Infertility: Have you done an Abortion?
Understanding the Problems and Undergoing Treatment
If can be rather depressing when a family is ready for children but realize that infertility is present in any one of them. This is especially apparent in Taiwan due to negative mentality towards the inability to procreate. However, with strong determination and understanding of the causes of infertility, one would eventually overcome its setbacks.
Definition of Infertility
How many unsuccessful attempts at pregnancy should it take for a woman to suspect that she is infertile? And what are the causes of sterility? There are many factors that contribute to sterility. Instead of making wild guesses, you are better off undergoing a medical examination to identify the reason for your unsuccessful attempts at pregnancy.
What is Infertility?
It is considered infertility when a couple engages in regular sexual intercourse without taking contraceptive measures and yet unable to conceive a child for one year. There are about 15% of couples trying to conceive a child that are suffering from impotence. Impotence may lie with gender, so to identify the cause of their unsuccessful pregnancy; both the husband and wife should undergo a medical examination.
Normally, if a couple engages in regular sexual intercourse without contraception, a successful pregnancy should occur within six months to 2 years. Therefore, it is advisable for a couple to undergo a medical examination if they are unable to conceive within a year. Infertility, like all other health issues, has higher chances of being treated when identified early.
Causes of Infertility
Until recently, women are often thought to be responsible in the case of sterility. However, active research on sterility has finally proved that there are many factors contributing to it, and men could also be the reason for it. Nevertheless, as long as the cause of impotence is identified, overcoming it may be possible with the appropriate treatment.
Research have shown that among infertile couples, 30% of infertility are due to men, 20% are due to both parents being infertile, and 10% are due to unknown factors. Furthermore, the entire process of pregnancy is complicated; so as long as a single process did not perform successfully, a successful pregnancy will not occur.
Causes of Male Infertility - Abnormalities in Sperm Production
80-90% of infertile men are infertile due to the inability to produce sperm. This may be caused by problems in testicular functions, hormonal abnormalities, radiation, drugs, cancer, as well as genetics. Even if the testes are capable of producing sperms, other parts of the male reproductive system need to function properly in order to deliver the sperms to the egg. Other factors such as erectile dysfunction, ejaculatory dysfunction, premature ejaculation and other abnormalities may also result in impotence.
Causes of Female Infertility – Ovulation Disorders
Infertility in women is largely causedby ovulation disorders where the ovaries are unable to produce an egg. The endocrine system responsible for ovulation consists mainly of the brainstem, the hypothalamus, pituitary and the ovaries. A breakdown in any of these hormonal glands will disrupt proper ovulation and cause impotence. Stress, improper diet, obesity may also result in abnormal ovulation.
Dysfunction of the fallopian tubes may also be the cause of infertility. Some examples of fallopian tube dysfunction are tube blockage and tube passage being too narrow. For tube blockage, the sperm is unable to enter the fallopian tube to fertilize the egg. In the case of tubal passage being too narrow, the sperm may enter the fallopian tube but even if the egg is successfully fertilized, it may not be able to pass through the fallopian tube and result in an ectopic pregnancy. Tubal inflammation is also accountable for half of the infertility cases.
Ectopic pregnancy and endometriosis may also lead to the fusion of tubal walls, causing sterility. Uterine abnormalities such as implantation problems, reduced secretion of cervical mucus and sperm immobility are also causes of sterility.
In a scenario where both the male and female reproductive systems are completely healthy but yet unable to conceive, the reason for infertility may lie with immunization. The female body may identify sperm as invasive foreign material, and hence develop antibodies against them. In the case where the sperm considers the egg to be unfit, it will also ‘attack’ and destroy the egg instead of fertilizing it, leading to infertility.
Types of Medical Examination for Infertility
In principle, both men and women should undergo medical examinations if they are suspected of sterility. However, medical tests for male infertility are relatively cheaper and simpler. Hence, it is advised that men should undergo the examination first.
Medical Examination for Male Infertility
Male infertility tests basically involve checking of testicle size and structure, along with semen, urine and hormonal examination. For sperm mobility and strength test, a sperm penetration test will be done via animal testing.
Sperm abnormalities account for 8O-9O% of male infertility and this could be due to sperm count, sperm mobility and sperm structure. For a semen test, men must abstain from sex for around 3-5 days before ejaculating in a sample container provided by the hospital. Ensure that hands and genitalia are cleaned before collecting the semen sample in the container. Test results will be ready around 2 weeks after the medical examination.
Men may develop antibodies towards sperm in their body known as anti-sperm antibodies, causing a decline in sperm activities. These anti-sperm antibodies are identified through a simple blood test.
During a semen test, several other special tests are necessary to ascertain whether the semen contains abnormal sperms. Each and every aspect of the reproductive system such as the size and appearance of external genitalia, functionality of testicles, urinary tract, are required to be checked along with a blood hormone test. To determine Azoospermia, a testicular tissue examination is also necessary to check whether the testicles are functioning normally.
Medical Examination for Female Infertility
The tests include measurement of basal body temperature, endometrial examination, hysterosalpingography, ultrasound screening and intrauterine sperm status.
This test is to determine the day of ovulation and whether the process is smooth. Before undergoing the implementation hormone test (3 days from the start of menstruation), tests must be done to determine if the woman is suffering from high lactation hyperlipidemia, early menopause or polycystic ovary syndrome. To check if there is an adequate secretion of antibody hormones, two more hormonal examinations will be required.
Through an X-Ray test, we will be able to determine if there are any abnormalities in the uterine cavity or fallopian tubes. However, even if they seem normal from hysterosalpingography, a laparoscopy is necessary to confirm if they are indeed normal.
Infertility due to Abortions
It is very common for the endometrium to be wounded during an abortion. The more frequently a woman undergoes abortion, the weaker the endometrium gets. This drastically reduces chances of successful pregnancy and increases the probability of a miscarriage. Normally, the uterus lining thickens to 10-14 mm in preparation for implantation around 14-15 days after menstruation.
However, if the endometrium is damaged due to a previous abortion, the endometrium cells may not be able to thicken, and implantation will not be possible. The pregnancy rate is extremely low if the endometrial thickness is less than 7mm and impossible if it is less than 6mm. The only treatment for this would be hormone therapy, but it may not be successful if the endometrial base layer is too severely damaged.
If the couple wants to have a child within 6 months and hasn’t had any luck yet, it is best to already undergo examinations for infertility in order to treat such, instead of waiting for a year before undergoing examination.