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When a pregnancy has not occurred after at least one year of unprotected sexual intercourse or coitus, infertility is said to exist. About 14% of couples in the United States are infertile. In about 40% of couples with an infertility problem, the cause of infertility is multifactorial; in about 30% of couples, it is the man who is infertile; 20% to 25% of couples experience ovulatory failure; another 20% experience tubal, vaginal, or uterine problems as the cause of their infertility. In as many as 25% of couples, no known cause of infertility can be discovered despite all the diagnostic tests currently available. Now, the question is this: How to cure infertility?
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Management of infertility focuses on correction of any underlying problem or causative factor that was discovered upon assessment.
The factors that cause infertility in women are analogous to those causing infertility in men: anovulation (faulty or inadequate production of ova or egg), problems of ova transport through the fallopian tubes to the uterus, uterine factors such as tumors or poor endometrial development, and cervical and vaginal factors that immobilize spermatozoa.
In men, these factors include a disturbance in spermatogenesis (production of sperm cells), obstruction in the seminiferous tubules, ducts, or vesicles that prevent movement of spermatozoa, qualitative or quantitative changes in the seminal fluid that prevent sperm motility, development of autoimmunity that immobilizes sperm, and problems in ejaculation or deposition that prevent spermatozoa from being placed close enough to the woman’s cervix to allow ready penetration and fertilization.
Increasing sperm count and motility, reducing the presence of infection, hormone therapy, and surgery are just some of the ways in which these problems may be addressed. But for some couples, even treatment with infertility with procedures may not succeed, and so they need to consider still other options such as alternatives to childbirth including surrogate mothers, adoption, and even child-free living.
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