Men
Infertility in men is diagnosed by semen analysis tested for parameters such as sperm count/ concentration, motility and morphology. Causes of male infertility can be categorically listed down as follows:
- Disruption of ejaculatory functions: Variceoles (inflammation of veins on the testes causing the production of heat affecting sperm count and quality), trauma to the testicles, lifestyle habits such as smoking, drinking and unprescribed consumption of drugs, cancer treatment involving chemotherapy and targetted radiation, diabetes, infections, cystic fibrosis and some autoimmune disorders may cause failures in testicular functioning.
- Hormonal disorders: Caused by improper functioning of the hypothalamus or the pituitary gland influencing the testes and sperm development.
- Genetic disorders: Disorders such as Klinefelter’s syndrome, Y-chromosome microdeletion, myotonic dystrophy are among the few genetic conditions that can cause a male to produce very low to no sperms in their semen.
Women
Women need to have fully functional ovaries, a fallopian tube and a uterus to have a successful pregnancy. Any condition affecting one or more of these organs may lead to infertility in women.
- Ovarian dysfunction: Some indications of ovarian dysfunction includes anovulation (inability to ovulate), PCOS (polycystic ovarian syndrome), DOR (diminished ovarian reserve- less number of eggs in the ovary at a given age, FHA (functional hypothalamic amenorrhea- caused by factors such as excessive exercise, extreme diet habits and intense stress), improper functioning of hypothalamus and pituitary gland and POI (premature ovarian insufficiency- a condition where a woman reaches menopause prematurely).
- Fallopian tube obstruction: The fallopian tube is extremely vital to a successful pregnancy, the fertilization of the egg by the sperm takes place in the fallopian tube. A blocked fallopian tube, presence of sexually transmitted infections in the body such as gonorrhoea or chlamydia, pelvic infection, history of abdominal surgery or ruptured appendix and known endometriosis are some of the symptoms that may cause a disruption in the functioning of the fallopian tube.
- Uterine physiology: The structure of the uterus is very important to grow and nurture the foetus for a successful pregnancy. Fibroids or other uterine abnormalities can make it unsuitable for the placenta to attach and the foetus to grow, leading to infertility or miscarriage.
Treatment:
Doctors can treat infertility in a number of ways. On the basis of the following factors, the clinician may advise medicine, surgery or assisted reproductive technologies among other things:
- Cause of infertility
- Age of the female
- The consent of the trying couple and their preferential treatment
Assisted Reproductive Technologies (ART)
This is a revolutionary technique to allow infertile couples to bear children. One of the most prominent ART techniques is IVF (in-vitro fertilization). This procedure involves the surgical removal of an egg from a woman’s body and sperms from the male body and force-fertilized in a petri-dish or a test tube in a laboratory. Once the fertilization has been confirmed, the zygote is planted back into the woman’s uterus. After observation, the uterus continues to grow and nourish the zygote leading to a successful pregnancy.
Other ARTs include ICSI (intracytoplasmic sperm injection), where the sperm is injected directly into a viable egg, and ZIFT/GIFT (zygote/ gamete intrafallopian transfer) where the fertilized zygote or an individual gamete is placed into the fallopian tube in hopes of inducing a natural embryo developmental process.
Intrauterine Insemination (IUI)
This technique is also called artificial insemination. Specially treated sperms are manually inserted into a woman’s uterus. Often times before the procedure, the woman is subject to a number of drugs to stimulate the uterus and the ovaries to accept the sperms for successful fertilization.
Couples can also go for surrogacy, adoption and sperm or egg donation to combat infertility based on preference and medical advice.
Conclusively, infertility is like any other medical disorder. With timely intervention, there are a lot of possible and viable options to explore. We should stop looking at an infertile couple as a pariah and instead offer them help and support and make them feel comfortable about their bodily functions, nothing wrong with them. One thing that may hinder infertile couples from exploring assistive pregnancy through ARTs and IUI is the fact that they are extremely expensive and not everybody can afford them. But clinical counselling will allow you to opt for the best way going forward.
Let’s normalize infertility and treat it as such- a disorder that can be combatted with mindfulness and early intervention!
Aashritha Ramesh
BTech Biotechnology
