What is infertility?
Infertility is commonly used to describe a scenario where a couple of reproductive age is unable to conceive after 12 months of regular, adequate and unprotected sexual intercourse despite not using any form of contraceptive – for a woman younger than 35 years. For a woman who is 35 years or older, it is the inability to achieve pregnancy after 6 months of regular, adequate and unprotected sexual intercourse despite not using any form of contraceptive.
Regular and adequate sexual intercourse means that there should be sexual intercourse on at least 3 different days per week.
Infertility is also known as sub-fertility, which is a preferred term. Sub-fertility is preferred because the inability of the couple to achieve pregnancy is not absolute.
Is infertility always because of the woman?
In this part of the world, especially in countries like Nigeria, the woman is usually blamed for a couple’s inability to conceive. Fortunately, research has shown that the reason for infertility in a couple is not always associated with the woman.
Infertility affects about 10-20% of couples.
And out of the couples who suffer from infertility/sub-fertility:
- About 30 – 40% of them are because of issues associated with the male (male factor).
- About 30-40% are due to the female (female factor).
- About 10% are due to problems with both the male and female.
- And in about 10%, there is no known cause as there are no abnormalities in both the male and female.
For a woman to get pregnant:
- She must be within the reproductive age (after her first menstruation and before menopause).
- The ovaries in her body must release an egg. In other words, she must undergo ovulation.
- The man’s sperm must be healthy and able to fertilise the egg.
- The fertilised egg must be able to travel through the Fallopian tube to the womb (uterus) without problems.
- The fertilised egg must also be able to attach to the inside lining of the uterus (endometrium).
When there is a problem with any of these things that should be in place for pregnancy to occur, infertility may result.
What are the factors responsible for female infertility?
A woman’s chances of achieving pregnancy within one year of adequate sexual intercourse with her partner may be reduced by:
- Increased age – In women, fertility declines from age 30, with a higher decline from the age of 35.
- Gaining excess weight or obesity.
- Excess weight loss.
- Using illicit drugs.
- Too much stress (for instance – excess exercise, emotional stress).
- Drinking too much alcohol.
- Using certain medication.
What causes female infertility?
- Disruption of normal ovulation:
If a woman doesn’t ovulate, then there is no egg for the sperm to fertilise since no egg is released. Sometimes, ovulation may occur but is irregular. Usually, menstruation in this case, is irregular or absent. There are various conditions that can disrupt normal ovulation.
- Abnormal Fallopian tubes:
The Fallopian tubes could be damaged or blocked, and this stops the sperm from reaching the egg to fertilise it. It also stops the egg from travelling down to the uterus where it attaches if it is fertilised. The parts of the Fallopian tube that help to move the egg through the Fallopian tube as it travels to the uterus may also not be functioning.
- Abnormalities of the uterus:
There might be malformations of the uterus or fibroid in the uterus (womb).
- Problems with the cervical mucus:
In this case, the mucus found in the woman’s vagina and at the entry of her womb does not allow the sperm to penetrate it. So, the sperm cannot travel through to fertilise the egg.
Pregnancy will usually result as far as a couple is having adequate sexual intercourse without contraception. Pregnancy will result within 3 months in about 50% of couples, within 6 months in about 75% of couples and within 1 year in about 90% of couples. So, don’t give up hope!
If you are less than 35 years old and have been trying unsuccessfully to get pregnant for one year, see a doctor who is an obstetrics and gynaecology specialist. The same applies if you are a woman who is 35 years or more and who has tried to get pregnant for at least 6 months.
The doctor will ask you questions, examine you and carry out tests that will show whether the infertility is associated with the male or female. And will also determine the exact cause of the sub-fertility/infertility in the male or female. The doctor who is an expert will then give you counsel on the steps and treatments to take to achieve pregnancy.