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Infertility is a complex issue that has many different factors requiring considering in both diagnosis and treatment. Structural, mechanical, external and internal causes all play a role in infertility. One of the most common internal contributors to infertility is abnormal hormone controls.
There are five (5) primary hormones involved with fertility, all of which are found in both men and women. These hormones are:
Estrogen and Testosterone aid in developing the gender-appropriate reproductive parts, control GnRH production, and promote development of the germ cells into mature sperm and ova.
Other hormones play smaller roles in reproduction, such as prolactin, which is produced by the pituitary and which inhibits GnRH production, resulting in decreased fertility.
Since these hormones work so closely and precisely in the reproductive cycles of both men and women, small variations in hormone levels can significantly impact fertility, including: immature sperm cells, immature ova, failure of the uterine lining to get ready for ova implantation after fertilization, and suppressed libido.
Tests for hormone levels may be performed by your Fertility Specialist, to determine if hormone variations are contributing to your inability to conceive. And it is easier to manage hormonal fluctuations than many other causes of infertility.
In both men and women, there are stages of conception which, if completed appropriately, lead to fertility and conception. These stages are distinct and precise, so if there are any anomalies, missed steps or interruptions, infertility can occur.
In men, the stages of conception include:
Infertility is more than just a physical condition. The inability to conceive children, or carry a child to term, has emotional impact, as well.
Common feelings associated with infertility can include:
Depression is a result of grief. Each type of loss, whether emotional or physical, elicits feelings of grief. Even positive change can contribute to grief, since change represents loss. When you desire children, but are having difficulty conceiving or carrying them to term, you "lose" the opportunity to become a parent, which results in feelings of grief and depression.
Frustration and anger may also be present, with infertility. The monitoring, timing and effort that is expended in attempting to achieve conception and birth, can be stressful. Failure to conceive, when a child is so greatly desired, contributes to anger - at ones' self and perhaps at society - for not being "allowed" to have a child, when others conceive so easily.
Feelings of inadequacy are frequently present, when one is coping with infertility. During the initial stages of assessment and testing, each partner wonders whether they is something "wrong" with THEM, which is preventing conception. Men and women, alike, may feel less than whole or adequate, if they are the one with the fertility problem.
Infertility Counselors are a wonderful resource for helping to sort out feelings related to infertility and infertility treatment, and to assist in developing additional coping mechanisms to ease the feelings of guilt, depression, frustration, anger and self-inadequacy.
There are myriad contributors to infertility, and some of them can be effectively managed with medications and surgical interventions, however there are some causes of infertility that cannot be addressed with a pill or a scalpel.
Emotions play a huge role in our overall well-being. Whether we are angry, depressed, anxious, exhilarated or content, our bodies respond to these feelings with internal changes that can include:
There are a myriad of medical conditions that can contribute to infertility - a common condition that affects both men and women.
For women, health conditions such as poly-cyctic ovarian disease - a condition where the ovary grows cysts which interfere with normal ovary function, history of sexually transmitted diseases and structural problems within the female organs, can prevent conception.
In men, low sperm count, structural problems within the male organs, hormonal problems, and the inability to achieve erection contribute to male fertility problems.
In some cases, it is both the man and the woman who have medical conditions that are contributing to the difficulty in conception, and it is the role of the medical practitioner to assess each of the potential causes, and find ways to overcome them.
In the medical community, the term "infertility" means the inability to conceive children within one year if the woman is under 35 years of age, or within 6 months of the woman is over 35. It does not define whether the inability is related to the man or the woman. It also does not explain the reason for the infertility, only that conception is not possible.
There is, however, a concern among health care professionals who treat infertility, that there is no consistent definition. Some reference it as a "condition," while others refer to it as a "disease." Practitioners in the field of treating infertility feel that the most reasonable definition must include 1) infertility is a disease of both men and women and 2) that it results in the inability to conceive a child, or to carry a pregnancy to term.
Regardless of how you define it, infertility affects both men and women, and impacts not only physical health, but also psychological well-being of those affected by it.
In both men and women, the structure of the reproductive system can significantly impact each person's fertility and ability to conceive children. The reproductive system is like other body systems, and must be intact and in good health, in order to function properly.
For women, some structural causes of infertility can include:
Since infertility affects both men and women, it is reasonable that there are many different causes. The majority of these causes are internal, such as structural problems within the reproductive organs, while others are related to external factors.
Some of the more common external factors related to infertility include:
Though the internal causes of infertility may be more numerous, we cannot forget to examine the external causes, as well, to best assess and address infertility. Talk to your Infertility Specialist about other causes of infertility and the best way to treat them.
Within most societies, there is an expectation that when people marry, or become a couple, children will soon follow. Society, in general, expects couples to reproduce in order to maintain both population and social status.
In many countries, children are needed to help support the family, assist with farm labor and, sadly, to replace children who have died due to prevalent disease. When couples do not have children, those around them may question their relationship, or motives, for not conceiving.
For couples who wish to have children and cannot do so, due to infertility, the situation becomes more than simply a social one. Questions by friends, family and others, produce not only pain, but embarrassment, as if infertility were a choice, rather than a medical disease. And these questions are sometimes hard to respond to, with understanding and without anger or frustration.
Though community education about infertility, and the growing societal awareness about the disease, is making strides in limiting the sometimes prejudicial impressions voiced by those who cannot understand the pain of infertility, it still requires the couple dealing with infertility, to provide education to family and friends about the impact of the condition, and of the questions.