Other causes of infertility
For some couples attempting pregnancy, something goes wrong in this complex process, resulting in infertility. The cause or causes of infertility can involve one or both partners:
• In about 20 percent of cases, infertility is due to a cause involving only the male partner.
• In about 30 to 40 percent of cases, infertility is due to causes involving both the male and female.
• In the remaining 40 to 50 percent of cases, infertility is due entirely to a cause involving the female.
Combined infertility
In some cases, both the man and woman may be infertile or sub-fertile, and the couple's infertility arises from the combination of these conditions. In other cases, the cause is suspected to be immunological or genetic; it may be that each partner is independently fertile but the couple cannot conceive together without assistance.
Unexplained infertility
Up to 26% of infertile couples have unexplained infertility. In these cases abnormalities are likely to be present but not detected by current methods. Possible problems could be that the egg is not released at the optimum time for fertilization, that it may not enter the fallopian tube, sperm may not be able to reach the egg, fertilization may fail to occur, transport of the zygote may be disturbed, or implantation fails. It is increasingly recognized that egg quality is of critical importance and women of advanced maternal age have eggs of reduced capacity for normal and successful fertilization. Also, polymorphisms in folate pathway genes could be one reason for fertility complications in some women with unexplained infertility.
General health and lifestyle. General health and lifestyle may affect fertility. Some common causes of infertility related to health and lifestyle include:
• Emotional stress. Stress may interfere with certain hormones needed to produce sperm. Your sperm count may be affected if you experience excessive or prolonged emotional stress. A problem with fertility itself can sometimes become long term and discouraging, producing more stress.
• Malnutrition. Deficiencies in nutrients such as vitamin C, selenium, zinc and folate may contribute to infertility.
• Alcohol and drugs. Alcohol or drug dependency can be associated with poor health and reduced fertility. The use of certain drugs also can contribute to infertility. Anabolic steroids, for example, which are taken to stimulate muscle strength and growth, can cause the testicles to shrink and sperm production to decrease.
Environmental exposure. Overexposure to certain environmental elements such as heat, toxins and chemicals can reduce sperm count either directly by affecting testicular function or indirectly by altering the male hormonal system. Specific causes include:
• Pesticides and other chemicals. Herbicides and insecticides may cause female hormone-like effects in the male body and may be associated with reduced sperm production and testicular cancer. Lead exposure may also cause infertility.
• Overheating the testicles. Frequent use of saunas or hot tubs can elevate your core body temperature. This may impair your sperm production and lower your sperm count.
• Substance abuse. Use of cocaine or marijuana may temporarily reduce the number and quality of your sperm.
• Tobacco smoking. Men who smoke may have a lower sperm count than do those who don't smoke.
Environmental and occupational factors
Certain environmental factors may cause men to produce a less concentrated sperm, according to a government report. Exposure to lead, other heavy metals, and pesticides has also been associated with male infertility. Many other factors, such as excessive heat exposure, microwave radiation, ultrasound, and other health hazards, are more controversial as to whether they induce infertility.
Toxic effects related to tobacco, marijuana, and other drugs
Smoking may cause infertility in both men and women. In experimental animals, nicotine has been shown to block the production of sperm and decrease the size of a man's testicles. In women, tobacco changes the cervical mucus, thus affecting the way sperm reach the egg.
Marijuana may disrupt a woman's ovulation cycle (release of the egg). Marijuana use affects men by decreasing the sperm count and the quality of the sperm.
Heroin, cocaine, and crack cocaine use induces similar effects but places the user at increased risk for PID and HIV infection associated with risky sexual behavior.
In women, the effects of alcohol are related more to severe consequences for the fetus. Nevertheless, chronic alcoholism is related to disorders in ovulation and, therefore, interferes with fertility. Alcohol use by men interferes with the synthesis of testosterone and has an impact on sperm concentration. Alcoholism may delay a man's sexual response and may cause impotence (unable to have an erection).
Exercise
Exercise should be encouraged as part of normal activities. However, too much exercise is dangerous, especially for long-distance runners. For women, it may result in disruption of the ovulation cycle, cause no menstrual periods, or result in miscarriages (loss of pregnancy). In men, overexercise may cause a low sperm count.
Inadequate diet associated with extreme weight loss or gain
Obesity is becoming a major health issue in the United States. Obesity has an impact on infertility only when a woman's weight reaches extremes.
Weight loss with anorexia or bulimia can create problems with menstrual periods (no periods) and thyroid levels, thus disrupting normal ovulation.
