Infertility has become a major setback for both men and women, caused by a wide range of problems. Their difficulty in conceiving and carrying out the conception successfully throughout the entire pregnancy term has caused the potential parents seek medical help. Although the assisted reproduction treatments have become quite useful for them, it is always better to prevent the possibilities of infertility and proceed to have offspring. 84% people in the world can have natural conception, but one in every 7 couples may have difficulty in conceiving.
What is Fertility?
The term fertility is a commonplace one and is not unknown. However, the exact definition may be stated as the ability of both men and women to reproduce and give birth to their offspring as a result of natural sexual intercourse. For men, it defines to the ability to father children; and for women, it relates to the ability to become pregnant and carry the baby for the full nine months of the pregnancy.
What is Infertility and What Are Its Types?
Infertility on the other hand is the inability to conceive, despite regular unprotected sex for a period of more than one year.
Infertility can be of two types – Primary and Secondary. In primary infertility, the woman is either unable to conceive or miscarries, after conception. In secondary infertility, a woman, even if she has had previous pregnancies and successful deliveries, might not be able to conceive again.
What Can Cause Infertility in Men and Women?
Infertility was, in earlier times, associated exclusively with females and believed that men were blessed with supreme fertility eternally. However, with the advancement of science, it has been proven that infertility has got nothing to do with gender discrepancies and can impact both on males and females. 30% of infertility rate has been attributed equally to males and females individually in every couple. In 10% cases, both the men and women can have infertility problems, in 25% cases, there can be reasons and causes that are 'unexplained' and in 5% cases, there can be other reasons.
The Major Causes Infertility in Men That Are Prevalent Are:
- Male Infertility Due To Erectile Difficulties: If a man is unable to sustain the erection for long, or until the orgasm and successful ejaculation, the couple might find troubles in having conception.
- Male Infertility Due To Ejaculation Troubles: Despite production of healthy sperm, the male might not be able to ejaculate the sperm on time and in case of retrograde ejaculation, the sperm travels backward to the bladder. In such a case, there is no chance that the sperm will fertilize the egg.
- Male Infertility Due To Sperm Troubles: It is mandatory that healthy sperm is produced by the testicles and also the sperm count is adequate in the semen, which should be more than 15 million sperms per millilitre of semen or about 39 million sperms in every ejaculation. And to trigger the proper ejaculation, testosterone and other hormone secretions should also be proper.
- Infertility Due To Varicocele, Tumour and Other Infections: Varicocele is a medical condition in which the veins that drain the testicles become swelled. If there are Cancers and non-malignant tumours, it can also affect the fertility. Even surgeries and chemotherapies, treating these tumours can also affect fertility. Several infections like chlamydia and gonorrhoea and others can also be the reason for this.
The Major Causes For Infertility in Women That Are Prevalent Are:
- Female Infertility Due To Ovulation Troubles: Monthly release of the egg from the woman's ovaries is the most important aspect of her fertility. There can be many reasons that trouble this ovulation like PCOS or poly cystic ovarian syndrome, thyroid problems and others.
- Female Infertility Due To Fallopian Tube and Womb Difficulties: Both of these organs play a very important role in conceiving. As fallopian tube is the organ that carries the eggs to the womb and it is in this tube that the egg is fertilised and then fixed to the wall of the womb, any damage in both these organs can cause infertility.
- Female Infertility Due To Tumours: Cancerous as well as benign tumours beneath the wall of the womb can also become the hindrances on the path of fertility.
Common Causes of Infertility in Both Men and Women:
- Age: With the increase in age, both men and women lose their fertility. Women enter in their menopausal state in their mid 40s to 50s and men also lose the volume and sperm motility with age.
- Lifestyle: Smoking and alcohol consumption can also affect fertility. According to the National Institute for Health and Care Excellence, drinking more than 3 to 4 units of alcohol daily, will affect fertility.
- Stress: With the busy and hectic lifestyle, the libido or sexual urge is highly affected, leading to infertility.
- Weight: One of the major causes that affect fertility is being overweight or obese. It can impact both male and female in their release of semen as well as ovulation of the egg. With the recurrent food habit and dietary flaws, both men and women tend to gain weight in an early age that is extremely unlikely to get conception naturally.
Weight gain is one of the very basic reasons, why despite other fertile conditions, a couple might not be able to conceive. Normal overweight is not as much a problem as obesity is.
