by Dr Noah O. Olaomo
Fertility is the natural ability to procreate. It is the ability to produce offsprings. while Infertility, on the other hand, is the inability of a couple (not only the woman) to achieve pregnancy despite regular, unprotected sexual intercourse for at least a year (12months).
The 12 month waiting period is particularly important because it is only 90-95% of couples that will achieve pregnancy in the first year of cohabitation even without any problem. However, for a woman that is 35 years old and beyond or with known problems, investigations can start much earlier from about 6 months.
The coitus ( sexual intercourse) must also be regular for a couple to be properly regarded as infertile. Coitus is said to be regular if it is at least thrice a week, well spaced, penetrative and ejaculatory. The coitus must also be unprotected, that is there must be no use of condom or any other barrier method.
Couples living apart particularly face the challenge of achieving adequate coitus. The presently economic realities particularly make staying together challenging for some couples.
There are basically two types of Infertility namely primary or secondary:
a. Primary infertility refers to a situation where pregnancy has never been achieved while
b. Secondary infertility is when pregnancy(ies) have been achieved previously irrespective of the outcome. For instance, a woman who has had miscarriages, preterm births or stillbirths or has delay after delivering live baby or babies in the past is said to have a secondary infertility.
There is a need to gain some understanding of the female reproductive parts that are important in achieving fertility, these are:
a. Ovary: Produces the eggs. A woman has about 500 eggs to release in her reproductive career.
b. Fallopian tubes: This is the transport route of the egg, it allow fertilization, then transport the embryo to the womb (uterus).
c. Womb (uterus): This houses the fetus and its growth for the gestation period.
d. Vagina: For copulation (sex) and delivery.
Also, there are important parts of the male that helps to achieve fertility, these are:
a. Testes: Produces the sperms
b. Vas deferens (spermatic duct): Transports sperm externally
c. Penis: For copulation (sex) and ejaculation.
Let’s look at the various factors that affects fertility:
a. Age: For women fertility is maximal between 18-24 years. 22 years of age is an average best age to marry but other factors must be put into consideration. Fertility in men declines much later in life.
b. Genetics/family history: There genetic disorders running that can cause infertility
c. Hormones: Excessive prolactin level leading to milk or water production from the breasts of a woman who is not pregnant or breastfeeding (galactorrhea) can lead to infertility, excessive androgens (eg testosterone in women) can affect fertility too.
d. Lifestyle: Smoking impairs sperm production and its qualities. Drinking of alcohol in the long run can depress sperm production. Promiscuity (having multiple sexual partners) and engaging in unprotected sex is a strong risk factor for sexually transmitted diseases which in turn can damage the fallopian tubes thus causing infertility.
e. Past medical history/presence of disease: Diabetes Mellitus and Hypertension can cause erectile dysfunction. They can also promote miscarriages and fetal deaths. Thyroid diseases cause infertility and miscarriages.
f. Surgeries: Some surgeries (removal of tubes, womb, etc) also are causes of sterilization
g. Drugs: Cancer drugs, family planning drugs prevent conception
h. Congenital, anatomical, gynaecological problem*: Absence of ovaries, womb, vagina etc. are known reasons why some women are infertile.
Watch out for other articles on Infertility
Dr Olaomo Noah Oluwafemi is a Consultant Obstetrician and Gynecologist with a love for writing. His desire is to enhance people’s lifestyle and effect positive change in their health through his writings