Causes of Infertility in Males and Females

Infertility is a part of reproduction where not getting pregnant is termed infertility. It is equally important for us to know the causes of infertility in males and females. We know that nature has chosen a woman for this privilege of bearing a child. But this doesn’t mean or claim that only a woman is responsible for unsuccessful pregnancy. There could be many reasons for not conceive a baby even after trying hard for a long time. Many times, there are different causes of infertility in males and females. 

Usually, women have uterine abnormalities, tubal obstruction, ovulation dysfunction, peritoneal factors for not getting pregnant. But other than regular issues, genetic anomalies, cervical factors, long-term pre-illness or post-partum complications, or malefactors could be a reason for infertility. If a woman is not having a pregnancy, then the male may be having infertility issues. Generally, 30% of the male suffers from infertility abnormalities. And almost 45% facing infertility worldwide.

Causes of Male Infertility

Men’s Infertility is evaluated based on semen analysis and fertility diagnosis. In simple words, having issues with sperm or semen and other external factors causes infertility in males. Go through the brief description for further understanding of male infertility. 

According to medical terminology sperm abnormalities, low sperm counts, inaccurate shape and size of sperm, sperm motility, disrupted sperm behavior, abnormal genital glands, hormonal imbalance can be the causes of male infertility. To know the actual cause of infertility, the couple facing issues in pregnancy must visit a fertility specialist. Also, a urologist or a gynecologist can help with a proper diagnosis.  

Medically known as: 

• Azoospermia, Varicocele, Hypogonadotropic hypogonadism
• Sperm Morphology, Sperm Motility, Sperm volume
• Anejaculation, Retrograde Ejaculation, chromosomal defects
• Genital Tract Infection, Obstruction (Blockage), overheating of testicles
• Male Immunologic infertility, Hormonal imbalance, and Genetic issues 

According to common approaches Unhealthy eating habits, irregular lifestyle, work-stress, overuse of drugs or alcohol, overstated gymnasium,  genetic discrepancies, any kind of abuse or harassment can also be a reason for Male Infertility. 

Besidesmedical treatment, an approach to a good lifestyle and healthy habits may help overcome infertility issues. Research and medical science have now completely changed the ideology of infertility. Advancements in medical methodology, equipment, and medicine made it possible to have a child. There are types of advanced treatment and healthcare essentials that help in conceiving and make child-rearing. 

Causes of Infertility in Females

Of course, there is an issue if a woman is not conceiving even after planning and trying hard for a longtime. To know what the actual cause is, visiting a gynecologist or fertility specialist is compulsory. A woman could have many internal (uterus & tracts) and environmental issues for not getting pregnant. Below is a brief description to have a better understanding of the causes: 

According to medical terminology: disruptive uterus, obstructed fallopian tubes, primary ovarian insufficiency, polycystic ovaries, endometriosis, uterine fibroids are few common female infertility issues. Thyroid, diabetes, cysts, hormonal imbalance, and many other physical issues adversely affect fertility.  Usually, abnormal menstruation, disruptive reproductive organs, genetic and disorders are common factors of female infertility. 

According to common approaches: Unhealthy lifestyle, low-quality hygiene products, overstress, pollution are some causes of infertility in females. Furthermore, aging, physical/mental abuse, overuse of drugs/alcohol, unprotected sex, body fat, and obesity may also affect Female Infertility. 

Male Vs Female Infertility

Modern media and digital technology have impacted lives unpredictably. No doubt there are countless achievements of this era with the pace of digitalization. 10 to 14% of the population is inclined to infertility as per recent researches, especially in urban areas.

As per recent records, 28 million couples are struggling with infertility in India itself. Where 7% of total men are infertile compared to women, the male infertility ratio rises rapidly. And only 20 % of couples are found diminutive or prolonged infertility. 

Infertility in Men and Women in Terms of Aging

Infertility grows in women by the age of 35 and enhances the difficulties in conceiving. Ignoring your age is another barrier to having a child in the future. The child-bearing complications increased with aging and made it more challenging to have a safer pregnancy. Women’s age is indeed an essential factor for pregnancy. Still, with a healthy lifestyle and mental health, women can go longer with their fertile ability. 