• Caffeine intake. Studies are mixed on whether consuming too much caffeine may be associated with decreased fertility. Some studies have shown a decrease in fertility with increased caffeine use while others have not shown adverse effects. If there are effects, it's likely that caffeine has a greater impact on a woman's fertility than on a man's. High caffeine intake does appear to increase the risk of miscarriage.
Age
A woman becomes less fertile as she ages into her fifth decade of life (age 40-49 years). Among men, as they age, levels of testosterone fall, and the volume and concentration of sperm change.
Healthy couples younger than 30 years who have regular sexual intercourse and use no birth control methods have a 25-30% chance of achieving pregnancy each month. A woman's peak fertility is early in the third decade of life. As a woman ages beyond 35 years (and particularly after age 40 years), the likelihood of becoming pregnant is less than 10% per month.
we come in many different colors and flavors (:
Wednesday, October 6, 2010
Female Infertility Causes
Causes of Failure to Ovulate
Ovulatory disorders are one of the most common reasons why women are unable to conceive, and account for 30% of women's infertility. Fortunately, approximately 70% of these cases can be successfully treated by the use of drugs such as Clomiphene and Menogan/Repronex. The causes of failed ovulation can be categorized as follows:
(1) Hormonal Problems
• Failure to produce mature eggs
In approximately 50% of the cases of anovulation, the ovaries do not produce normal follicles inwhich the eggs can mature. Ovulation is rare if the eggs are immature and the chance of fertilization becomes almost nonexistent. Polycystic ovary syndrome, the most common disorder responsible for this problem, includes symptoms such as amenorrhoea, hirsutism, anovulation and infertility. This syndrome is characterized by a reduced production of FSH, and normal or increased levels of LH, oestrogen and testosterone. The current hypothesis is that the suppression of FSH associated with this condition causes only partial development of ovarian follicles, and follicular cysts can be detected in an ultrasound scan. The affected ovary often becomes surrounded with a smooth white capsule and is double its normal size. The increased level of oestrogen raises the risk of breast cancer.
• Malfunction of the hypothalamus
The hypothalamus is the portion of the brain responsible for sending signals to the pituitary gland, which, in turn, sends hormonal stimuli to the ovaries in the form of FSH and LH to initiate egg maturation. If the hypothalamus fails to trigger and control this process, immature eggs will result. This is the cause of ovarian failure in 20% of cases.
• Malfunction of the pituitary gland
The pituitary's responsibility lies in producing and secreting FSH and LH. The ovaries will be unable to ovulate properly if either too much or too little of these substances is produced. This can occur due to physical injury, a tumor or if there is a chemical imbalance in the pituitary.
(2) Scarred Ovaries
Physical damage to the ovaries may result in failed ovulation. Eg. extensive, invasive, or multiple surgeries, for repeated ovarian cysts may cause the capsule of the ovary to become damaged or scarred, such that follicles cannot mature properly and ovulation does not occur. Infection may also have this impact.
(3) Premature Menopause
This presents a rare and as of yet unexplainable cause of anovulation. It is hypothesized that their natural supply of eggs has been depleted or that the majority of cases occur in extremely athletic women with a long history of low body weight and extensive exercise. There is also a genetic possibility for this condition.
(4) Follicle Problems
Although currently unexplained, "unruptured follicle syndrome" occurs in women who produce a normal follicle, with an egg inside of it every month yet the follicle fails to rupture.
Causes of Poorly Functioning Fallopian Tubes
Tubal disease affects approximately 25% of infertile couples and varies widely, ranging from mild adhesions to complete tubal blockage. Treatment for tubal disease is most commonly surgery and, owing to the advances in microsurgery and lasers, success rates (defined as the number of women who become pregnant within one year of surgery) are as high as 30% overall, with certain procedures having success rates up to 65%. The main causes of tubal damage include:
(1) Infection
Caused by both bacteria and viruses and usually transmitted sexually, these infections commonly cause inflammation resulting in scarring and damage. A specific example is Hydrosalpnix, a condition in which the fallopian tube is occluded at both ends and fluid collects in the tube.
(2) Abdominal Diseases
The most common of these are appendicitis and colitis, causing inflammation of the abdominal cavity which can affect the fallopian tubes and lead to scarring and blockage.
(3) Previous Surgeries
This is an important cause of tubal disease and damage. Pelvic or abdominal surgery can result in adhesions that alter the tubes in such a way that eggs cannot travel through them.
(4) Ectopic Pregnancy
This is a pregnancy that occurs in the tube itself and, even if carefully and successfully overcome, may cause tubal damage.
(5) Congenital Defects
In rare cases, women may be born with tubal abnormalities, usually associated with uterus irregularities.
