Globally, infertility affects approximately 1 in 6 people, according to a 2023 World Health Organization fertility report. The Centers for Disease Control and Prevention (CDC), reports that 16% of females in the United States experience infertility.
Though male-factor causes of infertility account for 20-30% of infertility cases, medical experts predict that the male-factor infertility rate may worsen due to increased exposure to environmental toxins. Therefore, it is essential to raise awareness of the prevalence of infertility.
Infertility occurs when couples or individuals are unable to achieve conception after one year of trying if less than age 35 and six months if 35 years or greater. Infertility typically delays or prevents couples from starting or growing their family. However, with the rapid advances in assisted reproductive technologies such as in vitro fertilization (IVF), couples now have an alternative solution.
This article discusses the rise of infertility, common causes, treatment options, and alternative solutions.
The most current WHO infertility report states that 17.5% of the adult population in the world is infertile. This figure represents approximately 1.36 billion people worldwide. This is in comparison to a 2004 WHO report which estimated that 60-80 million couples globally struggle with infertility. Personal, lifestyle, and environmental factors play a role in the swift increase in infertility.
Potential Causes and Risk Factors of Infertility
There are various causes and risk factors of infertility in men and women. Your awareness of some of these risk factors may cause you to adopt healthy lifestyle factors and understand if you should seek infertility evaluation early. Here are the common risk factors.
Age and fertility
Everyone regardless of gender is more fertile when they are young. As an individual's age advances, fertility gradually reduces, which is more dramatic in females. With more couples waiting to build a family later in life, infertility has risen, and fertility treatment is often necessary.
Race and ethnicity
Your race and ethnicity could also affect your fertility rate. A report from the CDC noted that Black women are less likely to seek infertility care, take longer to seek care, and have lower success rates with fertility treatment. Also, a 2021 women's health study found that infertility was more common among female minority groups than non-Hispanic whites.
Unhealthy habits such as tobacco use are associated with infertility, early menopause, and poor pregnancy outcomes. Alcohol should be stopped at pregnancy due to the detrimental effects of fetal development. Marijuana exposure is also associated with infertility. Marijuana use in men is associated with lower sperm counts. Hence, individuals who use these substances are at risk of infertility.
Medical conditions or treatment procedures that can affect the male and female reproductive tract can also increase the risk of infertility. Examples include untreated pelvic or genital infections, thyroid disease, uterine surgeries or abdominal surgeries, etc.
Infertility in females
The following are common causes of female infertility:
- Ovulation Disorders: In females with ovulation disorders like PCOS, the ovaries do not release an egg for fertilization. This affects a female’s ability to get pregnant.
- Fallopian Tube Blockage: Fertilization occurs in the fallopian tubes, and damage to the tubes hinders the process.
- Uterine Disorders such as adhesions, polyps, and fibroids impair the implantation necessary for conception.
- Prior history of pelvic inflammatory infections (caused commonly by chlamydia) can cause scarring of the fallopian tubes, which can block the female reproductive tract.
- Genetic causes involving chromosomal disorders such as Turner's syndrome.
- Endometriosis: This is a medical disorder in which the cells lining the uterus, called the endometrium, are found outside the uterine cavity. Endometriosis can lower egg reserve, block fallopian tubes, and impair the sperm from finding the released egg.
Causes of male infertility include:
- Genetic Causes such as chromosomal disorders like Klinefelter syndrome.
- Hormonal disorders affecting the pituitary gland
- Undescended Testis
- Blockage in Sperm Transport Tubules due to physical trauma, prior pelvic surgeries, and infections
- Prior sexually transmitted diseases can cause blockage in sperm transport tubules.
- Medications such as chemotherapy drugs or steroids like testosterone may affect sperm production and increase the risk of male infertility.
- Exposure to Environmental Toxins such as heavy metals and industrial chemicals.
It is crucial to seek help from a fertility expert for a thorough clinical evaluation and screening and schedule an appointment early if there are any risk factors for infertility. However, in some cases, the exact cause of infertility in males and females may be unknown.
