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Infertility is the inability to reproduce even after attempting to do so for a duration of more than a year. In women, this is reduced to six months if her age is more than 35 years, additionally, diagnostic criteria include the inability to stay pregnant. The prevalence of infertility is around 10% of women in the USA, as per CDC data. In all cases, one out of three cases are due to male issues, the other one-third is caused by female concerns, and the others are undefined causes, not attributable to male or female members. Infertility in male and females is caused by a variety of biomedical causes. Sex differences are key in infertility causes.
Male Infertility
10. Physical Structure and Sperm Anatomical Movement
For men, infertility can be connected to the veins on the testicle, a condition termed as varicocele, wherein the veins on the testicle are excessive in structure, which determines the heat in which the sperm is formed: the sperm count and formation are disturbed due to this. Additionally, this sperm’s movement is also affected due to the deformation in shape. This may also happen in concurrence with issues in the reproduction structure that inhibits the flow of sperm. However, aside from structure, birth defects may also influence sperm formation. Cystic fibrosis, cancer, and the resulting radiation also affect sperm and physical structure.
9. Direct and Indirect Environmental Exposure
Modern environment is riddled with chemicals and substances that can have adverse effects on health. Some of these which influence fertility are pesticides, cigarettes, alcohol, radiation, drugs, marijuana, antihypertensives, particular medication, and anabolic steroids. Aside from these direct exposures, indirect exposures that frequently elevate body temperature too high levels may interfere with sperm manufacturing.
8. Reduction in Sperm Count or Abnormality in Delivery and Behavior
A reduced amount of sperm or abnormality in their behavior is a result of various factor, including: testicles that are not descended, DNA defects, steroids, alcohol, marijuana, surgical removal of testicles, varicoceles, trauma to the testicles and/or inguinal area, bacterial infections in the area in the vein of mumps/adenovirus, and radiation. Delivery of sperm is also affected by premature ejaculation, injury to the area, the route to the bladder for sperm instead of exit through penis termed as retrograde ejaculation, and as a by-product of some amount of genetic diseases.
Female Infertility
7. Ovulation and It’s Complications
Ovulation is the movement of the egg to the fallopian tube for fertilization. Therefore, issues with ovulation mean that despite the fully functional sperm, there will be no egg for the sperm to turn into a zygote. Menstrual cycles are indicative signs of a healthy ovulation mechanism: they must be regular and women must not miss the cycles. PCOS is the most common cause of ovulation difficulty: polycystic ovarian syndrome causes infertility; another causal factor is POI or primary ovarian insufficiency, wherein the ovaries deteriorate before menopause, which normally occurs as 40 years of age. Other ovulation concerns include those of fallopian tubes being blocked or tangled via pelvic inflammatory disease, uterus anatomical issues, and uterine fibroids or thick build ups that coagulate on the uterus walls. However such clumps are not related to cancer and are benign.
Ovaries can be affected directly as well: the number of eggs in the ovaries and the quality of the eggs can be altered due to the condition of primary ovarian insufficiency.
6. Hormones
Hormonal issues are common in contemporary times due to the rise of unhealthy substances and pollution. This is also clearly visible in the rising incidents of girls getting their menstrual cycles at early ages and with irregular occurrences of menstruation. Hormones are regulated through the hypothalamus, pituitary gland, thyroid gland, and adrenal gland. Thyroid issues such as excessive or less of the hormone of the thyroid, and gland disorders of PCOS, Cushing’s syndrome, and congenital adrenal hyperplasia cause hormonal issues.
5. Structural Issues
Aside from the structural issues in the ovulation area, anatomical differences that are abnormal in cervix or uterus can cause infertility. Additionally, endometriosis and scar tissue are also causes, wherein the former occurs when wrong tissue growth is present on the outer side of the uterus.
4. Pelvic Adhesions
These are formations of scar tissues that tend to form links between differing organs after infection the pelvis or after surgery in the area such as appendicitis.
3. Fallopian Tubes
These tubes connect the ovaries, which contain all the eggs to be fertilized, to the uterus, where the fertilized zygote to the walls to grow into a fetus. Damage to the tubes from pelvic infections and surgeries prevents the free flow of eggs to the area where sperm can actually reach, as they cannot swim up all the way to the ovaries. This damage can occur due to PID, pelvic inflammatory disease, chlamydia, and gonorrhea.
2. Diseases
Certain diseases are precipitating factors for infertility: among these include sickle cell disease, diabetes, celiac disease, and kidney disease. Celiac disease is wherein the small intestine is affected, pregnancy complications arise causing miscarriage, the inability for the baby to grow fully inside the uterus, and complications after birth in the child such as low weight. Sickle cell disease is an inherited condition wherein the hemoglobin, which stores the oxygen for the body, is deformed. The relation to infertility is the same inability for the baby to grow in the uterus, with pre-eclampsia and abortion that can be instantaneous.
1. Self-Inflicted Risk Factors
These are all biomedical conditions that cannot be entirely under the control of the individual, of either sex. However, there are other risk factors that are entirely under the control of the individual which deals with lifestyle and health choices. These risk factors are the same for both the sexes. One that is out of control but natural is aging, as individuals age, the quantity, and quality of reproductive elements will decrease. Tobacco and marijuana: both of these interfere with fertility issue, whilst also interfering the treatment for fertility and cause a higher rate of miscarriage in women while causing erectile dysfunction in men. Alcohol is detrimental in that it should not be consumed during pregnancy by women, whilst is mostly interferes with sperm elements in the male sex. Obesity and overweight based on BMI as well as being underweight cause infertility, so both extremes are undesirable. Exercise is a final corollary to these factors: no exercise combined with a bad diet is equally bad as over-exercising. For women, too much exercise causes infertility.
Infertility is a delicate issue as it takes away the fundamental actions of all species: reproduction. It can be difficult to deal with medically and psychologically, therefore, consider the self-inflicted risk factors and combat them wisely.
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