Infertility : Causes, Symptoms And Prevention
Every sixth couple in Austria waits in vain for the longed-for offspring. Afric Studio
Every
sixth couple in Austria remains childless unintentionally. One speaks of
infertility or infertility if the woman does not become pregnant within a year
despite having sexual intercourse.
There
are a number of reasons for infertility (sterility, infertility). Sterility in
both men and women has physical or psychological reasons, among other things:
hormonal disorders, infections or operations that have survived, blockages in the fallopian tubes, or vas deferens that can lead to infertility.
The frequency is equally distributed between the sexes, in 20% of cases it
affects both partners. Depending on the cause, a number of treatment options
are available.
Desire
to have children later
In
modern industrial society, many couples' desire to have children is shifting to
a later phase of life. However, since natural fertility decreases continuously
with age, the number of couples who do not want to have children is also
increasing. The real causes are diverse, often combined, and add up over the
years: The probability that a mature egg cell is genetically healthy decreases
many times over with the age of the woman.
For
comparison: Even if the individual fluctuation range is high, in a young woman
about every 4th egg cell is healthy, in a woman over 40 years of age only every
18th egg cell is. Since ovulation only occurs once a month, the likelihood of
becoming pregnant naturally decreases with age. But the percentage of sperm
with a normal chromosome set also decreases over the years.
Frequency
of infertility
The
frequency of infertility in couples with an unfulfilled desire to have children
is equally distributed for both sexes at around 40%. In about 20% of couples,
the problem affects both the man and the woman, or the reasons for it are not
clear.
What is
infertility?
There
are several medical terms to better describe infertility:
1. Primary
sterility: the woman was not yet pregnant, and despite regular sexual intercourse,
pregnancy does not occur.
2. Secondary
sterility: the woman has already been pregnant but cannot conceive again.
3.
Female infertility: the woman was already pregnant but miscarried or was unable
to carry the child to term.
4.
Idiopathic sterility: the cause of an unfulfilled desire to have children is
unknown.
The most common causes of infertility in women
In
women, the most common reasons for childlessness are hormones, lifestyle, or
organic diseases:
A.
hormones
The
correct interplay of hormones is important for egg cell maturation:
FSH and
LH hormones: The anterior pituitary hormones, follicle-stimulating hormone
(FSH), and luteinizing hormone (LH) are directly responsible for egg cell
maturation. FSH levels that are too low or LH levels that are too high have a
negative effect.
Hormones
TSH, prolactin: Hypothyroidism, increased values of the thyroid-stimulating hormone (TSH), or increased prolactin
levels also have a negative effect on egg cell maturation
Corpus
luteum hormone: You often hear the buzzword corpus luteum hormone weakness. The
corpus luteum hormone is produced by the corpus luteum after ovulation and is
intended to prepare the lining of the uterus for the implantation of an embryo. A
lack of corpus luteum hormone has a negative effect on nidation and is also a sign of impaired egg cell maturation.
B.Lifestyle
factors
Obesity
can cause infertility. Male hormones are also produced by the female body,
namely in adipose tissue. If you are overweight, too many male hormones are produced
so that egg cell maturation cannot take place. In the worst case, the so-called
PCO syndrome (polycystic ovary syndrome, characterized by irregular cycles,
irregular ovulation, increased hair growth, and weight gain) develops. Egg
maturation is blocked.
C.Organic
Causes
Organic
reasons include...
a). Adhesions
and adhesions: They can occur after inflammation of the fallopian tubes caused
by chlamydia, gonococci, or other pathogens
b). Fibroids
(benign muscle knots of the uterus): They are more common with age and are of
particular concern when fibroids are just below the lining of the uterus
c). Endometriosis
(deposits of the lining of the uterus on the fallopian tubes and ovaries):
Endometriosis is often painful, especially before menstruation. Smaller foci
are not visible in the ultrasound and can therefore often only be detected with
a laparoscopy.
The most regular causes of infertility in males
or man
The
spermiogram provides information about sperm quality. The spermiogram is in
the normal range when the ejaculate
1.
