Infertility in Men and Women

Infertility in Men and Women | Dr. Ali Ghahary

Infertility, which is defined as the inability to conceive after one year of regular, unprotected intercourse, is something that is much more common than you might realize. In fact, 1 in every 6 couples in Canada experience problems with fertility; and, if you’re not directly impacted by fertility problems, then you most likely know someone who is or has been affected by it in the past.

There are many reasons why couples may have trouble conceiving, and those reasons differ between males and females.

When it comes to women and infertility, age can play a significant role. A woman’s fertility can decline by as much as 40% in her early 30s, and declines even further by the time they reach the age of 40. Different types of medical conditions can also cause issues with fertility in females; the most common conditions being PCOS (polycystic ovary syndrome) and endometriosis. PCOS is a condition that causes an imbalance in hormones and results in menstrual and ovulation cycles becoming disrupted. In addition to infertility and menstruation irregularity, PCOS can also cause other symptoms, including excess weight, excess hair, as well as acne. As many as 30% of women who are infertile also suffer from polycystic ovary syndrome. Endometriosis is a very common condition that occurs in women. With endometriosis, the tissue that lines the uterus (also known as the endometrial tissue) winds up growing in other areas of the body, such as the pelvis. This tissue then gets trapped, resulting in inflammation and the formation of scar tissue which can cause the pelvic structures to stick together, and can also cause damage to the ovaries and blockages to the fallopian tube, which prevents fertilized eggs from travelling to the uterus, thus affecting implantation. Aside from infertility, some common symptoms of endometriosis include painful periods, excessive bleeding, pain with intercourse, and severe pelvic pain. Weight can also cause issues with fertility. For example, if a woman is underweight and has a low percentage of body fat, they can develop issues with ovulation. Similarly, being overweight can also cause the same problems. In this case, it’s important to try and maintain a healthy weight. However, sometimes as much as a 5% change in weight can be enough to improve a woman’s chances at becoming pregnant (as long as there are not other contributing factors.) If a woman has had a sexually transmitted infection that has gone untreated, this can lead to a condition known as PID – also referred to as pelvic inflammatory disease. In many cases, an STI will not necessarily cause symptoms, meaning you are less likely to get tested and seek out treatment. However, if you have unprotected sex or have had multiple sexual partners, then it’s important to be tested for any potential STDs/STIs. Stress and poor diet have also been linked to infertility in females.

Males can also have problems with fertility. Contributing factors that can make a male infertile include excessive alcohol use, drug use, tobacco use, certain environmental toxins, as well as health problems like kidney disease, mumps, or issues with hormones. Men can also develop fertility problems from certain medications they may be taking, and if they’ve undergone treatment for cancer (such as chemotherapy or radiation.) Like women, age can also play a role. Fertility in males tends to start to decline after age 40, and sperm quality decreases. This not only makes it harder for their partner to conceive, but also increases the risk of miscarriage.

In order to determine whether or not you have fertility problems, a number of different tests can be done. For women, these tests often consist of things such as pap smears (to check for things like cervical cancer or other problems that could prevent pregnancy), urinalysis, transvaginal ultrasound, and surgical procedures like a laparoscopy or hysteroscopy. Blood tests can also be ordered to check a woman’s follicle-stimulating hormone levels. For men, tests can consist of a physical examination, hormone evaluation, sperm and semen analysis, as well as a blood test known as an anti-sperm antibody test. Getting these tests done will help your healthcare providers determine the root cause of your infertility issues.

There are many different ways in which infertility issues can be treated in both men and women, including with medication, assisted reproductive technology, and artificial insemination. In some cases, these treatment methods may be combined. Assisted reproductive technology is done by removing eggs from a woman’s body, mixing them with sperm to create embryos, then placing those embryos back in the woman’s body. IUI (intrauterine insemination) and IVF (in vitro fertilization) are also two common methods used for fertility treatment. During IUI, concentrated and processed sperm is directly inserted into a woman’s uterus. This is a method that is timed with a woman’s ovulation and can be performed as much as twice per day. IVF, which is considered to be one of the most common and most successful methods of fertility treatments, includes the stimulation of ovaries and egg retrieval. Those eggs are then fertilized in a laboratory, and the resulting embryos are then transferred into the uterus.

It is important to note that issues with infertility can have a major psychological impact on couples. If you are struggling with infertility, remember to pay close attention to your own mental health as well as the mental health of your partner, and take the steps that you need to take in order to help yourself and your partner get through this challenging time – whether it’s having an open dialogue with each other, discussing infertility with close friends or family members, seeking help from a therapist, or even practicing calming exercises such as meditation or yoga.

For more on fertility problems, visit HealthLink BC.