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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