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Cause of Male and Female
Infertility
What is
Infertility?
A couple is considered infertile if the woman does not
conceive a child after one year of unprotected, well-timed intercourse or she
has been unable to carry a pregnancy to a live birth. The diagnosis is sped up
for women over 35. Treatment is normally recommended after six months of trying
to conceive.
It is a medical problem of both male or female reproductive system. In 40% of
cases, the cause is traced to the woman, another 40% of cases are traced to the
man. The rest are caused by unknown factors or a physiological incompatibility.
Women under the age of 35 are usually
advised to try for 12 months before consulting a physician. A couple that knows
of adverse medical conditions, such as irregular menstrual cycles or a history
of tubal infections, should consider a basic examination sooner. Doctors usually
advise women over age 35 to have an initial examination after only six months of
trying, while those over 40 may begin fertility tests immediately.
Couples should have sexual relations 3 to 4 times a week during the week before
ovulation. The egg (oocyte) only survives for 24 hours after ovulation, so good
timing is essential.
In some couples, infertility can be attributed to one specific
factor such as low sperm count, fallopian tube damage, or a problem with
ovulation. For others, a variety of factors may be present. Causes of
infertility also include improper sexual technique, stress, smoking, alcohol, or
drug use. In about 10 percent of infertile couples, there is no apparent cause.
For the woman, the physical exam may include a pap smear, pelvic
exam, cervical cultures, urine analysis, blood tests, and pelvic imaging.
The man will usually undergo a semen analysis and, in some cases, a general
physical exam.
Infertility Tests
Semen Analysis
The semen analysis, used to detect male fertility
problems, should be performed immediately unless the man has recently proven
fertility. He provides a semen sample by masturbation or through intercourse
with the use of a special condom. A laboratory examines the sample for the
volume of the ejaculate and the number (count), movement (motility), and the
size and shape (morphology) of the sperm, as well as their ability to survive
for several days.
If the semen analysis shows abnormalities, the man should consult with a
urologist who is versed in infertility. Repeat the test if the semen analysis
results are borderline.
Testing and monitoring ovulation
If the woman has regular menstrual cycles, the couple can
do the first two of these tests at home to make sure they are having sex at the
right time, just prior to ovulation.
Basal body temperature (BBT) charting
In most women, body temperature before ovulation is low
(97.2 to 97.4°F) and rises above 98°F just after ovulation. A slight
temperature rise (0.5°F) at the middle of the menstrual cycle indicates that
ovulation could have occurred.
Beginning with the first day of menstruation, the woman takes her temperature
immediately upon awakening each morning, using a basal thermometer. Basal
thermometers give precise temperature measurements. She records the temperature
on a BBT chart.Other events such as intercourse, bleeding, sleepless nights, or
an illness should also be noted on the chart.
Ovulation test kits (the LH surge test)
The woman tests her urine for the presence of lutenizing
hormone (LH) with an over-the-counter ovulation test kit. A woman’s body
produces a surge of LH before ovulation. A positive test result indicates that
she will probably ovulate in about 12 to 36 hours.
Progesterone level (blood test)
Before ovulation, a developing follicle in the woman’s
ovary makes estrogen. When the follicle releases the egg at ovulation, the
follicle remnant--the corpus luteum-- makes less estrogen and a greater amount
of the hormone progesterone. Progesterone prepares the uterine lining for the
arrival of the embryo and increases the basa
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