Types of Infertility
Causes of Infertility in Men and Women
Infertility is defined as the inability to conceive despite having unprotected sex for one year or longer. Incapacity to conceive after receiving artificial insemination is also infertility. Infertility affects both men and women, contrary to the widespread belief that it’s a women problem. The different types of infertility in men and women are discussed below.
Primary and Secondary Infertility
Infertility can broadly be classified into secondary and primary infertility.
Primary infertility is when the couple has never conceived despite having unprotected sex for more than one year. Secondary infertility is when sex partners who had previously conceived are no longer able to do so.
Infertility can be further classified depending on its cause. Similar factors cause primary and secondary infertility. The following are the different types of infertility classified according to the cause.
Types of Infertility in Males
Obstructive infertility/obstructive azoospermia: This type of infertility occurs when the sperm ducts are partially or fully blocked. This leads to a lack or shortage of sperms in semen. The blockade of the sperm ducts can result from
- Genital injury
- Malformation of the urethral canal and epididymis
- Sexually transmitted infections
- Inflammation of the genital canal
Non-obstructive infertility: This type of infertility is characterized by lack of sperms in semen due to the failure of the testicles to produce sperms. Non-obstructive infertility can be caused by trauma to the testicles, varicocele, inflammation of the testicles, and underdeveloped sperm-producing cells due to genetic disorders.
Hormonal deficiency: The shortage of luteinizing hormone (LH) and follicle stimulating hormone (FSH) leads to infertility. This only affects about one percent of infertile men. LH stimulates the production of testosterone while FSH promotes testicular growth. The deficiency of these hormones leads to lack of sperms in semen.
Ejaculation disorders: Ejaculation disorders such as premature ejaculation and retrograde ejaculation can lead to infertility. These disorders hinder movement of sperms from the penis to the vagina. In premature ejaculation, the male releases semen before copulation. Retrograde ejaculation is when sperms enter the urinary bladder during orgasm rather than emerge through the penis.
Types of Infertility in Females
Tubal blockage: This type of infertility accounts for about 40 percent of infertility in females. It occurs due to occlusion of distal or proximal tubes. This blockage affects the movement of the ova from the ovarian follicles to the uterus. The proximal and distal tubes may get blocked due to:
- Inflammatory pelvic diseases
- Sexually transmitted infections
- Genetic factors
Endocrine/hormonal factors: The development and release of the ovum by the ovaries is controlled by hormones such as progesterone, estrogen, luteinizing hormone, and follicle stimulating hormone. When there is an imbalance of these hormones in the body, the development and release of the ova at the right time for fertilization is hindered leading to infertility.
Ovary, uterus, and cervical disorders: The ovary houses and releases the ova. Failure of the ovary to perform these functions properly leads to infertility. The failure can result from tumors and treatments such as chemotherapy. Tumors and other infections along the uterine walls can hinder implantation leading to infertility. Cervical disorders such as deformation cause infertility by disrupting the flow of sperms from the penis to the uterus.
Immunological factors: Sometimes, the vagina and cervix contain sperm antibodies. These antibodies fight sperms thus hindering fertilization.
This is also known as unexplained infertility. This is where the causes of the infertility are unknown. Analysis of the reproductive organs, semen, and hormones reveals no disorders. Idiopathic infertility affects both males and females.
How is the Type of Infertility Established?
When infertility is suspected, the doctor will first evaluate the sexual and medical history of the couple. This gives them a clue of what might be causing infertility. They then carry out further analysis such as ovarian reserve testing, tubal analysis, and semen evaluation.
The treatment that the doctor recommends depends on the cause of infertility. Treatments for infertility include surgery, intrauterine insemination, medication, and assisted reproductive technology.