Endometriosis
For women with endometriosis, the monthly fecundity (chance of getting pregnant) diminishes by 12 to 36%. This condition is characterized by excessive growth of the lining of the uterus, called the endometrium. Growth occurs not only in the uterus but also elsewhere in the abdomen, such as in the fallopian tubes, ovaries and the pelvic peritoneum. A positive diagnosis can only be made by diagnostic laparoscopy, a test that allows the physician to view the uterus, fallopian tubes, and pelvic cavity directly. The symptoms often associated with endometriosis include heavy, painful and long menstrual periods, urinary urgency, rectal bleeding and premenstrual spotting. Sometimes, however, there are no symptoms at all, owing to the fact that there is no correlation between the extent of the disease and the severity of the symptoms.
Additional Factors
(1) Other variables that may cause infertility in women:
• At least 10% of all cases of female infertility are caused by an abnormal uterus. Conditions such as fibroid, polyps, and adenomyosis may lead to obstruction of the uterus and Fallopian tubes.
• Congenital abnormalities, such as septate uterus, may lead to recurrent miscarriages or the inability to conceive.
• Approximately 3% of couples face infertility due to problems with the female cervical mucus. The mucus needs to be of a certain consistency and available in adequate amounts for sperm to swim easily within it. The most common reason for abnormal cervical mucus is a hormone imbalance (too little estrogen or too much progesterone)
(2) Behavioral Factors:
Diet and Exercise
Optimal reproductive functioning requires both proper diet and appropriate levels of exercise. Women who are significantly overweight or underweight may have difficulty becoming pregnant.
Smoking
Cigarette smoking has been shown to lower sperm counts in men and increases the risk of miscarriage, premature birth, and low-birth-weight babies for women. Smoking by either partner reduces the chance of conceiving with each cycle, either naturally or by IVF, by one-third.
Alcohol
Alcohol intake greatly increases the risk of birth defects for women and, if in high enough levels in the mother’s blood, may cause Fetal Alcohol Syndrome. Alcohol also affects sperm counts in men.
Drugs
Drugs, such as marijuana and anabolic steroids, may impact sperm counts in men. Cocaine use in pregnant women may cause severe retardations and kidney problems in the baby and is perhaps the worst possible drug to abuse while pregnant.
(3) Environmental and Occupational Factors:
Lead: Lead can produce teratospermias (abnormal sperm) and is thought to be an abortifacient
Medical Treatments and Materials: radiation therapy
Ethylene Oxide: may cause birth defects in early pregnancy and has the potential to provoke early miscarriage.
Dibromochloropropane (DBCP): Handling the chemicals found in pesticides, such as DBCP, can cause ovarian problems, leading to a variety of health conditions, like early menopause, that may directly impact fertility.
Ovulatory disorders are one of the most common reasons why women are unable to conceive, and account for 30% of women's infertility. Fortunately, approximately 70% of these cases can be successfully treated by the use of drugs such as Clomiphene and Menogan/Repronex. The causes of failed ovulation can be categorized as follows:
(1) Hormonal Problems
• Failure to produce mature eggs
In approximately 50% of the cases of anovulation, the ovaries do not produce normal follicles inwhich the eggs can mature. Ovulation is rare if the eggs are immature and the chance of fertilization becomes almost nonexistent. Polycystic ovary syndrome, the most common disorder responsible for this problem, includes symptoms such as amenorrhoea, hirsutism, anovulation and infertility. This syndrome is characterized by a reduced production of FSH, and normal or increased levels of LH, oestrogen and testosterone. The current hypothesis is that the suppression of FSH associated with this condition causes only partial development of ovarian follicles, and follicular cysts can be detected in an ultrasound scan. The affected ovary often becomes surrounded with a smooth white capsule and is double its normal size. The increased level of oestrogen raises the risk of breast cancer.
• Malfunction of the hypothalamus
The hypothalamus is the portion of the brain responsible for sending signals to the pituitary gland, which, in turn, sends hormonal stimuli to the ovaries in the form of FSH and LH to initiate egg maturation. If the hypothalamus fails to trigger and control this process, immature eggs will result. This is the cause of ovarian failure in 20% of cases.
• Malfunction of the pituitary gland
The pituitary's responsibility lies in producing and secreting FSH and LH. The ovaries will be unable to ovulate properly if either too much or too little of these substances is produced. This can occur due to physical injury, a tumor or if there is a chemical imbalance in the pituitary.
(2) Scarred Ovaries
Physical damage to the ovaries may result in failed ovulation. Eg. extensive, invasive, or multiple surgeries, for repeated ovarian cysts may cause the capsule of the ovary to become damaged or scarred, such that follicles cannot mature properly and ovulation does not occur. Infection may also have this impact.
