Many people confuse the concepts of “infertility” and “sterility”
Use them interchangeably to define long-term (regular, annual intercourse without the use of contraceptives) state of inability to get pregnant. These concepts, however, are not identical:
- Infertility is a reversible condition, it occurs among couples who only have difficulties with conceiving a child.
- Sterility is a condition of permanent inability to have a baby, which may appear due to the lack of ovaries (women) or testicles (men).
Today, it is assumed that unfortunately as many as 10% to 15% of couples face the problems to conceive the offspring.Where do these problem stem from and does the fault alway lie on one side? Unfortunately, it is not easy to explain the problem, especially the matter of making only one side responsible for infertility. Obviously it is often the case that only one partner is responsible for difficulties to get pregnant, but let us not forget that also in 10% of cases both partners are responsible.
Even today, the Institute of Health agrees to recognize infertility as one of the social diseases, because apart from religious and ethical factors, we often forget the suffering which goes together with the inability to have children. And what are the reasons for infertility? We present factors which most frequently affect the increased risk of occurrence among men and women.
Causes of infertility on the woman’s side:
- Systemic factors, mainly: thyroid, adrenal disease, obesity or excessive thinness, psychogenic factors, severe liver or kidney disease, alcoholism
- Venereal diseases
- Pituitary gland diseases; among others, Kallmann syndrome, hyperprolactinemia and hypopituitarism
- Ovarian diseases that cause ovarian disorders, ovarian cancer, polycystic ovary syndrome, abnormal ovarian structure (eg. Turner syndrome) and corpus luteum disorder
- Fallopian tubes diseases: mainly contributing to their occlusion, for instance endometriosis, pelvic inflammatory disease (caused by Chlamydia trachomatis), peritoneal adhesions in the small pelvis
- Uterine diseases: developmental uterine dysfunction, uterine fibroids or Asherman syndrome which comprise intrauterine adhesions
- Cervical diseases: cervical stenosis, anti-epithelial antibodies, cervical mucus abnormalities (manifested by the lack of transport of semen to the womb opening)
- Vaginal diseases: all diseases leading to the vaginal opening constriction
- Genetic factors: mainly Turner syndrome, which is the presence of only one X chromosome
Causes of infertility on the man’s side:
- Systemic disease: thyroid, gonadal dysgenesis, hypopituitarism, hyperprolactinemia, psychological factors, impotence as well as drugs, alcohol and some medicines (spironolactone, ketoconazole, cimetidine, guanethidine, (anticancer drugs)
- Testicular diseases: testicular cancer, idiopathic hypofunction, cryptorchidism, varicocele, testicular injury, testicular damage due to viral infections (eg. mumps)
- Genetic disorders: karyotype disorders (Klinefelter syndrome, Kallmann syndrome, Prader-Willi syndrome), mutations or microdeletions in the AZF region of the chromosome Y long arm, CFTR gene mutation (responsible mainly for inherited undevelopment of vas deferens)
- Other factors: inflammatory conditions of the reproductive system, that is prostatitis, seminal vesiculitis, epididymitis; retrograde ejaculation, hypospadias