Infertility can be a sneaky little issue that can creep on both men and women without any warning. You may not suspect infertility until you and your partner start trying to conceive. When a couple is unable to conceive after a year of trying, they could be facing fertility issues. Can you identify infertility before that? Are there any signs and symptoms of infertility to watch out for? Come, let’s find out.
Infertility is a disease that affects the reproductive system. Infertility is the inability to conceive even after a year or more of having unprotected sex. Infertility can occur due to various factors. Sometimes, the reason for infertility may not be known. Many may not be aware of their infertility until they try to conceive. While some causes of infertility are preventable, some will need treatment or assistance in getting pregnant.
Infertility can affect anyone with reproductive organs – be it a male or a female. Millions of people across the world have infertility. Not all cases of infertility are reported and recorded. One main reason is the person may be unaware of themselves or may not want to discuss this private issue with anyone – even a doctor.
Gone are the days when only women were checked for infertility. With the advancement of science and awareness, even males are tested for infertility. Sometimes, both partners may not have any fertility issues but may still struggle to conceive. In such cases, it is known as unexplained infertility, and assisted reproductive technology can help them conceive.
Infertility in women is not restricted to the regularity of her menstrual cycle or her egg reserve. Infertility in females can be due to many reasons. Some common reasons are:
1. Tube Disorder – A block in the fallopian tubes can prevent the sperm from travelling up to meet the egg or can prevent the egg from coming down for fertilisation and implantation, thus preventing pregnancy.
2. Uterine Disorder – An issue with the uterus like fibroids, endometriosis, or some issue present since birth can cause infertility.
3. Ovarian Disorder – Issues with the ovaries like PCOD, PCOS, POI, or ovarian cysts can interfere with conception or pregnancy, thus leading to infertility.
4. Endocrine Disorder – The endocrine system produces hormones, including reproductive hormones. An endocrine disorder can lead to hormonal imbalance, which can result in fertility issues.
5. Maternal Age—The older a woman gets, the less her egg reserve will be. A woman’s egg reserve and fertility start dwindling once she reaches her 30s. After the age of 35, her egg reserve decreases drastically, leading to fertility issues or delays in conception.
6. Health Issues—Certain underlying health conditions, such as lupus, diabetes, hypertension, and asthma, can impact fertility in the long run.
7. Weight – Being severely overweight or having a very high BMI can interfere with conception attempts or lead to infertility.
8. Exposure – Exposure to toxins, nicotine, or excess alcohol can also affect fertility.
9. Infections – Sexually transmitted diseases and illnesses can affect a woman’s fertility. It may or may not be treatable.
10. External Damage – Damage to any part of the reproductive system due to some accident, surgery, or any injury can affect a woman’s ability to conceive.
Yes, men can have infertility too. Some common causes of infertility in men are:
1. Issues with Sperm – The most common infertility cause is some issue with the sperm. It could be poor sperm health, low or no sperm production, damaged sperm, or sperm with low motility that can affect the sperm’s ability to fertilise an egg.
2. Sexual Dysfunction – Issues like erectile dysfunction, inability to ejaculate, or premature ejaculation can cause infertility.
3. Physical Issues – An issue with the testicles, like an injury or undescended testicles, can prevent pregnancy.
4. Health Issues – Underlying health issues like hypertension, endocrine disorders, infections, inflammations, or immunity issues can interfere with their fertility.
5. Hormonal Issues – Hormonal issues can affect male fertility too. Very low levels of the luteinising hormone can affect a male’s libido, and very high levels of the luteinising hormone can damage the testes and affect sperm production. Hyperprolactinemia is the condition where the pituitary gland produces excess prolactin, and this can decrease testosterone or sperm production, reduce libido, and can also cause erectile dysfunction. Hypogonadism is a condition that interferes with the production of the male sex hormone – testosterone.
6. Varicocele – Enlarged veins in the scrotum – the sac that houses the testes, can decrease sperm production and testicular function, thus causing fertility issues.
7. Genetics—Genetic disorders like cystic fibrosis, Klinefelter syndrome, Robertsonian translocation—a structural rearrangement of the chromosomes—and Noonan syndrome—mutation in more than eight genes and missing or issues with the Y chromosomes can cause infertility.
8. Injury – An injury to the reproductive organs can affect sperm production and the functioning of the organs.
9. Vasectomy – Surgical sterilisation, unless reversed, will prevent the release of sperm and hence pregnancy.
10. Exposure – High exposure of the testes to heat like sauna, bathtub, and tight clothing; exposure to chemotherapy or radiation and other harmful toxins can interfere with fertility.
The most common symptom of infertility is the inability to conceive naturally, even after one year of having unprotected sex. Men and women may experience certain signs and symptoms of infertility, but these can be easily missed or mistaken for other health issues.
Signs of Infertility in Women
● Lack of periods
● Irregular periods
● Abnormal periods – very little or excess bleeding during periods
● Painful periods
● Low libido
● Symptoms of hormonal imbalance like excess weight gain, thinning of hair, facial hair growth, excess body hair, acne, abnormal growth of breasts,
● Difficulty in ejaculating fully
● Lack of ejaculation
● Swollen or painful testicles
● Unable to hold an erection
● Penile disorders
● Symptoms of hormonal imbalance
If a woman is unable to conceive, the doctor will take the following tests to check her fertility levels:
● A pelvic exam to check for any structural issues
● A blood test to check hormones
● A transvaginal ultrasound to get a closer look at the vagina and the reproductive organs
● A hysteroscopy to check the uterus
● A saline sonohysterogram is to check the reproductive organs after filling the uterus with a saline water solution.
● A sono hysterosalpingogram (HSG) to check for tubal blockages
● An HSG X-ray to check for tubal blockages
● A laparoscopy helps identify issues inside the uterus, like endometriosis, uterine fibroids, and scar tissue, which can interfere with fertility.
If a man is unable to impregnate his partner, the doctor will take these tests to check for infertility:
● An analysis of the semen to check the sperm count, mobility, and morphology. If the male is unable to ejaculate enough sperm for the test
● A blood test to check the hormone levels and genetic chromosomal abnormalities.
● An ultrasound of the scrotum to check for testicular issues or varicoceles.
Medication, surgery, and lifestyle changes can help many men and women overcome fertility issues like hormonal imbalance, structural problems with the reproductive organs, or excess weight and stress.
Assisted reproductive techniques like IVF, IUI, ICSI, assisted hatching, or using a donor egg, donor sperm, or a surrogate can help couples suffering from infertility.
Infertility affects more people than you are aware of. It is not uncommon or entirely preventable or under one’s control. Getting tested and undergoing timely treatment can help many couples overcome their infertility.
If you and your partner are unable to conceive even after a year of having unprotected sex, you should consult a fertility specialist. They will take the required tests to check for infertility in both partners and help narrow down the possible reason for infertility as well.
Unlike many diseases, infertility does not have specific feelings associated with it. Lack of sex drive, inability to hold an erection or ejaculate in men, and irregular periods in women are some common symptoms. Many infertile individuals will not know about their infertility until they take a clinical test.
Some fertility issues can be resolved or improved with the help of medications, surgery or lifestyle changes. IVF, IUI, ICSI, the use of donor eggs or sperm, and surrogacy are some ways in which couples can have children despite their fertility issues.
There could be many reasons for you not getting pregnant. It could be fertility issues with you, with your partner, stress, age, weight implantation issues, or even psychological issues. Not having unprotected sex the right way on fertile days can also prevent pregnancy.