Not only do females, even men, suffer from aging, but the sperm quality also falls with the age of 40-45 years. Male infertility indeed grows with age, and chances of pregnancy are rare. Therefore poor sperm fertility affects the pregnancy later, and it risks the chances of fetal death and miscarriages. Not all men have the same consequences; men who have a good diet and a healthy lifestyle remain fertile for long. 

A Shared Understanding of Infertility in Men and Women 

Earlier, peoples were not open enough to discuss infertility, but today it is taken seriously. Most couples experience unexplained infertility that they overcome on their own and find perfectly legible for having baby infertility tests. Due to physical restrictions or an unsuitable environment, both men and women have infertility. 

There are few common factors of infertility in men and women: anxiety, work stress, inadequate mental health, overuse of alcohol/drugs, smoking, unprotected sex, and aging. Still, these issues resolve when followed by a healthy routine. 

Impact of Exposure to Pollution & Environmental Toxins on Male/Female Fertility

Infertility can also cause by exposure to pollution and an unhealthy environment. The overuse of medical drugs and the habit of eating street food, pesticides in vegetables, fruits, toxic drinks, and eatables are life-threatening threats to human health and infertility. 

Residing in an overly crowded place, noise and air pollution also increase infertile deficiency. Bad sleeping routines, overeating, obesity, anxiety is some indirect causes of infertility.  

Impact of Chronic Health Disorders and Post-Partum Illness on Fertility:

Post-partum or pro-longed illness, chronic health disorders, and genetic impairments are some added factors to infertility. Pro-long illness, surgeries, high radiation, chemotherapy, tumor treatments, medical drugs to treat chronic illness may also raise male infertility. 

Whereas diabetes, hypothyroid, obesity, hypertension, epilepsy, sclerosis, and anemia are some health deficiencies that affect pregnancy. Similarly, women also have these chronic disorders and major complications in their fertility period.

Impact of Modern Medical Science on Male Infertility 

Male Infertility is not always a lasting disability as this is cured through proper diagnose and fertility treatment. Some of the best fertility specialists helped thousands of couples to conceive and lead a healthy pregnancy.  And the impact has gone the same with female infertility as well. 

Fertility science has advanced with the modernization of medical equipment, medications, and ways of treatment. Researched-based treatment and modern fertility techniques have significantly raised the child-bearing possibilities around the world. Today couples are happy adopting infertility treatment both in natural and artificial ways. 

Latest Researches Breakthrough Infertility Treatment in Males:

Researchers at Harvard University concluded that a medical drug (RANKL protein) against obstetrics boosts sperm quality by 40-60%. The research indicates that it will raise male fertility and pregnancy worldwide. Now the researchers are studying to know the side effects and the area of infertility that will benefit highly. 

Not all men have the same fertility issues. Geographic, epidemiologic, socioeconomic factors also influence fertility in males. Most urologists are not considered fertility specialists, which is why males face a barrier in infertility treatments. Apart from this, male infertility is increasing due to a low number of andrologists worldwide. 

Diagnostic experimental tests focus on sperm components as they understand the significance of healthy sperm. Furthermore, male infertility is recognized as a serious project and later undertaken to enhance successful pregnancy. Semen analysis with molecular understandings will help reach out the causes of male infertility and treatment. 

Female Infertility Treatment

With the pace of generation, women also have a drastic change in their lifestyle. They are adopting a more modernize culture (western culture) and whereabouts of metropolitan lifestyle. Instead, individual growth is suitable for their career and personal growth, but it has also harmed female fertility and pregnancy. 

Most females today are working or willing to work, especially those of age 35. Any young woman is best for conceiving in her 25-35 age as per fertility experts. Age 25 is known as the best reproductive age for women, but most women from urban areas don’t prefer having a child for some specific reason. 

Later, using pills or some other medications will restrict the chances of pregnancy and causes infertility in females. Few reasons that influence female fertility are listed below:

• Regular termination of pregnancy, postponement of gestational age,
• Smoking, high intake of alcohol or drugs, caffeine consumptions
• Overly use of medication to avoid pregnancy (contraceptive methods)
• Unhealthy eating habits, obesity, lack of nutrition, extreme exercising
• Exposure to the electromagnetic and radioactive environment, chemicals, toxins 
• Artificial supplements, hormones, unprotected sex, STDs

There are a few more significant environmental and economic factors that are gradually affecting female fertility. Physical, as well as psychological stress, also impacts fertility as per researches and considerations. Occupational exposures, work overload, anxiety increases the deficiency in females.  

