Sterility is the inability to reproduce nevertheless there is regular sexual intercourse (2-3 times a week) and no methods to prevent pregnancy are used. A couple is considered sterile if the woman is up to 29 years old, the man is up to 39 years old and conceiving is not achieved under the abovementioned conditions for one year. When one or both of the partners is older we consider sterility if conceiving is not achieved for 6 months. Infertility includes the term sterility and combines two other conditions – inability to carry a pregnancy to full term (miscarry) and inability to give birth to a vital baby.
Sterility is the main reason for infertility. Sterility is an important factor and is socially significant. In developed countries about 16% of married couples in reproductive age can not have children. Researches show that in about 40% of all cases infertility arise from problems in the man’s system. About the same percent infertility arise from abnormalities in the woman’s system.
About 20 percent of the time, the man and woman both have fertility problems. It is necessary to remind that the understanding that infertility in a family is identified with woman’s infertility is totally incorrect nevertheless this believe unfortunately exists. Half of the man’s potency is identified with their fertility which is not always correct. That is why when a fertility problem exists it is necessary both of the partners to be examined.
Reasons for infertility in man
Main reason for man’s infertility is disorders in spermatogenesis. Reasons for pathological change in this process ca be:
- Disorders of the male reproductive system – Orchitis,Epididymitis, Hydrocele, Varicocele
- Urogenital infections– venereal diseases, chronic prostate infections, etc.
- Operational interventions done because of hernia, varicocele, Cryptorchism, testicular torsion, etc.
- Genital traumas
- hormone endocrine disorders – diabetes, obesity, thyreotoxicosis, hypothalamic disorders, etc.
- Stress and use of alcohol, tobacco, drugs, etc.
- Deleterious work conditions, medications, especially chemio – radiotherapy
- Occlusion of the ductus deferens – it can be inborn absence of ductus deferens, as well as occlusion as a result of a trauma, inflammatory disease, result of gonorrhea, operative intervention, etc.
- Sexual difficulties such as impotence, premature ejaculation, phimosis, epispadia and hypospadia
- Genetic defects –Klinefelter syndrome, Sertoli cell-only syndrome, cryptorchidism, epididymal dysgenesis, congenital anorchia, etc.
- Morphology anomalies in sperm
- Sperm agglutination.
Reasons for infertility in woman
Infertility in women can a result of endocrine and metabolic disorders, genetic malformation syndromes, genital inflammations, psychogenetic, immune and other factors.
- Urogenital infections – venereal diseases, specific and non-specific illnesses Chlamydia, tuberculosis, gonorrhea, etc.
- Abdominal surgery and operations of the reproductive system – abortion, appendectomy, peritonitis, cystectomy,ovarian resection, uterus operations, еlectrocauterisation, etc.
- Endocrine and metabolic disorders – hypothalamus – hypophysis – ovarian axis, Hyperprolactinaemia, diabetes, Thyroid dysfunction, adrenocortical disorders, obesity, anemia, metabolic disorders, etc.>
- Genetic defects of the vagina (aplasia, different accretions, longitudinal and transverse vaginal septum), the uterus (hypoplasia, one horn or bicornuate uterus, etc.) and other reproductive organs
- Pelvic traumas, genital and spinal cord injuries.>
- Deleterious work conditions, lifestyle, diet, use of alcohol, tobacco, drugs. Medications, including chemio – radiotherapy.
- Immunological factors
- Psychogenetic factors
To diagnose the reasons for infertility is a complex process because most often it is a result of the effect of several factors at the same time. This imposes a complex examination of both partners and individual approach to each couple in order achieving fast and precise diagnose. The choice of an effective treatment in order to achieve the desired conception depends on the diagnose accuracy.