What is Infertility ?
Infertility is a disease of the reproductive system that impairs one
of the body's most basic functions: the conception of children. Conception
is a complicated process that depends upon many factors: on the production
of healthy sperm by the man and healthy eggs by the woman; unblocked
fallopian tubes that allow the sperm to reach the egg; the sperm's
ability to fertilize the egg when they meet; the ability of the fertilized
egg (embryo) to become implanted in the woman's uterus; and sufficient
embryo quality.
Finally, for the pregnancy to continue to full term, the embryo
must be healthy and the woman's hormonal environment adequate for
its development. When just one of these factors is impaired, infertility
can result.
What Causes Infertility ?
No one can be blamed for infertility any more than anyone is to
blame for diabetes or leukemia. In rough terms, about one-third
of infertility cases can be attributed to male factors, and about
one-third to factors that affect women. For the remaining one-third
of infertile couples, infertility is caused by a combination of
problems in both partners or, in about 20 percent of cases, is unexplained.
The most common male infertility factors include azoospermia (no
sperm cells are produced) and oligospermia (few sperm cells are
produced). Sometimes, sperm cells are malformed or they die before
they can reach the egg. In rare cases, infertility in men is caused
by a genetic disease such as cystic fibrosis or a chromosomal abnormality.
The most common female infertility factor is an ovulation disorder.
Other causes of female infertility include blocked fallopian tubes,
which can occur when a woman has had pelvic inflammatory disease
or endometriosis (a sometimes painful condition causing adhesions
and cysts). Congenital anomalies (birth defects) involving the structure
of the uterus and uterine fibroids are associated with repeated
miscarriages.
How is Infertility Diagnosed ?
Couples are generally advised to seek medical help if they are unable
to achieve pregnancy after a year of unprotected intercourse. The
doctor will conduct a physical examination of both partners to determine
their general state of health and to evaluate physical disorders
that may be causing infertility. Usually both partners are interviewed
about their sexual habits in order to determine whether intercourse
is taking place properly for conception.
If no cause can be determined at this point, more specific tests
may be recommended. For women, these include an analysis of body
temperature and ovulation, x-ray of the fallopian tubes and uterus,
and laparoscopy. For men, initial tests focus on semen analysis.
How is Infertility Treated ?
Most infertility cases "85 to 90 percent" are treated
with conventional therapies, such as drug treatment or surgical
repair of reproductive organs.
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