The ability of a man to father his own children is known as male fertility. The male reproductive system is fully functional by puberty. This produces more than 5 million sperm also known as male gametes in the testis. These are the cells having chromosomes and the only cell that can fertilize an egg. They pass down the reproductive and urinary tract and are expelled with the semen. The semen ejaculated during sexual intercourse carries the sperm into the vagina of the woman. The sperm is active and swims towards the egg. One such sperm may fuse with the egg and result in fertilization of egg thus forming an embryo.
Any problems related to this process may result in infertility. With advancing age, the sperm count and motility gradually decreases.
The ability of a woman to conceive, carry the foetus to term and give birth to a live baby after nine months of gestation is what is termed as female fertility. Fertility in females is dependent on hormonal levels. Regular monthly changes in hormone levels bring about a cyclic chain of events known as the menstrual cycle. The average age at which this begins is 12-13 years. This cycle repeats for every 28 days that results in the formation of an egg in the ovaries and released outside to get fertilized.
Every month, hormonal changes in a woman’s body cause the ovaries to release a single egg. This egg passes into the fallopian tubes that link the ovaries to the uterus. At the same time, under the influence of hormones, the uterus is being prepared to receive a fertilized egg. The lining of the womb thickens. If fertilization does not occur, the womb lining will break down and will be shed through the vagina. This is a woman’s period. Women of childbearing age have a period approximately every 28 days, although the length of the cycle can vary between 24 and 35 days. If a woman has unprotected sex with a man around the time of her egg being released, sperm from her partner may fertilize her egg while it is in the fallopian tube. The fertilized egg will then travel to the womb and become embedded in its lining, where it will start to grow.
Women’s fertility declines gradually starting at about 32 years of age. It decreases more rapidly after 35 years of age.
Over 80% of couples in the general population will conceive within 1 year if the woman is aged under 40 years and they do not use contraception and have regular sexual intercourse. Of those who do not conceive in the first year, about half will do so in the second year (cumulative pregnancy rate over 90%).
A woman of reproductive age who has not conceived after 1 year of unprotected vaginal sexual intercourse, in the absence of any known cause of infertility, should be offered further clinical assessment and investigation along with her partner. There are many reasons for infertility and so are the treatments available.
Infertility in males and females
Infertility refers to an inability to conceive after having regular unprotected sex for at least a year for most people and six months in certain circumstances. If a year hasn’t passed yet, a good strategy is to plan to have sexual relationship during the days the woman is ovulating. If a woman has regular menstrual cycles, sexual relationship between the 8th & 20th day will help.
There are two kinds of infertility –
– Primary infertility means that the couple has never conceived.
– Secondary infertility means that the couple has experienced a pregnancy before and fails to conceive later.
A number of people face these problems but are embarrassed or hesitant. It’s best to seek help. Meet our doctors, counsellors and fertility specialists who will guide through this journey with compassion and care.
It is a myth that infertility is always a woman’s problem. Studies have shown that in 32% of cases there are problems associated in the male partner, in 32% of cases, the causes are related to the female partner, in 17% of cases with both and in 19% of cases the reasons are unexplained.
Among couples that seek medical treatment for infertility, 20% conceive before the treatment actually begins. One reason may be that anxiety about infertility may have contributed to the problem, so contacting a doctor and counselling helps. 50% conceive within two years of starting treatment.