Quantitatively more than 1.5 ml
2.
contains more than 15 million sperm/ml,
3.
contains more than 50% motile sperm (at least 4% ideal forms)
4.
Sperm quality can be reduced by lifestyle, environmental toxins, and diseases
of the testicles or vas deferens and by hormones:
Lifestyle factors
Overweight
men have fewer sperm. Due to excessive body weight, the man loses about a
quarter of his sperm cells. The number and motility of the sperm cells is also
significantly reduced by:
a). Excessive
alcohol consumption
b). Smoking
c).stress
d).environmental
toxins
Studies
show that young men today produce about a third less sperm than men 30 years
ago. The quality is about half worse due to the effects of endocrine disruptors
(textiles, pesticides, and some cosmetics).
Decreased
testicular tissue
Can
occur as a result of early damage in childhood, after undescended testicles or
testicular inflammation from mumps.
Sticking
together of the vas deferens after inflammation
Chlamydia,
gonococci, or other urinary tract infections can lead to impairment of the vas
deferens; it can also be caused by inflammation of the testicles, epididymis,
or prostate, or by injury.
Hormones
As in
women, a lack of follicle-stimulating hormones (FSH) can lead to reduced germ
cell production. However, the phenomenon is rare in men and can be treated
well. More often, however, there are problems with testosterone. The intake of
hormones, for example in the context of anabolic steroid abuse, can lead to an
excess that permanently damages sperm production. A testosterone deficiency is
also a hindrance to reproduction, which can be attributed, among other things,
to reduced testicular tissue after testicular inflammation (e.g. mumps ) or
undescended testicles as a child.
Gender-independent
factors
Regardless
of gender, the following impairments can also influence family planning:
Injuries,
malformations (e.g. testicles or uterus)
Mental
stress (stress, fear of existence, anxiety disorders)
Metabolic
diseases (diabetes, hypothyroidism)
Lifestyle
factors (smoking; in women, it delays or prevents ovulation; in men, there is
reduced semen production) similar effects are caused by excessive alcohol
consumption and environmental toxins.
Stress
is no child friend
In many
cases, it is also due to a stressful lifestyle or a challenging job that thwarts
family planning. Negative feelings are often reinforced by the environment,
friends, relatives, and one's own image of a "real family".
Psychological pressure can affect the hormonal balance in both women and men,
for example, women may not ovulate. In men, it can inhibit semen production and
worsen sperm quality. It is beneficial to learn relaxation techniques to reduce
stress. Joint yoga, exercise in nature, and light endurance sports not only
connect in partnership but also clear your head.
It has
not been scientifically proven that the psyche is significantly involved in
unwanted childlessness, but it has been shown repeatedly that couples
suddenly become parents without help as soon as they have decided on medical
treatment. It is difficult to walk a tightrope, but a way needs to be found not to make involuntary childlessness a burdensome ongoing issue, but also not display unrealistically positive expectations.
Infertility: Symptoms
In
women, pain in the lower abdomen during the menstrual period (a possible
indication of endometriosis or fibroids ...) and menstrual cycle disorders
(irregularity, cycles of different lengths...) should be clarified by a doctor.
Menstrual cycle disorders can lead to no ovulation, no menstruation, and no
fertilization of the egg cell.
In men,
pain in the lower abdomen, and problems with urination or ejaculation can be
indications of a disease that may promote the development of sterility.
Diagnosis of infertility
In
order to determine the causes of unwanted childlessness and to rule out
possible sterility, there are various examinations for women and men.
Therapy of
infertility
Depending on the result of the examination, the therapy is
aimed at the woman or the man – or at both. There are different ways:
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THERAPY OPTIONS FOR WOMEN |
THERAPY OPTIONS FOR MEN |
THERAPY OPTIONS FOR BOTH PARTNERS |
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Therapy options for women
Below are treatment options for
women:
Weight loss
If you are overweight, male hormones
are produced in the excess fat tissue. Losing weight can help increase the
chances of conception.
Surgery
If organic changes are also involved
as a cause, an operation should definitely be considered before fertility
treatment. Often it is only small interventions that solve the problem on
their own. For example, small fibroids can be removed by
hysteroscopy.
