Causes of infertility

Infertility can be male or female.

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Male infertility

Some time has passed, the problems that prevented you from thinking about having a child have been solved: your career is done, your financial situation has stabilized, your housing problems have been solved. It's high time to have a child. But... Unfortunately, it often happens that many successful, loving couples face the problem of infertility.

When people talk about infertility, they usually mean female infertility, forgetting that male infertility accounts for slightly less than 50% of these sad statistics.

Considering that the male reproductive system is no less vulnerable than the female one, it can be adversely affected by many factors. These include the environment (or rather, its unfavorable factors), various diseases, bad habits, and stress. Moreover, an infertile man, as a rule, does not experience any unpleasant sensations, he considers himself completely healthy and is extremely surprised when a doctor offers him to do a spermogram analysis.

The fact is that in most cases male infertility is caused by a violation of spermatogenesis (sperm maturation). This is secretory infertility. The most common cause (about 50%) is a violation of blood circulation in the testicles, associated with the expansion of the veins of the spermatic cords - varicocele. Another 35% of cases of male infertility are "provided" by infectious and inflammatory diseases of the genitals. Autoimmune infertility is much less common, associated with the fact that the immune system of the body itself damages the tissue of the testicles and sperm. And infertility is very rarely caused by genetic diseases.

Thus, male infertility is manifested by the inability to fertilize regardless of the ability to perform sexual intercourse. Causes: absence of spermatozoa (azoospermia), absence of ejaculate (aspermia), decrease in the proportion of live spermatozoa in semen (necrospermia). It has been established that if sperm motility is less than 75% (of their total mass), then we can talk about male infertility.

A marriage is considered infertile if pregnancy does not occur within one year of regular sexual intercourse in persons of childbearing age without the use of contraceptives. Both partners must be examined. The "peak" of fertility, both for men and women, is at 24 years of age. Therefore, men over 35 years of age should begin examination without wasting time.

Modern diagnostic and treatment methods 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 can be primary and secondary. Primary infertility is characterized by the absence of pregnancy in the woman's life history (anamnesis). Secondary infertility is when a woman has had pregnancies that ended in childbirth, abortions, ectopic pregnancies, and then, for one or more years of regular sexual activity without the use of contraceptives, pregnancy does not occur.

Statistics have proven that in primary infertility, the most common causes are hormonal imbalances (3 times more often), in secondary infertility - inflammatory processes of the genital organs (the most common is tubal infertility).

Causes of female infertility may include both diseases of the genital area and extragenital pathology (infections, intoxications, industrial hazards, radiation, etc.), as well as the conditions and lifestyle of the woman (poor nutrition, vitamin deficiencies, constantly high nervous tension, psychosomatic disorders and related diseases - hypertension, gastric ulcer and duodenal ulcer, etc.). Often, infertility in women is caused by inflammatory diseases of the uterus and appendages. In this case, one of the signs of such inflammatory processes is pain and leucorrhoea (vaginal discharge).

Cervical erosion, inflammation of the cervical canal (endocervicitis) reduce the possibility of conception; changes in the composition of cervical mucus prevent sperm from entering the uterine cavity. Neoplasms of the uterine body (myomas), accompanied by bloody discharge from the vagina and bleeding, play a certain role in female infertility. The presence of congenital malformations of the genitals (absence of ovaries, etc.) are also a cause of infertility. In addition, some couples may experience 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 the sealing of the uterine or ampullar sections; sperm cannot reach the egg, and the egg cannot pass into the fallopian 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 cannot enter the fallopian tube. The causes of hormonal (endocrine) infertility, which is second in secondary infertility, can be:

• disruption 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 by the pituitary gland.

The information presented allows a young couple, provided that they are planning their family responsibly and in a businesslike manner (not in words), to seek medical advice from a gynecologist and begin diagnosing the causes of infertility.

In this case, if we are talking about primary infertility, the examination begins with the man - sperm is examined. If the examination allows to exclude male infertility, the woman is examined. Considering that the main cause of primary infertility is 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 testing usually begins with diagnosing the patency of the fallopian tubes. If the fallopian tubes are well patented, a hormonal examination of the woman is necessary. Treatment is carried out depending on the pathology identified; however, diagnostics in modern conditions is by no means limited to the two areas indicated. If necessary, it is deployed with all its modern power, including medical genetic counseling, etc., etc., which ultimately opens a bright and fruitful path for targeted treatment, ensuring the development of pregnancy, including artificial pregnancy.

However, it should be especially emphasized that in reproductive age, the most important problem is the risk of contracting sexually transmitted diseases, as they can become a formidable cause of infertility. Therefore, basic ideas about venereal diseases can help newlyweds to take the path of a permanent sexual partnership that ensures the preservation of their own health, the health of the developing fetus and the newborn baby.

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