The World Health Organization (WHO) has defined infertility as a failure to conceive over 12 months of exposure which is a good practical guide to management, and leaves a longer term residual incidence of infertility of 10–15%. Epidemiological data suggest that approximately 80 million people worldwide are infertile. WHO indicates the highest incidence in some regions of Central Africa where the infertility rate may reach 50%, compared to 20% in the Eastern Mediterranean region, and 11% in the developed world. From the beginning of time, the command “Be fruitful and multiply” remains a permanent truth for most societies. In every society a woman’s childbearing ability is often closely linked to her status as a woman, so that when a woman is infertile she may feel unfeminine. Due to the inability of childbearing, many women fear separation from their partners. Fear of losing attraction and self-worth make them even depressed. Most of the couples when faced with the crisis of infertility go through a chain of emotional changes that can be harmful to the couple. Moreso, infertility means not being able to get pregnant after one year of trying. Or, six months, if a woman is 35 or older. Women who can get pregnant but are unable to stay pregnant may also be infertile.

Infertility may be caused by an underlying medical condition that may damage the fallopian tubes, interferes with ovulation, or causes hormonal complications. These medical conditions include pelvic inflammatory disease, endometriosis, polycystic ovarian syndrome, premature ovarian failure, uterine fibroids and environmental factors. Other causes of infertility in females include ovulation problems, tubal blockage, age-related factors, uterine problems, previous tubal ligation and hormone imbalance. Available evidence suggests that social factors, such as stress, anxiety or sudden weight loss after a crash diet inhibit normal gonadotropin-releasing hormone secretion, leading to ovulation failure. The literature has clearly indentified a series of modifiable lifestyle factors, such as psychological stress, smoking, alcohol and caffeine consumption, poor diet, obesity, and insufficient exercise that could potentially impact fertility in the general population. 

 

Prevention is by maintaining a healthy lifestyle, preventing or treating existing diseases, and avoiding sexually transmitted diseases and so many much more. Preconception medical care and counseling is advisable for all those planning a pregnancy failure of which the couple may choose to remain childless or consider adoption, or non-spousal sperm options.

Solutions to infertility

CHAPTER TWO