Infertility is the inability of a couple to have a child. A couple is considered infertile if after about twenty four months of regular sexual intercourse without any form of contraception, the woman is unable to conceive. Infertility can be primary or secondary. In primary infertility, a pregnancy has never occurred while in secondary infertility, there has been a previous pregnancy.
In those days, women were mainly blamed for childlessness in a family but today the situation is different; both men and women appear to be equally at fault but actually percentages varies from country to country. In Nigeria, it is about 50/50.
Several reasons account for infertility in women as discussed below.
1. Failure to ovulate
Some women do not ovulate (release of eggs) regularly; this could be due to diseases affecting the ovaries directly such as ovarian cyst, endometriosis and cancer of the ovaries. Other conditions that can cause irregular ovulation include sudden weight loss, obesity and stress among others.
Hormonal in-balance can also cause irregular ovulation.
Without ovulation there cannot be conception. This is said to account for about 10% of infertility problems.
2. Blocked tubes
The fallopian tubes which transfer fertilized eggs to the womb could be blocked due to gonorrhea, chlamydial infections, and some non-sexually transmitted diseases. If this happens, eggs produced by the woman whether fertilized by sperm or not cannot get to the womb by natural means.
3. Immunological hostility
In some cases, both the woman and the man are found to be okay yet the woman is unable to conceive. There have been reports of such couples separating and remarrying new partners with children.
Cervical hostility to the sperm cells of the man has been incriminated in some cases; the cervix sees the sperm as a foreign body and produces antibodies to kill the cells. This can be diagnosed by the doctor by examining the sperm obtained from the cervix of the woman after intercourse.
4. Hormonal problems.
Infertility in women could also be due to hormonal problems; various hormones involved in the release of eggs in women by the ovaries must be in the right proportions for her ovaries to release eggs.
Some hormones are not directly involved in the release of eggs but their levels could inhibit it, such hormones include prolactin and prostaglandin. Prolactin usually prevents ovulation (release of eggs) when a woman is pregnant while prostaglandin prevent the implantation of the fertilized egg in the womb.
5. Endometriosis.
Sometimes, the lining of the womb grows in certain areas of the woman’s body in addition to the womb itself. Such areas include the ovary, around the womb itself and in the fallopian tubes. This situation may make conception difficult for the woman.
6. Pelvic Inflammatory Disease
Pelvic inflammatory disease (PID) can be due to sexually transmitted disease and non-sexually transmitted disease. PID can lead to blocked tubes and or adhesions in which case the tubes may be inappropriately positioned and so cannot receive the eggs. Without the latter happening, the eggs cannot be fertilized by sperm.
7. Age
The fertility of women decreases with age; the most fertile age bracket is between 20 and 35 years of age. After 35 years, it takes more time of regular sex without contraception for a woman to become pregnant; the situation worsens after 38 years of age.
8. Uterine Problems
Uterine problems can also be responsible for infertility. Such problems include abnormally shaped uterus, fibroid and any other tumours in the uterus, scars in the uterus due to repeated surgical abortions, miscarriages and infections.
This is said to account for about 20% of infertility problems.
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