Male and Female infertility


Q.54. Describe the male and female infertility?

Ans. Infertility or sterility and fertility  is the inability to conceive despite normal sexual performance over a long period by a mature couple. It must be realized that failure to reproduce inspite of normal sexual potency of the male partner and menstruating age group of female partner indicates infertility. It is estimated that over ten percent of marriages are infertile. Of all the cases of infertility, the defect lies in about 30 percent in males, 60 percent in females and 10 percent by the combined male-female interaction. A man between 20-30 years and a woman between 18-25 years has maximum fertility.

Male infertility is usually the result of destruction of seminiferous tubules by inflammation of testes because of disease, injury and frequent X-ray exposure. Sperm mobility is affected by the formation of coiled tails because of infection of a micro-organism called ureolyticum which adheres to spermatozoa. Reduction in sperm count and increase in sperm deformity occurs as a result of environmental pollution. Spermatogenesis is hampered by very high environmental temperature, use of certain drugs and chemicals, alcoholism, smoking, tobacco chewing, deficiency of vitamin-Exercises, hypopituitarism and hypothyroidism. Some men develop auto-agglutinating and auto-immunological defects. Extreme obesity prevents satisfactory performance of the sexual act particularly if the female partner is also fat. Psychological disorder, physical and the mental exhaustion, unsatisfactory stages of intercourse and marital maladjusted-adjustment also leads to infertility.

Each ejaculate contains 3 ml of spermatic fluid containing over 100 million sperms per ml. The semen containing less that 30 million sperms per milliliter is infertile. At lest 75 percent of the sperms must be initially motile at the time of ejaculation and at least 60 percent must remain motile in the female genital tract even after two hours. At least 75 percent of the sperms should have normal size, shape, and form with movements in the straight route.

Treatment of male infertility is by curing the underlying problems by symptomatic treatment, balanced and timely nutritive diet rich in proteins, vitamins particularly vitamin-E and minerals, serene environment, mental cruelty peace, adequate rest and physical exercise contribute in restoring normal fertility.

Female infertility may be primary if the woman has never conceived and secondary if she has become pregnant at least once which resulted in either spontaneous abortion or normal parturition and later became infertile. Primary infertility is because of absence of formation and development of ova in the ovary. Of all the cases of secondary infertility, the maximum occur after delivery of one child or after abortion due to infection of the fallopian tubes from below upwards which causes their occlusion or atresia thereby preventing the passage of ovum and sperms in the fallopian tubes resulting in failure of the sperm to fertilize the ovum.

An ovulatory menstrual cycle is the most important cause of infertility. The reason may be physiological, psychological or pathological. Hypogonadotrophins, hypothyroidism, hyperthyroidism hypo-oestrogens, diabetes mellitus, thickened ovarian walls, systemic diseases, severe anemia, and obesity are the common pathological causes which can be treated to restore normal fertility. A few women have unovulatory menstrual cycles till about twenty years of age. Congenital deformities of the genital tract, genital tract tumors, endometriosis, Salpingitis and cervical erosion may result in infertility. Salpingitis results in fibrosis and occlusion of fallopian tubes. Increased acidity of utero-vaginal orgasm tract destroys the sperms and antibodies in cervical secretion which immobilize or agglutinate the sperms are the other causes of female infertility. Good balanced diet particularly vitamin-E present in germinating and sprouting seeds of gram, bean and pea as well as milk, egg, meat and fish, physical exercises, adequate rest and mental serenity help to restore the body function thereby producing normal level of law and sex stimulating hormones, sex hormones and other endocrinal hormones resulting in curing of infertility in a fair proportion of women. Systematic diseases are adequately treated.

The combined male and female interaction is responsible for infertility in some couples in which both man and woman are independently fertile but become infertile for each other. The woman secretes sperm-antibodies it, her genital secretions particularly from cervix which immobilize and agglutinate the sperms of a group of men carrying particular immunological factors. Unhappy marital life and deep-rooted hatred for each other makes a couple infertile.