A laparoscopy is necessary for the
treatment of endometriosis, the removal of larger fibroids, or the
"opening" of blocked fallopian tubes. By removing small areas of
endometriosis, the chance of pregnancy can be increased by 30%. If the
fallopian tubes are severely damaged, it is often advisable to remove the
fallopian tubes before in vitro fertilization.
Mental support
An unfulfilled desire to have children
usually leads to insecurity and creates a high level of psychological strain,
which often also puts a strain on the partnership. It's very crucial to
talk about it at length. Psychological support can often relieve a lot of
tension and strengthen confidence in one's own body.
Hormonal treatment
More than 1/3 of women who are
unable to have children have a hormonal disorder. Oocyte maturation can be
supported with hormone-like medication. The drugs are given either as
tablets or injections. Therapy usually begins on the third day after the
onset of menstruation. After about a week, an ultrasound is used to check
whether the egg cells are maturing. At the same time, hormone control in
the blood is carried out.
To induce ovulation, the doctor may
prescribe another drug that contains an active ingredient that is similar to
the body's luteinizing hormone (LH). About 36 hours later, ovulation
begins, and the woman could become pregnant naturally.
The chance of getting pregnant with hormonal stimulation is 15-20% per attempt.
Therapy options for men
Weight loss
If you are overweight, you will not
produce enough sperm. Losing weight can help increase the chances of
conception.
Surgery
Surgery can be considered for
varicose veins in the testicles, undescended testicles, or blockage of the vas
deferens. After such an operation, the man can sometimes realize a common
desire to have children again in a natural way.
Mental support
Stress reduction and relaxation
techniques help to prevent mental blockages because fertility is also closely
related to psychological well-being.
Medication
Antibiotics and
anti-inflammatories for chronic inflammation and infections. Antioxidants,
which are offered and advertised as dietary supplements, are very much in
fashion. The study situation is not yet quite sufficient to recommend it
on a large scale.
Therapy options for both partners
If one (or both) of the partners have
been diagnosed with infertility, it is possible to conceive a child by means of
artificial insemination. When sperm or embryos are placed in the uterus,
it is called assisted reproduction. This term essentially includes
insemination, IVF, and ICSI.
Sperm transfer (insemination)
The semen is processed and the
motile sperm are concentrated and introduced directly into the uterine
cavity. This method should be carried out as soon as possible before
ovulation, but it may also be useful to support egg cell maturation at the same
time.
Couples benefit best if the only
reason for sterility is a slightly reduced sperm quality. The chance of
getting pregnant is well below 20%. If pregnancy occurs, it is usually
during the first 4 attempts, after which the chance of success drops sharply.
This procedure can also be used if
the woman's cervical mucus is too impermeable for the partner's sperm. If
the woman also has fertility problems, insemination can be combined with
hormonal stimulation of the female ovaries. The success rate per treatment
cycle is 7% to 15% with additional hormonal stimulation. After several
treatment cycles, up to 40% can be achieved.
It is also possible to donate sperm
from third parties.
In Vitro Fertilization (IVF)
With in vitro fertilization,
both partners and many causes of sterility are treated at the same
time. It is therefore the method of choice more and more frequently. The
chance of pregnancy is around 35% on average, the highest of all treatment
options. It is unavoidable in the case of severely damaged fallopian tubes
and a severely restricted spermiogram.
In classic IVF, mobile sperm are
added to the egg cells. Fertilization takes place naturally in the culture
medium.
Micro-Injection (Intracytoplasmic
Sperm Injection = ICSI)
It is necessary if the spermiogram
is severely restricted. The best possible sperm are selected at 400x
magnification and injected into the egg cell.
In both IVF and ICSI, the developing
embryos are observed over a few days and assessed daily. After 2-5 days, 1
or 2 embryos are placed in the uterine cavity. The success rate depends on
age and the cause of sterility.
Infertility: what you can do yourself
If conception has not taken place
for more than 12 months despite unprotected sex, you should go to your gynecologist/urologist
to clarify possible causes.
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