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Infertility in Couples

Updated on November 13, 2017
Martin Buuri profile image

Works for the University of Nairobi-Kenya in the Department of Medical Physiology,and currently pursuing a Masters degree in Immunology,

Background

Sterility is a major health concern globally. It is estimated that 10-35% of couples throughout the World take more than one year to conceive. This causes a lot of mental and emotional anguish to the couples, which may result in anxiety and tension between relationships, marriages and can even lead to divorce.

Some of the main causes of infertility include:

  • Lack of egg availability
  • Lack of sperm availability
  • Inability of sperm and egg to meet

How to determine which of the above is responsible for infertility.

(A) Egg availability

To find out whether the cause of infertility is due to lack of egg availability, the following tests are carried out on the woman.

  • Basal body temperature records
  • Luteal phase endometrial biopsy analysis
  • Serum progesterone level measurements
  • Body temperature measurement for a period of one Month

(B) Sperm availability

This is done by analysis of semen. Semen or Seminal fluid is a sticky fluid greyish, whitish or even yellowish in colour, secreted by a male’s gonads and may contain sperms.

  • Volume; On average, the amount of semen per ejaculation should be between 1.5 – 6.8 ml according to World Health Organisation.(WHO)
  • Sperm morphology; this is a critical factor in determining the success of egg fertilization. It should have a head and a tail.
  • Number of sperms; they should be over 15 million per ml.
  • Motility; A man may have over the required amount of sperms but be of bad quality if they lack or have low motility.
  • PH; This should be between 7.2 – 7.8 according to World Health Organization (WHO) This influences the ability of the sperm to penetrate the egg.

(C) Ability of the sperm and egg to meet

When a sperm and an egg meet, they fuse and hence fertilization of the egg takes place, resulting to a zygote.

Some of the methods used to assess the ability of a sperm and an egg to meet are:

  • Laparoscopy; This is a minor surgical procedure that involves insertion of a thin lighted tube into the abdomen or pelvis to look into the woman’s pelvic organs to find out whether there is any blockage. Some causes of blockage include; fibroids, cysts and other infections.
  • Hysterosapinography; This involves injection of a dye into the uterine cavity through the cervix. The flow of the dye is monitored on a screen. This way, failure of the dye to flow would indicate the site of blockage.

When results of these investigations fail to establish the cause for inability to get pregnant, the condition is referred to as unexplained infertility. The preference of unexplained infertility range between 6 – 60 % of all infertile couples, with an average of 20% .

Treatment of unexplained infertility is limited by;

  • Lack of understanding of the cause
  • Inability to correct the cause

85% of all pregnancy waste occurs prior to clinical awareness.

Women suffering from such recurrent pre-clinical pregnancy failure would present a complain of unexplained infertility rather than recurrent spontaneous abortion.

It has been suggested that recurrent spontaneous abortion and infertility could be different manifestations of a common underlying pathology.

A spermatozoa

spermatozoa mophology
spermatozoa mophology | Source

© 2017 Martin

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