Impact of Obesity on Fertility in Men & Women
What is Obesity?
Obesity is a term that is quite popular in the present medical scenario. However, it is often mistaken for being overweight. Overweight is a condition where the weight of the body is excess in respect of normal conditions. This weight includes the bones, muscles, fat as well as water. But obesity is having excess amount of body fat.
It is not only a cosmetic concern, but also has various ill effects on the health of the person. It can well be determined by the BMI or the body mass index. It is a statistical measurement that is determined by the ratio of your height and weight that can be stated as BMI = m/h2, where 'm' is the weight and 'h' is the height. When a person's body weight is 20% higher than normal range, he or she can be called obese. In terms of BMI, he or she should have a BMI of more than 30.
According to the 2009 – 2010 finding by the National Health and Nutrition Examination Survey, more than 1 in every 3 adults are obese and more than 1 in every 20 adults are extremely obese. The average range of BMI for adults is 18.5 to 24.9 and when it crosses BMI 30, it is obesity and above 40 it is extreme obesity.
Causes of Obesity:
- Diet: Unhealthy diets with high levels of calorie intakes are the very basic reason for obesity.
- Inactivity: If burning the calorie down is not taking place through daily activities and regular exercises, then this can lead to obesity.
- Medication and Medical Problems: Taking regular medicines like antidepressants, diabetes medications, anti-seizure medications, antipsychotic medications, beta blockers and corticosteroids can lead to obesity. Cushing's syndrome, Prader-Willi syndrome etc diseases are also causes for obesity.
Effects of Obesity on Fertility:
Obesity can lead to a range of health issues and they include high blood pressure and heart problems, high level of cholesterol, diabetes and others. It is also a significant reason for osteoarthritis. It blocks the arteries and risks the cardiovascular conditions. According to the U.S. Cancer Detection and Prevention 2003 research, obesity has also caused 41,000 new cases of cancer. In fact, its impact on the kidneys is also a reason for hypertension and release of more insulin, elevating blood pressure.
However, one of the worst effects of obesity is its impact on fertility. Obesity elevates the secretion of a hormone named Leptin that prevents the successful fertilization possibilities. According to the Epidemiological data, whereas inadequate diet has been the cause of infertility in 6% women, obesity and excess body weight too has been reason for infertility in 6% women.
Obesity and Hormonal Imbalance:
The principal male hormone testosterone and the principal female hormone Estradiol, which are the Sex steroid hormones, are lipid soluble and insoluble in water. In the obese bodies, these hormones get dissolved and accumulated in the body fat or the adipose cells and come to equilibrium with the blood. As the limit of the adipose cells exceeds for the obese body to store the fat and the sex hormones, there is a tendency for these cells to convert the weak male hormone namely androstenedione, to the weak female hormone, estrone. These hormones have a regulatory impact on the reproductive functions of the brain and impair the fertility.
Impact of Obesity on Fertility in Women:
Obesity and fertilisation in women have deep connections than what they seem apparently. From irregular menstrual period to ovulation, obesity can result in miscarriages as well as lower levels of response to fertility treatment. The very first change will be seen in the menstrual cycle and the later symptoms that would be found are:
- Production of estrogens and resistance in ovulation
- Endocrine disorders, leading to PCOS
- Leutal phase changes.
Impact of Obesity on Male Fertility:
Not only does obesity impact female fertility, obesity also affects male fertility by reducing the sperm concentration and sperm quality. It can also bring in Erectile Dysfunction and decrease the libido for intercourse. With reduction of weight, this can be bettered and it increases the chances of fathering the child.
Reducing Weight and Increasing Fertility:
Weight loss is the best and the only way out from the difficulties of fertility due to obesity. However, decreasing weight does not refer to crash diets, but systematic exercise and diet consumption, leading to proper BMI rate within the normal range of 18.5 to 24.9. Low calorie and high fibre diets with more fruits, vegetables and wholegrain and proper activity throughout the day is the best way to reduce weight. With weight reduction, the possibility of successful conception and carrying the pregnancy to a successful delivery automatically increases.
Although infertility is a growing concern for most couples, but the ones due to obesity can be tackled and solved very easily. However, if obesity has already caused the onset of other problems, conception can still be achieved with assisted technologies available. Yet the necessity of weight reduction remains the same.