Types of Complications in Female Fertility 

• By the age of 35, miscarriages, natural conceiving, chromosomal abnormalities rise within the females.  
• Other complications like gestational diabetes, placenta previa, and stillbirth are common in older women.
• Kidney disorders, celiac disease, tubal pregnancy, cell anemia, uterine infections 
• Pelvic inflammation, pituitary disorders, uterine polyps, fibroids, blockages, 
• other syndromes like endometriosis, polycystic ovary, PCOS syndrome, abnormal syndrome, etc. 
• Post-partum effect of surgeries and therapies for chronic diseases
• By the age of 45, the percentage of having pregnancy is reduced from 50 % to 5% every month.

Nowadays, most working women prefer not to marry or not have a baby for some economic issues or career evolution. This phenomenon is coming into practice, and it inclines females towards severe infertility. Nature has blessed women with the privilege of bearing a child, and often terminating or obscuring a pregnancy is not worthy.  

Two significant types of infertility are primary and secondary. Let’s understand this-

Primary infertility: women not getting pregnant if not taking precautions during sex and never get pregnant.

Secondary infertility: women once had safe and successful pregnancies but could not conceive later or subsequent time. 

Types of Diagnosis for Female Infertility: 

Blood test and Pelvic examination

• A blood test checks the hormones, sugar level, and other supportive elements in the female body that initiates a healthy pregnancy.
• Pelvic examination performed to find whether the internal/external structure of the pelvis is fit for pregnancy or not.

Ultrasound Abdominal/Transvaginal

• Abdominal ultrasounds perform to examine the close structures of internal glands, tracts, blockage, ovarian defects, cyst, etc. 
• Generally, Transvaginal ultrasounds perform to detect uterine defects and other vaginal dysfunctions. 

Hysteroscopy, Laparoscopy,

• A light tubeis inserted into the uterus through the vaginal opening for a more specific examination of the uterus during the hysteroscopy procedure. 
• In Laparoscopy, a tube with a camera is inserted via an abdominal incision to identify fibroids, cysts, endometriosis, and other dysfunctions in the uterus and fallopian tube. 

Saline sonohysterogram (SIS), Hysterosalpingogram (HSG): 

• A saline sonohysterogram is a procedure where saline water fills in the uterus, and ultrasound is examined during the process to get a more precise diagnosis of infertility.

• During Hysterosalpingogram, x-rays track the blockages through injected dye through the fallopian tube. 

Intrauterine Semination and In Vitro Fertilization

• • IUI procedure does help conceive a baby where a sperm with an injectable tube is infused directly in the female uterus.  

• Where IVF is an ART procedure done to harvest eggs, sperm muted with eggs in a lab. In the process, the sperm fertilizes the egg, and when it develops safely, it is placed in the female uterus to continue with the pregnancy. 

In Female infertility treatment, proper medication to stimulate ovulation and hormones, and surgeries to clear the blockages, polyps, and uterine fibroids.Women undergo many tests and examinations during infertility treatment. 

Treatment of Male Infertility

The treatment of male infertility contains diagnosis and treatment done through few tests and comprehensive examination.

Diagnosis of male infertility:

Blood Test: blood samples help detect hormonal deficiencies, testosterone, thyroid, diabetes, chromosomal defects, etc. Some genetic tests diagnose the causes of infertility in males. 

Scrotal ultrasound: Scrotum ultrasound diagnoses the testicular abnormalities, varicoceles, tract, and blockages in the scrotum and other glands. 

Semen Analysis:

During semen analysis, diagnosis of sperm shape, size, movement, and morbidity tests are necessary. With the help of needle biopsy, the sperm extracts from the semen for infertility examination. Lots of other procedures follow during the treatment to enhance sperm quality while treating male infertility. 

Let’s discuss the causes of infertility in detail:

Factors that affect semen quality are sperm morphology, sperm morbidity, and sperm volume. We can understand this further.

Sperm Volume: The size, shape, and behavior of sperms in the semen are the infertility indicators in males. A healthy sperm may have oval heads with an elongated tail. Over 15 million sperms per ml of semen drop are meant normal.