(3) Premature Menopause
This presents a rare and as of yet unexplainable cause of anovulation. It is hypothesized that their natural supply of eggs has been depleted or that the majority of cases occur in extremely athletic women with a long history of low body weight and extensive exercise. There is also a genetic possibility for this condition.
(4) Follicle Problems
Although currently unexplained, "unruptured follicle syndrome" occurs in women who produce a normal follicle, with an egg inside of it every month yet the follicle fails to rupture.
Causes of Poorly Functioning Fallopian Tubes
Tubal disease affects approximately 25% of infertile couples and varies widely, ranging from mild adhesions to complete tubal blockage. Treatment for tubal disease is most commonly surgery and, owing to the advances in microsurgery and lasers, success rates (defined as the number of women who become pregnant within one year of surgery) are as high as 30% overall, with certain procedures having success rates up to 65%. The main causes of tubal damage include:
(1) Infection
Caused by both bacteria and viruses and usually transmitted sexually, these infections commonly cause inflammation resulting in scarring and damage. A specific example is Hydrosalpnix, a condition in which the fallopian tube is occluded at both ends and fluid collects in the tube.
(2) Abdominal Diseases
The most common of these are appendicitis and colitis, causing inflammation of the abdominal cavity which can affect the fallopian tubes and lead to scarring and blockage.
(3) Previous Surgeries
This is an important cause of tubal disease and damage. Pelvic or abdominal surgery can result in adhesions that alter the tubes in such a way that eggs cannot travel through them.
(4) Ectopic Pregnancy
This is a pregnancy that occurs in the tube itself and, even if carefully and successfully overcome, may cause tubal damage.
(5) Congenital Defects
In rare cases, women may be born with tubal abnormalities, usually associated with uterus irregularities.
Endometriosis
For women with endometriosis, the monthly fecundity (chance of getting pregnant) diminishes by 12 to 36%. This condition is characterized by excessive growth of the lining of the uterus, called the endometrium. Growth occurs not only in the uterus but also elsewhere in the abdomen, such as in the fallopian tubes, ovaries and the pelvic peritoneum. A positive diagnosis can only be made by diagnostic laparoscopy, a test that allows the physician to view the uterus, fallopian tubes, and pelvic cavity directly. The symptoms often associated with endometriosis include heavy, painful and long menstrual periods, urinary urgency, rectal bleeding and premenstrual spotting. Sometimes, however, there are no symptoms at all, owing to the fact that there is no correlation between the extent of the disease and the severity of the symptoms.
Additional Factors
(1) Other variables that may cause infertility in women:
• At least 10% of all cases of female infertility are caused by an abnormal uterus. Conditions such as fibroid, polyps, and adenomyosis may lead to obstruction of the uterus and Fallopian tubes.
• Congenital abnormalities, such as septate uterus, may lead to recurrent miscarriages or the inability to conceive.
• Approximately 3% of couples face infertility due to problems with the female cervical mucus. The mucus needs to be of a certain consistency and available in adequate amounts for sperm to swim easily within it. The most common reason for abnormal cervical mucus is a hormone imbalance (too little estrogen or too much progesterone)
(2) Behavioral Factors:
Diet and Exercise
Optimal reproductive functioning requires both proper diet and appropriate levels of exercise. Women who are significantly overweight or underweight may have difficulty becoming pregnant.
Smoking
Cigarette smoking has been shown to lower sperm counts in men and increases the risk of miscarriage, premature birth, and low-birth-weight babies for women. Smoking by either partner reduces the chance of conceiving with each cycle, either naturally or by IVF, by one-third.
Alcohol
Alcohol intake greatly increases the risk of birth defects for women and, if in high enough levels in the mother’s blood, may cause Fetal Alcohol Syndrome. Alcohol also affects sperm counts in men.
Drugs
Drugs, such as marijuana and anabolic steroids, may impact sperm counts in men. Cocaine use in pregnant women may cause severe retardations and kidney problems in the baby and is perhaps the worst possible drug to abuse while pregnant.
(3) Environmental and Occupational Factors:
Lead: Lead can produce teratospermias (abnormal sperm) and is thought to be an abortifacient
Medical Treatments and Materials: radiation therapy
Ethylene Oxide: may cause birth defects in early pregnancy and has the potential to provoke early miscarriage.
Dibromochloropropane (DBCP): Handling the chemicals found in pesticides, such as DBCP, can cause ovarian problems, leading to a variety of health conditions, like early menopause, that may directly impact fertility.
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