Infertility in men and women: Understanding the causes, treatment

It can be challenging for couples to process and accept infertility, which is only worsened owing to the many stigmas attached to the same. According to WHO, infertility affects millions of people, and there are between 48 million couples and 186 million individuals who live with infertility globally.

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“Various factors cause infertility, and it can affect both men and women. Sometimes, the cause of infertility in a person may be unexplainable,” said Dr Mohit Saraogi.

In women, infertility may be caused due to the following reasons:

*Tubal disorders such as blocked fallopian tubes, which are in turn caused by untreated STI (sexually transmitted infections) or complications of unsafe abortion, postpartum sepsis or abdominal/pelvic surgery
*Uterine disorders that could be inflammatory (such as endometriosis), congenital (such as the septate uterus), or benign (such as fibroid)
*Disorders of the ovaries, such as polycystic ovarian syndrome and other follicular disorders
*Disorders of the endocrine system cause imbalances in reproductive hormones. The endocrine system includes the hypothalamus and the pituitary glands. Some common examples of conditions affecting this system include pituitary cancers and hypopituitarism.

“Female infertility is stigmatized in various countries. However, not enough attention is paid to male infertility, which can sometimes be a significant cause as to why a couple could not conceive,” Dr Saraogi said.

In men, the causes of infertility can be: 

*Obstruction of the reproductive tract causes dysfunctionalities in the ejection of semen. This blockage can occur in the tubes that carry semen (such as ejaculatory ducts and seminal vesicles) and is commonly caused due to injuries or infections of the genital tract
*Hormonal disorders lead to abnormalities in hormones produced by the pituitary gland, hypothalamus, and testicles. These hormones, such as testosterone, regulate sperm production and can sometimes even cause pituitary or testicular cancers
*Testicular failure to produce sperm can be due to varicoceles or medical treatments that impair sperm-producing cells (such as chemotherapy).
*Abnormal sperm function and quality

“In addition, environmental and lifestyle factors like smoking, excessive alcohol intake, and obesity can also cause infertility. It is essential to understand that infertility affects a couple and not just one person for them to bear brunt of the stigma,” Dr. Saraogi said.

What can be done?

Currently, no treatments can improve the quality of a man’s sperm. However, various techniques can be implemented to increase the odds of conception using the existing sperm quality. Further, many men have sufficient sperm to fertilize their partner’s eggs in a test tube, even if it is not possible during sexual intercourse. In most cases, the couple can be helped with assisted reproductive technologies (ART). “ART procedures sometimes use donor eggs, sperm, or previously frozen embryos. It may also involve a surrogate or gestational carrier.

Further, lifestyle changes (including a good diet, exercise, and sleep), medications, surgeries (like vasectomy reversal and vasoepididymostomy) are other ways men can manage and overcome male infertility.

Infertility affects different couples in various ways — both physically and emotionally. However, when a couple is tackling such a life-challenging moment, it is essential to remember that you are not alone and that there is help available. Keep active, talk, and treat your mind and body well, Dr Saraogi said.

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