Sperm Motility:in the semen, not all sperms are active; some are feeble and low in quality. The low quality and inactive sperm movement are considered very usual in males. 

Semen morphology: morphology of sperms refers to an ideal sperm with oval heads with elongated tails. Having multiple heads, tails, shredded heads, round heads directs to poor sperm morphology. 

Semen quality:color and behavior of semen, concentration, thickness, and progression refer to the quality of sperm. Healthy sperm is always white and translucent with no odor; it shows no infections in semen. 

Testicular defects: overheating of testicles, toxic releases, swelling in veins, regressive ejaculation, Immunologic male infertility, chromosomes, and genetic deficiency, scrotum dysfunctions, and ill-structured are other common testicular infertility in males.

Types of treatment for male infertility:

• Most hormonal deficiencies and unstable testosterones can cure through medications, medical drugs, and natural approaches to cure other erectile defects.
• Sometimes surgeries are done in males to open the blockages in tracts and tubes that hold sperm and process the semen. Varicoceles surgery helps on a greater level to increase fertility in males. 

• Sperm wash Technique,Intracytoplasmic Sperm Injection Technique
• Intrauterine Insemination Technique, IVF(In Vitro Fertilization) Technique
• TESE Testicular Sperm Extraction,PESA & MESA Micro-surgical Techniques
• TFNA Testicular Fine Needle Aspiration Technique, Opt for donated sperm. 

All the above techniques refer to male infertility, and treatment after diagnosis helps to increase the male quality in males.

Who Requires Undergoing Medical Treatment for Infertility?

• Males having prostate or genital infections
• Males suffering from twisted testicles
• Male with late or early puberty, puberty abnormalities
• Male having exposure to heat to genital organs
• Hernia, undescended testiclesin males

Globally adopted Top Fertility Treatment

With advancements in medical fertility techniques, the world is enjoying other options of fertility. The strong desire to be a parent has changed the perception of fertility in couples worldwide. The infertile couples have desirably moved to other options of fertility without infamy. 

Fertility Drugs

After getting a proper diagnose by an endocrinologist, couples rely on medications and fertility drugs. The medicinal drugs accelerate ovulation or remove the deficiencies in both males and females vigorously. 

IVF and IUI/ICSI

Other than natural therapies, couples can switch to IVF/ICSI/IUI procedures to overcome infertility. More artificial treatments like assisted hatching, gamete intra-fallopian transfer, and zygote intra-fallopian transfer made it possible to conceive. 

Egg/Sperm or Embryo Donation and Preservation

Freezing of egg/embryo/sperm helps to conceive later in chronic illness or post-partum surgery consequences. Couples with mutual understanding can plan for having childbirth by the gametes of healthy persons. Or they can plan to have a child if neither of them is suitable to conceive. IVF has helped many LGBT to experience family with a child. 

Surrogacy 

Other than ARTs, couples can opt for surrogacy that is successful in more cases. In this scenario, either partner can donate gametes or, if one out of the couple has fertility changes, can conceive with the help of surrogacy.

Gestational surrogacy is where the surrogate owes gametes of intended parents. And during traditional surrogacy, surrogates are biologically connected with the baby—the process of surrogacy done with legal formalities with the specialist’s recommendations.  

Couples/single or anyone willing to have a child through a rented uterus with their eggs/sperm or entirely with other’s gametes can choose surrogacy. The percentage of surrogacy in India raised since 2009. Surrogacy was announced legal in India in 2002. By now, India has become a hub for transnational surrogacy.

Adoptions

Adoption is a kind process for infertile couples. Also, it’s an appreciable deed to adopt a child and give them a good life. In adoption, child and parents have no biological connections into their families. Types of adoptions are: International adoption, private domestic adoption, and foster care adoption are three legal ways of adoption. 

Infertility statistics in India Vs. Worldwide

Approximately one out of ten couples struggle with infertility in India, and the numbers gradually increase day by day. The infertility rate in India varies as per the state and epidemiology. The minimum percentage is 3.5, and it goes further up to 16.5 % in different states as per WHO estimation. 

According to AIIMS observation, approx. 12-15 couples suffer infertility and the inability to conceive a baby. Overall, as per fertility specialists and gynecologists in Delhi

10% of infertility is on the mark in India.

