INFERTILITY CAUSES IN A NUTSHELL
- Hormonal Changes – FSH, LH, TSH, Prolactin, Testosterone are the hormones that control sperm production and also influence sexual function of male. Any alterations in it will affect the sperm count / motility / Sexual function.
- Varicocele – It is a condition of dilated veins in the scrotum. As a result the basal temperature of scrotum is increased affecting the sperm production. Surgically treating the varicocele improves the semen parameters a lot.
- Medical conditions like long standing Diabetics, decreased thyroid levels, increased prolaction levels.
- H/o mumps / chicken pox / measles in childhood and H/o trauma to scrotum / Any Hernia or Hydrocele surgery etc.
- H/o Smoking / alcohol consumption – It has been proved scientifically that having more than 2 cups of coffee a day can alter sperm functions. Then think of smoking and alcohol!! More over it takes 75 days for a sperm to mature completely. So anything deleterious in that 2 months can produce change in sperm parameters. So stopping alcohol consumption (or) cessation of smoking for a week or so during treatment will not give much results.
- Block in the passage between the testis and the external genitalia which can be differentiated by hormones and scan.
- Working on laptops by keeping them on our lap. It emits radiations as well as heat which is detrimental to the sperms.
GROUP I HORMONAL CHANGES
The hormones are secreted by a gland in the brain & any alteration in their levels influences the ovulation, endometrial receptivity and embryo implantation.
GROUP II OVARIAN FACTORS
- Infrequent ovulation as in polycystic ovaries.
- Premature ovarian failure where the egg count is depleted prematurely at an young age.
- Endometriosis – where there is blood clots in the ovaries.
GROUP III TUBAL FACTORS
- By nature, the egg which is released from the ovary is fertilized by the sperm which took place in the fallopian tube which is present on both sides of uterus. This embryo then travels to the uterus to get embedded there in 4 – 5 days.
So at least one tube should be patient for natural conception. These fallopian tubes can be blocked as a result of infection (pelvic inflammation disease) or there can be adhesions around the tube as in endometriosis or pelvic tuberculosis which prevents the tube from moving freely and picking up the eggs from the ovary.
GROUP IV – UTERINE FACTORS
The common uterine factors for infertility are
- Fibroid uterus which prevents the embryo from implanting (or) it can cause abortion by increasing uterine contractions.
- Adenomyosis – A condition in which there are blood cysts in the muscle of the uterus.
- Intrauterine adhesions
- It occurs due to Tuberculous infection of the uterus or due to repeated trauma in the form of D&C where the inner layer of uterus (ie) the endometrium is thin and adherent to each other. So there is no place in the uterine cavity for the embryo to implant.
- Septate uterus – Uterus is usually formed by fusion of two mullerian ducts (genital precursors) from both sides and by resorption of the middle septum. If this resorption doesn’t take place completely, it results in septate / sub septate uterus.
This septum prevents embryo implantation and also causeabortion