Infertility is usually diagnosed after a couple has been actively trying to conceive for 6 months and has not become pregnant. In addition, couples who are able to conceive but have suffered through multiple miscarriages often consider put themselves in the category of infertility. Approximately 1 in 6 couples has fertility concerns. The causes of infertility are varied. Female infertility accounts for ~30% of cases and male fertility accounts for ~20% of the cases. The remainder of couples may have a combination of female and male factor or the cause may be unknown.
Female Infertility
Female infertility can be attributed to hormonal, anatomic, systemic, genetic, psychological or lifestyle issues. A woman’s hormonal system is intricate and consists of many hormones acting at different levels. Hormones directly involved in our fertility include estrogen, progesterone, LH, FSH, Beta-HCG as well as the thyroid hormones. If any of these have abnormal levels at any specified time within a woman’s cycle, ovulation may fail to occur or a pregnancy may be unable to sustain itself. In addition, hormonal abnormalities may interfere with the mechanisms, such as cervical mucous, that allow sperm to enter the uterus to combine with an egg or interfere with mechanisms that prevent a fertilized egg from implanting (attaching itself) to the uterine wall.
Our hormone levels are affected by many areas of our life. Stress, drugs, excessive alcohol, certain medications, excessive exercise, being overweight or underweight all will have an impact on the hormone levels. Thus, some hormonal issues may resolve with simple measures such as weight loss, weight gain or lifestyle changes. However, in most cases, intensive hormonal monitoring and supplementation is warranted.
Anatomic abnormalities affecting pregnancy also occur at many levels. Inflamed or scarred fallopian tubes, such as occurs with a history of Pelvic Inflammatory Disease or surgical adhesions, prevent an ovulated egg from reaching the uterus. On the other hand, an abnormal shape of the uterus, uterine polyps, uterine fibroids, or uterine scarring can make it difficult for a fertilized egg to implant in the uterus. Even lower, a cervix that is scarred (from STIs or surgery or trauma) may prevent sperm from entering the uterus preventing conception as well. In cases where the anatomy is affected, any contributing hormonal issues will be addressed. However, most cases will require a surgical procedure in attempt to restore the anatomy.
Systemic disease such as diabetes, Lupus, or other autoimmune diseases may cause infertility due to inflammatory processes throughout the body or due to an overactive immune system. Treatment for these types of infertility involve treatment of the underlying disease. Endometriosis, a common cause of infertility where uterine tissue is found outside the uterus may also act like a systemic disease by causing inflammation throughout the body making conception as well as maintaining a pregnancy more difficult. In some cases of endometriosis, surgical removal of the abnormal tissue reduces the inflammatory response enough for pregnancy to occur.
Genetic conditions affect pregnancy when an egg and sperm come together with the wrong number or type of chromosomes present. These “chromosomal abnormalities” often do not implant on the uterine wall so couples will be unaware that a conception even occurred. Others will implant but later stop developing, resulting in a miscarriage or a fetal demise. Not all chromosomal abnormalities are complicated by infertility as some abnormal chromosomal combinations, like those involved in Down’s Syndrome, are compatible with life and lead to beautiful children!
Male Infertility
Male infertility also has multiple etiologies that involve the hormonal, anatomic, genetic, systemic or psychological processes seen in female infertility. All of these factors affect sperm production and thus can impair fertility. In order to be effective, a sperm must have the correct genetic material, proper shape, a long life, strong motility and their numbers must be high. Past diseases (such as mumps or cancer) affecting the testes, hormonal abnormalities, certain medicines, trauma/surgery to the testes, STIs, or underdeveloped testes all preclude normal sperm production. In addition to sperm production, problems with ejaculation will also lead to male infertility.
Much research is needed on causes and treatments of male infertility. At present, the focus is on treating the underlying condition as much as possible. Hormonal supplementation or a surgical intervention may be necessary as well as lifestyle changes.
When diagnosed with infertility, a great place to start for a thorough evaluation and for therapies that focus on treating the underlying issue is a physician who specializes in NaPro Technology. (insert link http://www.naprotechnology.com) NaPro Technology is a science solely dedicated to treating obstetrical and gynecological pathology in a manner that respects the human body and focuses on restoring it to its natural and whole form. NaPro Technology physicians can be found around the world.
If you have a non-emergent, general question about the causes of infertility or their treatments, please email info@teachmehealme.com. Although our physicians would love to assist everyone, we are unable to provide specific treatment recommendations to patients not under our care. So please remember to discuss any questions or concerns with your primary health provider.
