Infertility

Infertility is the diminished ability of a couple to conceive a child over a two-year period whether due to a known cause or not.

Causes of Female infertility

  • Ovarian dysfunction (eg. Polycystic ovaries)
  • Tubal disease (commonly caused by gonnorhoea, chlamidya or any pelvic infection, eg. appendicitis or diverticulitis)
  • Endometriosis – causes scarring intra-abdominal inflammation and blockage of the tube
  • Age-related changes – decline in quality and quality of oocytes (egg cells)
  • Uterine abnormalities – eg. congenital (from birth), acquired (uterine fibroid)
  • Cervical abnormalities – the quality of cervical mucus is important for sperm penetration and maturation.


Causes of Male Infertility

  • Abnormal semen parameters -abnormal sperm production and maturation are caused by low testosterone levels, obesity and endocrine diseases. Numerous other factors influence sperm production and maturation, including alcohol abuse, smoking, drugs and toxins.
  • Ejaculatory Duct obstruction – causes impairment of sperm transport. This can be due to complication of surgery, or infections.
  • Erectile dysfunction – may be due to vascular, metabolic or psychological problems.

 

Treatment depends on the underlying cause and includes:

  • Hormonal therapy
  • Correction of any congenital or acquired defects
  • Optimization of any other medical condition
  • Counselling

 

 

Infertility may bring on other sexual problems.

In men, these include:

  • Loss of desire, with a consequent decrease in sexual activity
  • Erectile dysfunction
  • Premature ejaculation
  • Difficulty ejaculating


In women, these include:

  • Loss of desire
  • Painful sex
  • Anorgasmia (difficulty having orgasms)


Couples find that undergoing infertility treatment and trying to get pregnant reduces the spontaneity and pleasure of sex as they feel quite anxious about having to have sex. Couples should be open with each other as well as with their doctor or psychologist about their experience who could suggest ways of dealing with these difficulties. Counselling would also help couples deal with the impact of having difficulties conceiving (such as feelings of shame, letting the partner and family down, fear of not having children), and the effect this is having on the relationship.