Available Treatments for Infertility
If you or your partner have risk factors for infertility, consult an experienced fertility doctor for expert clinical care. The fertility specialist will typically combine findings from the clinical and laboratory evaluation to confirm the diagnosis of infertility.
The treatment option depends on the cause of infertility. Here are some treatment methods for infertility.
Women are commonly prescribed gonadotropins, clomiphene citrate or letrozole to induce ovulation. Men can also be prescribed similar medications in the treatment of male factor infertility.
Surgery is typically the most suitable treatment method for infertility due to structural abnormalities in the female or male reproductive tract. Surgery can help females who have fibroids, uterine polyps, blocked fallopian tubes, or uterine scarring.
Similarly, in males, surgery may be recommended in certain cases of varicocele, undescended testis, or blockages within the male reproductive tract.
Assisted Reproductive Technology
Assisted reproduction technology (ART) is a broad term that covers fertility-based treatments in which the fertility doctor handles eggs or sperm to aid conception. In-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) are the two common types of ART.
With ART, the doctor retrieves eggs from the ovaries during an outpatient procedure and then uses IVF techniques to fertilize the egg in a specialized culture medium in the laboratory. During Intracytoplasmic sperm injection (ICSI), the embryologist injects a single sperm directly into each egg.
After successful fertilization via IVF or ICSI, the fertilized egg develops into an embryo until it reaches the blastocyst stage (usually over a period of five days) until it is either transferred into the uterus or biopsied for genetic screening.
The success rate of ART differs for each person depending on age, but the average rate for young females is up to 54%.
The Emotional Impact of Infertility and Coping Strategies
Couples experiencing infertility may face emotional distress, such as stress, social stigma, anxiety, and depression. These emotions can be worsened by the family pressure and societal expectations.
In a study published in Fertility and Sterility reported that women diagnosed with infertility had twice the prevalence of depressive symptoms as women without infertility. s. Research has supported the availability of mental health professions for all individuals seeking infertility evaluation and treatment.
Couples or individuals can use the following coping strategies to handle the emotional distress from infertility:
- Seek help from a mental health professional: Counseling and psychotherapy sessions from a qualified mental health professional can help resolve negative feelings or moods about infertility.
- Social support: Join support groups filled with individuals with similar interests.
- Engage in relaxation techniques such as meditation and yoga.
- Openly communicate how you feel with your partner or loved one.
Alternative Paths to Parenthood
Couples or individuals may choose other pathways to build their family such as adoption or surrogacy.
The process of adoption can be complicated and overwhelming. For individuals who cannot carry a pregnancy or who do not want to pursue fertility treatment, adoption may be the ideal way to expand your family. Gestational Surrogacy
Gestational surrogacy is the process of using a gestational carrier and assisted reproduction techniques to help a couple or an individual to create a family when they cannot do so themselves.
The gestational carrier is not the biological parent, but her role is to carry pregnancy from an embryo(s) created using the intended parents' or donated sperm and egg.
Gestational surrogacy allows couples or individuals to become parents who are unable to carry a pregnancy themselves. However, the gestational surrogacy process involves many steps and requires a series of legal procedures and ma special contract between the intended parent(s) and the carrier.
Are You Looking for Solutions to Infertility?
Couples or individuals going through infertility face many challenges and emotional distress. However, regardless of the cause of infertility, there is a solution and support for you.
It is essential to consult an experienced fertility expert to evaluate you and recommend a solution that fits your unique health needs. Fertility treatments such as medications, surgery, and assisted reproductive techniques are tailored to each patient who is seen at Reproductive Gynecology & Infertility.
Our team of fertility experts at Reproductive Gynecology & Infertility are board-certified fertility specialists with experience and a proven record of helping couples and individuals with alternative family-building options.
We offer a personalized treatment plan that is specific to your peculiar needs. To get professional help from one of our experts, contact us today.