Major Causes of Infertility

Infertility is a problem shared equally by women and men: 35 percent of the time the cause can be traced to the female partner, 35 percent of the time it can be traced to the male partner, and 20 percent of the time both partners have a fertility problem. For the remaining 10 percent of infertile couples there is no traceable problem.

In women, infertility is most often caused by faulty hormonal signals or obstructions within or around the reproductive organs. In men, the most common cause of infertility is a swollen vein in the testicle. In only 2 percent of all infertile couples can the disease be traced to a chromosomal defect, and these couples are unable to conceive under any circumstances. Genetic defects are passed along in the "normal" fertile population just as frequently as they are in the "abnormal" infertile population.

Conception does not often occur at first intercourse. Of couples who plan pregnancy, 63% will have conceived by the end of 6 months, and 83% by the end of a year . In order to conceive, coitus must take place at or around the time of ovulation and the sperm count must be adequate. Once gynecological, endocrine and seminal impediments to fertility have been excluded, sexual factors must be considered, as infertility may be caused by sexual dysfunction. Conversely, infertility may result in sexual dysfunction. Couples who are infertile have considerable stresses imposed on them by self, each other, family and peers. These pressures are compounded by embarrassing and uncomfortable investigatory procedures, and "sex to order".

SEXUAL DYSFUNCTION AS A CAUSE OF INFERTILITY

Non consummation is the cause of infertility in 5% of cases. In practice couples have presented with "infertility" due to non consummation as long as 15 years after marriage, with vaginismus as the underlying problem.

Male factors:

Erectile dysfunction: primary or secondary.

Ejaculatory dysfunction: premature prior to intromission, inhibited, or retrograde. Inhibition of ejaculation may be a symptom of the man's fear of pregnancy, or an expression of rejection his his wife.

Very frequent ejaculation lowers the sperm count, and this could be important in men with marginal fertility.

Female factors:

Vaginismus or thick hymen.

Dyspareunia and avoidance of coitus.

Amenorrhea and anovulatory cycles associated with the stress of sexual dysfunction.

Lack of arousal: sperm survival is thought to be enhanced by the sexual response which favorably affects the vaginal pH. Inadequate arousal necessitates the use of artificial lubricants which may be spermicidal. When orgasm occurs, the cervix is optimally placed in the seminal pool. However, it is not essential for sexual arousal and/or orgasm to occur in women for conception to occur.

The major causes of infertility are 1. Varicocele
2. Mumps
3. Stress
4. Scrotal injuries
5. Venereal disease like Gonorrhea
6. Hormonal Disturbance
7. Chromosomal and genetic disorders
8. Tubal blockage
9. Sexual problems
10. Low sperm count