Infertility in males recorded up to 40%, and the prevalence of infertility in males is 23% in India. Most couples aged 35 to 45 have 5.5 %, and 45-50 have a 5.2% infertility rise. 

There is a steady decline from 1970 to 2020 in India. The total sperm count is less than39% per ejaculation, and less than 15 million sperm per ml of semen counts as male infertility. 

Controllable Causes of Infertility and Effect of Ejaculation in Males:

Apart from common medical deficiencies, other causes of infertility in males and females are controllable. Most likely causes due to consumption of drugs/alcohol, excessive smoking, poor nutrition, and increased BMI rectified by adopting a healthy lifestyle. 

Regular ejaculation doesn’t lead to causes of infertility in males and females. On the contrary, it oozes healthy hormones and benefits mental and physical health. According to global fertility scenarios,masturbation helps in releasing stress, anxiety, physical tension, and toxins from the body, both in males and females.

Global Statistics of The Causes of Infertility in Males and Females:

• Exposure to environmental toxins like mercury, lead, pesticides, bisphenol, dioxin causes infertility in males globally. Mainly in urban and industrialized areas, men are supposed to have severe infertility due to high-efficiency toxins.
• Due to excessive smoking, socioeconomic impacts on men’s health regulate aneuploidy syndromes that affect genes, mental health, and ability. 
• Infertility is a global health concern where male cases are convicted to 50% approx-The pathophysiology in male infertility findings based on global men sperm assessment. 
• Post-partum uterine infections incline female fertility, and global female infertility has declined across the globe since 1990. 
• Sperm fragmentation SDF is the leading cause of infertility as it impairs the paternal genome through specific pathophysiological mechanisms. Recent clinical practice recommendations considered SDF testing had harm male fertility. 
• Where IVF and IUI are some of the best resolutions for male/female infertility, it is still costly that refrain treatment and sustains infertility worldwide. 
• Among the world, 10% population is affected by infertility. In this scenario drop out of infertility treatment is a global issue for both genders.
• In some western countries, sperm preservation before hormonal infusion may compromise gonadal function and leads to subfertility or infertility. 

Conclusion

Infertility is a stressful issue nowadays, and it is so common to experience it. The adverse effect of upgraded lifestyle, busy work schedules, unhealthy environment, irregular eating and sleeping habits concludes to infertility in males and females. Apart from poor routines, couples face genetic and organ disorders that also raise the causes of infertility in males and females. 

A proper diagnosis and top fertility treatments can help overcome infertility and also the causes of infertility in males and females. There are many natural, medical, and artificial ways explored to treat infertility in common. The modernization of medications, medical equipment, infrastructure, logistics, and treatment methodology has raised the standard of fertility treatment worldwide.  

FAQs

What is the most common cause of infertility in males and females?

Unhealthy sperm like immature sperm, abnormal shape & size, not having adequate sperm count, or impotent to swim up are common causes of infertility in males and females it is ovulation disorder, irregular menses, etc.  

What are four causes of female infertility?

Causes of infertility in males and females are dependent on many factors. Females are mainly diagnosed with abnormal menstrual cycles, imbalanced hormones, structure defects, and aging. Other than this sedimentary lifestyle, obesity and other chronic illness may also raise infertility in women. 

What are the four causes of male infertility?

Health disorders like hormonal imbalance, testicles anomalies, varicoceles, and defects in tubules are the four leading causes of male infertility.Genetic defects, lasting illness, post-partum surgery consequences are some more causes of infertility in men.

Who causes infertility?

Usually, ecological factors, sedentary lifestyle, and eating disorders harm male fertility, where excessive alcohol and drugs (marijuana) consumption may also increase men’s infertility. 

Can infertility be cured?

Infertility cure through proper diagnosis, medications, natural therapies, minor/major surgeries, and other artificial ways.

References 

https://pubmed.ncbi.nlm.nih.gov/

https://www.deccanherald.com/opinion/panorama/infertility-is-rising-in-india-s-populace-788978.html

https://my.clevelandclinic.org/health/diseases

https://www.singlecare.com/blog/news/infertility-statistics/

https://www.hopkinsmedicine.org/health

https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments

https://www.americanadoptions.com/adopt/infertility-options