Infertility and Its Causes
TRYING TO CONCEIVE: The World Health Organisation (WHO) defines infertility as lack of conception following one year of unprotected sexual intercourse.
To allow ample opportunity for conception to take place naturally, health professionals do not normally initiate assistive action until a period of at least a year has elapsed. It is estimated that one in six or seven Irish couples is infertile within the terms of the WHO's definition of infertility.
Causes of infertility
Male infertility The causes of male infertility are to be found either in the quality or quantity of sperm produced. A small number of males are congenitally unable to produce a sufficient quantity of sperm, or indeed any sperm at all, to achieve fertilisation by natural means. Other factors can also contribute to infertility. For example, mumps in post pubertal life or injury to the testes may result in failure to produce sperm or in the production of poor quality sperm. Male infertility can also be caused by genetic disorders.
Female infertility Known causes of female infertility are: (a) physical, e.g. following tubal disease that results in blockage or damage to the fallopian tubes such that the passage of the ovum down the tubes is impeded or stopped, thus preventing fertilisation; (b) hormonal and genetic abnormalities, e.g. polycystic ovarian syndrome, a condition where many small cysts form on the ovary and hormonal imbalances result which can cause infertility and (c) secondary to an ongoing or past pathology, e.g. endometriosis, a condition where the tissue that normally only lines the uterus is present in other areas of the reproductive system.
Sexual dysfunction Conditions such as erectile dysfunction or premature ejaculation may also render a male unable to father children. Similarly, a small number of women are unable, for physical and/or psychological reasons, to have sexual intercourse.
Lifestyle issues Lifestyle factors, such as excessive use of tobacco, drugs and alcohol, may contribute to infertility in both males and females. Infections, including those transmitted sexually, are a growing cause of infertility, particularly where they cause damage to the fallopian tubes in females. Current trends towards later first pregnancies, a higher incidence of second and later relationships and the growing availability of new reproductive technologies are likely to lead to an increased demand for fertility services in the future.
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