history of life (anamnesis) of a woman. Secondary infertility is called when the woman had a pregnancy, ending with childbirth, abortion, ectopic pregnancy, and then during one or more years of regular sexual life without the use of contraceptives, pregnancy does not occur.
Statistics show that in the case of primary infertility, the most common causes are hormonal disorders (3 times more often), with secondary infertility - inflammatory processes of the genital organs (in the first place in frequency - tubal infertility).
The causes of female infertility can be both diseases of the genital area, and extragenital pathology (infections, intoxications, production hazards, radiation, etc.), as well as the conditions and lifestyle of a woman (poor nutrition, beriberi, constantly high nervous tension, psychosomatic disorders and associated with them diseases - hypertension, peptic ulcer of stomach and duodenum, etc.). Often infertility in women is due to inflammatory diseases of the uterus and appendages. One of the signs of such inflammatory processes is pain and leucorrhoea (discharge from the vagina).
Erosion of the cervix, inflammation of the cervical canal (endocervicitis) reduces the possibility of conception; prevents penetration of spermatozoa into the uterine cavity, changes in the composition of the cervical mucus. A certain role in female infertility is played by neoplasms of the uterus (myoma), accompanied by bloody discharge from the vagina and bleeding. The presence of congenital malformations of the genital organs (absence of ovaries, etc.) also cause infertility. In addition, some couples may have a so-called "biological incompatibility", as a result of which pregnancy does not occur.
However, in the foreground, among the causes of secondary female infertility is tubal infertility: as a result of an inflammatory process (for example, gonorrheal etiology), the fallopian tubes become impassable due to sealing of the uterine or ampullar parts; spermatozoa can not reach the ovum, and the egg can not pass into the uterine tube and reach the uterus.
Sometimes the presence of inflammatory processes in the abdominal cavity (complicated appendicitis) leads to the formation of adhesions, as a result of which the egg can not enter the fallopian tube. The causes of hormonal (endocrine) infertility, which in second infertility takes the second place, can be:
- violation of menstrual function as a result of changes in the regulation and ovulatory function of the ovaries (cysts, tumors), when ovulation does not occur;
- absence of ovulation due to disorders affecting the production of follicle stimulating (FSH) and luteinizing (LH) hormones in the pituitary gland.
The information provided allows a young couple, subject to responsible, business (and not verbal) family planning, to seek medical and consultative help to the doctor of the gynecologist and proceed to diagnose the causes of infertility.
In this case, if it comes to primary infertility, the survey begins with a man - examine the sperm. If research allows the exclusion of male infertility, a woman is examined. Given that the main cause of primary infertility are hormonal disorders, the examination, as a rule, begins with hormonal studies. If the hormonal function is not impaired, then the patency of the fallopian tubes is examined.
In secondary infertility, diagnostic tests begin, as a rule, with the diagnosis of patency of the fallopian tubes. If the fallopian tubes are well passable, it is necessary to conduct a hormonal examination of a woman. Treatment is carried out depending on the revealed pathology; while the diagnosis in modern conditions is by no means limited to these two areas. If necessary, it unfolds with all its modern power, including medical-genetic counseling, etc., etc., which ultimately opens up a bright and fruitful path for targeted treatment that ensures the development of pregnancy, including artificial pregnancy.
However, it should be specially emphasized that in the reproductive age, the most important problem is the risk of infection with sexually transmitted infections, because they can become a formidable cause of infertility. Therefore, the basic ideas about sexually transmitted diseases can help the newlyweds to take the path of a permanent sexual partnership, ensuring the preservation of their own health, the health of the developing fetus and the newborn baby.