The Burden of Infertility; What you need to know

...with a baby or without, you are valuable, you are whole and you matter...

Recent data available shows that nearly 50 million couples worldwide experience infertility and nearly 50 percent of gynecology outpatient consultations in countries all over the world are infertility related.

Many homes continue to experience the agony of childlessness and the accompanying turbulence that comes with infertility in some parts of the world. While some couples enjoy the privilege of becoming parents, the same is not the case for many who continue to hope they will one day experience the joy of parenthood.

Infertility is defined as the inability to achieve a clinical pregnancy despite having frequent, regular (up to 3 to 4 times in a week) unprotected sex for at least a year. The inability to become pregnant or the inability to carry a pregnancy to a live birth is considered, primary infertility. On the other hand, the inability to become pregnant or the inability to carry a pregnancy to a live birth following either a previous pregnancy or a previous ability to carry a pregnancy to a live birth, is classified as secondary infertility. 

Infertility may be due to a single cause in either partner, or a combination of factors that may prevent a pregnancy from occurring or continuing. Fortunately, there are many safe and effective therapies for overcoming infertility. These treatments significantly improve the chances of becoming pregnant.

As the burden continues to stare many couples in the face, seeking early counselling, towards a diagnoses of the problem is very important for couples and treatment is often available.

The methods within infertility treatment have improved immensely over the last 2 decades even though there remains an inequitable degree of access and varying affordability to treatment modalities such as assisted reproductive techniques (in vitro fertilization) in many developing countries. This is a huge reproductive health concern.

Causes of infertility can more or less be divided into 3 equal parts. A female part, a male part and a third unexplained part.

Common causes in men include;

Abnormal Semen due to a medical condition, infection, hormonal imbalance, or ejaculation disorders, medications which can reduce sperm count, Mumps, radiation exposure and even mental stress.

Common causes in women include  ovulation disorders/hormonal imbalance, anatomic problems which affect the uterus or fallopian tubes, other medical conditions and medications. Advancing age, excessive exercise, sexually transmitted infections (STIs),smoking, alcohol consumption and mental stress  are also risk factors in women

The main sign of infertility is the inability of a couple to get pregnant. There may be no other obvious symptoms.

In some cases, an infertile woman may have irregular or absent menstrual periods. An infertile man may have signs of hormonal problems, such as changes in hair growth, sexual function, reduced sexual desire, or problems with ejaculation. He may also have small testicles or a swelling in the scrotum.

When should you consider seeing a doctor

In general, you may consider seeing a doctor about infertility if you and your partner have been trying regularly to conceive for at least one year.




You may consider being seen earlier if you're a woman and:

• You're age 35 to 40 and have been trying to conceive for six months or longer 
• You're over age 40 
• You menstruate irregularly or not at all 
• You have known fertility problems 
• You've been diagnosed with endometriosis or pelvic inflammatory disease 
• You've had more than one miscarriage 
• You've had prior cancer treatment 

If you're a man, you may wish to be evaluated sooner if you have:

• A low sperm count or other problems with sperm 
• Swelling in the scrotum (see 'varicocele' below) 
• You have had a previous vasectomy 
• Undergone prior scrotal or inguinal surgery 
• Small testicles or problems with sexual function or desire 
• Had prior cancer cancer treatment 
• Desire to know your fertility status. 

Medic-ALL 2018