Infertility
Nowadays, infertility is a major worldwide issue. According to The Center For Disease Control and Prevention (CDC) https://www.cdc.gov, infertility refers to being unable to get pregnant (conceive) after one year (or longer) of unprotected sex. Because fertility in women declines steadily with age, some providers evaluate and treat
women aged 35 years or older after 6 months of unprotected sex. Women with infertility should make an appointment with a reproductive endocrinologist — a doctor who specializes in managing infertility. Reproductive endocrinologists may also help women with recurrent pregnancy loss, defined as having two or more
spontaneous miscarriages.
Infertility Rates in the UK
Several recent surveys have proved what many people have thought for a long time: that infertility rates in the United Kingdom are on the rise. This is not a new condition; infertility has increased dramatically in the previous 60 years. We are not alone in this; infertility is on the rise across the developed world.
Is this just a sociological phenomenon resulting from women deferring parenthood until their mid-30s, when fertility diminishes, because of higher education and employment opportunities? Or are there other, more complicated variables at work? Is infertility on the rise in the UK because of environmental issues affecting sperm
quality? And what can people who aren’t sure if they want to have children do to protect their fertility and keep their options open?
The Office for National Statistics (ONS) produced a study in August 2019 confirming that the birth rate in England and Wales had dropped to a new low in 2018. According to the research, from a high of 20.5 live births per thousand inhabitants in 1947, the rate has dropped to 11.1 births in 2018. The ONS suggests that this dramatic drop could be due to both an aging population and falling birth rates.
A significant IVI study on decreased male fertility supports their findings. Another study looked at the total mobile sperm count, which is the most important determinant in the likelihood of conception. In just over a decade, the percentage of males at risk of needing reproductive therapy has nearly doubled, from 12.4 percent in 2004 to 21.3 percent in 2017.
Could environmental factors be the cause of infertility?
Environmental factors could affect male infertility and sperm health. Male infertility can be caused by a variety of circumstances, but absent a particular medical cause, the focus is increasingly on environmental and lifestyle variables. The quality of sperm can be harmed by heat, chemicals, and poisons. The following are some of my specific concerns:
- Herbicides and pesticides, organic solvents, and paint pigments are all examples of industrial and agricultural chemicals. These things can affect sperm quality.
- Radiation or X-ray exposure can cause a temporary or permanent reduction in sperm count and quality.
- Overheating, such as through frequent use of hot tubs or saunas, can lower sperm quality, as can an increase in scrotal temperature from sitting for extended amounts of time, wearing tight clothing, or even using a laptop for long periods.
- Drugs, alcohol, and tobacco use can have a significant impact on male fertility. Obesity has been linked to lower fertility, and even depression and stress can affect sperm quality.
Can Social changes lead to the rise in infertility?
We often hear that social changes are to blame for the surge in infertility. The fact that women have more freedom to choose between a job and family, social constraints that encourage many to put off having children until they have established a profession, financial security, and finding the perfect spouse, are frequently noted. As a result, many women delay having children until their mid-to- late-thirties, although it is generally known that fertility falls in the early thirties and gradually declines until the early forties, after which most women have a poor fertility prognosis.
These social variables are undeniably important, but another element contributing to the rise in infertility is the widespread loss in sperm quality. Men’s sperm counts have more than halved over the previous 40 years, according to a study by the Hebrew University of Jerusalem. Men are affected by the same social variables that
impact women. They, too, are delaying having children, and there is mounting evidence that the quality of men’s sperm reduces as they age. Their ‘best before’ date is almost 40 years old.
What are the causes of female infertility?
There is a lot of body-related infertility issues.
Disturbance of oocyte maturation
To become pregnant, women must have functioning ovaries external symbol, fallopian tubes external icon, and uterusexternal icon. Infertility in women can be caused by problems with any of these organs. Some of these conditions are described below, and they can be assessed with a variety of tests.
A woman’s menstrual cycleexternal icon is, on average, 28 days long. Day 1 is defined as the first day of “full flow.” Regular predictable periods that occur every 24 to 32 days likely reflect ovulation. A woman with irregular periods is normally not ovulating.
The capacity to conceive is heavily influenced by hormonal balance. Hormonal imbalances can cause oocyte maturation problems, anovulation, and luteal phase defects. Elevated levels of male hormones (androgens) with ovarian cysts are frequently discovered to be the reasons for infertility. Being underweight or overweight, rapid weight growth or loss, excessive physical load, thyroid function abnormalities, tumors (rarely), medication, and stress are all variables that might disrupt hormonal balance.
Tubal factor infertility
The fallopian tubes cause infertility in one-third of the women who are affected. They may be partially or fully blocked. Infection is the most common cause of damage to the tubes. Previous ectopic pregnancies, adhesions following surgery, or spontaneous endometrial proliferation are also possible causes (endometriosis).
Endometriosis
Endometriosis is a condition in which the endometrium grows outside of the uterus. It’s still unclear why this happens. Small amounts of endometrial tissue reach the abdominal tissue through the fallopian tubes during menstruation, where it clings to organs and can cause adhesions. This causes excruciating menstrual pain.
Abnormalities of ovaries, fallopian tubes, or the uterus
These occurrences are unusual, approximately 5 in 100 women. The anomalies can manifest themselves in varying degrees and are frequently inherited.
Antibodies against oocytes or sperm
Occasionally, the body cannot recognize its oocytes. Antibodies are produced by the immune system in response to them. Antibodies against a man’s sperm are more frequently produced in the cervical mucus.
What are the causes of Men’s infertility?
Disturbances of sperm maturation
The most frequent disorder of male fertility is the impaired production of normal and motile sperm in the seminiferous tubules. The normal quality of the male sperm means that the number of sperm cells is above 20 million per ml.
At least 50% of these should have high motility and 30% should be normal-formed sperm. The man’s ability to father a kid is limited if certain thresholds are not met. Even though the results of the semen analysis are normal, a functional problem can prohibit sperm from entering the egg.
A mumps infection throughout childhood may cause sperm maturation problems. Low sperm quality can also be caused by varicoceles (varicose veins in the testicles) or tobacco usage. Endocrine diseases, stress, pollution, undescended testicles, cancer surgery, or hereditary factors like DNA damage are among the other causes
(chromosome abnormality). Acute infections can also cause temporary sperm quality reduction.
Sperm transport disorders
A significant number of sperm cells are produced, but they do not reach the woman’s body after ejaculation due to a blockage in the vas deferens. This scenario is akin to a woman’s fallopian tubes being obstructed. A previous vasectomy, underdevelopment, or obstruction of the epididymis are all possible causes. Inflammation of the epididymis might cause it to become blocked.
Unexplained infertility
Even when investigations have been extensive, some couples will have no reason to explain their infertility. This can often be a frustrating diagnosis. In these cases, the duration of the infertility is the best parameter by which to judge the chances of future natural conception; the longer the time of infertility, the sooner intervention should be considered.