Infertility

Elize Kruger
Infertility is something none of us want to consider, but sadly it is becoming more and more prevalent in today’s society. If you have been trying for longer than a year to fall pregnant, you might want to ask your OB/GYN for a basic check-up.

Infertility or Primary Infertility is defined as an inability to fall pregnant within two years of having intercourse without contraception.
Secondary Infertility is not being able to fall pregnant after you’ve conceived a child.

What causes infertility?

Both Male and Female:

• Genetic factors.
• Diabetes mellitus, thyroid disorders, adrenal disease.
• Hypothalamic-pituitary factors.
• Hyperprolactinemia.
• Hypopituitarism.
• The presence of anti-thyroid antibodies.
• Environmental factors.
• Toxins: Glues, some organic solvents, silicones, chemical dust, pesticides, and tobacco.

Female Infertility Causes:
• Hypothalamic-pituitary factors.
• Hypothalamic dysfunction.
• Hyperprolactinemia.
• Ovarian factors.
• Polycystic ovary syndrome.
• Anovulation (not ovulating).
• Diminished ovarian reserve, or Poor Ovarian Reserve.
• Premature menopause.
• Menopause.
• Luteal dysfunction.
• Gonadal dysgenesis (Turner syndrome).
• Ovarian cancer.
• Endometriosis.
• Pelvic inflammatory disease (PID, usually due to chlamydia).
• Tubal occlusion.
• Tubal dysfunction.
• Uterine malformations.
• Uterine fibroids (leiomyoma).
• Asherman’s Syndrome.
• Cervical stenosis.
• Antisperm antibodies.
• Non-receptive cervical mucus.
• Vaginismus.
• Vaginal obstruction.

Male Infertility Causes:
• Hypogonadotropic hypogonadism due to various causes.
• Obesity.
• Drugs and alcohol.
• Strenuous riding (bicycle riding, horseback riding).
• Certain medications: Chemotherapy, anabolic steroids, cimetidine,  spironolactone, phenytoin, sulfasalazine and nitrofurantoin.
• Tobacco smoking.
• Genetic defects on the Y chromosome.
• Y chromosome microdeletions.
• Abnormal set of chromosomes.
• Klinefelter syndrome.
• Neoplasm, e.g., seminoma.
• Idiopathic failure.
• Cryptorchidism.
• Varicocele.
• Trauma.
• Hydrocele.
• Mumps.
• Malaria.
• Testicular cancer.
• Defects in USP26 in some cases.
• Acrosomal defects affecting egg penetration.
• Idiopathic oligospermia.
• Radiation therapy to a testis decreases its function.
• Vas deferens obstruction.
• Lack of Vas deferens often related to genetic markers for Cystic Fibrosis.
• Infection, e.g., prostatitis.
• Retrograde ejaculation.
• Ejaculatory duct obstruction.
• Hypospadias.
• Impotence.