Facts about Infertility
Facts about Infertility
Infertility is a distressing issue to couples and their families. Recognizing its importance, the World Health Organization has classified it as a global health problem.
At birth, the female child is born with about 5 million primordial follicles (potential eggs) which decrease to about 500,000 at menarche (the start of menses). With each subsequent menstrual cycle follicular atresia/apoptosis (death/ degeneration) continues with the numbers decreasing to about 25,000 in the late 30s age group and about a 1000 close to menopause.
Naturally, there is an age-related decline in fecundity (fertility), the decrease usually starting at the age of 32 with a dramatic fall after the age of 37. Put simply, the natural monthly fecundity rate which is about 25% between 20 and 30 years of age decreases to below 10% above the age of 35.
Several factors affect natural fecundity in addition to the above physiological decline – baseline health of the couple including any physical and mental health illness, smoking, alcohol intake, diet, lack of physical activity, environmental toxins and intentional delay using contraceptive methods. Increasing age of either parent is also associated with both obstetric and gynecological problems. The increased incidence of spontaneous abortions most often due to aneuploidy, babies born with chromosomal or gene abnormalities together with common obstetrics complications like , gestational diabetes mellitus, preeclampsia, preterm labor and intrauterine growth retardation are more likely.
Since spermatogenesis (sperm production) is a continuous process, the focus on the effects of paternal age has received limited attention. The likelihood for conception, spontaneous or otherwise, in older women with partners above the age of 40 is reduced, and pregnancies are associated with a higher incidence of complications like miscarriages, congenital anomalies, and genetic disorders.[5,6]
Down’s and Marfan’s syndrome has also been linked to increasing paternal age.
These poor outcomes are attributed to damaged DNA in sperm.
Infertility is a prevalent problem affecting about 10-12% of the couples worldwide.
- A couple could be at risk of infertility when they have not conceived after 12-24 months of regular unprotected sexual intercourse. The time line is variable as it takes in to account all the above health related factors for that individual couple. For eg fit healthy couples under 30 would be encouraged to try for up to 24 months whereas couples with any known medical issues or older than 30 would be encouraged to seek advice at the 12 month mark. It affects about 1 in 6 Australian couples of reproductive age.
- Approximately 3 out of 5 couples conceive within 6 months of trying; 1 in 4 take between 6 months and 12 months. For the rest, conception takes more than a year which means there may be a problem. There may not be a problem too but the 12 month mark serves as a reasonable point to seek medical advice starting with your GP or Integrative Medicine Practitioner.
- In about 40% of infertile couples, the problem is a male factor, in about 40% it is a female one, and for the remaining 20% it is a joint problem, or the cause is unknown (“idiopathic”).
- The causes of infertility are many and varied.
There are many causes of infertility such as obesity, improper diet, smoking, alcohol, infections, environmental pollutants, various medications, lifestyle disorders, stress, family history, endocrinal problems etc. In men, infertility is basically because of less number or poor quality of sperms or any problems in male reproductive system. When fallopian tubes are damaged, blocked, proper ovulation does not occur or sperms can’t reach the eggs, then also infertility occurs. Unexplained infertility pertains to those couples who have no physiological & pathological anomalies, yet do not conceive. Approximately 25% suffer from unexplained infertility.