Infertility is the inability of a couple to achieve pregnancy after 1 year for sexual conduct on a regular basis and not using contraception.
Primary infertility is the term used when couples have never had children. If previously married couples had children (at least 1 time a pregnancy), but subsequent pregnancies have been achieved, then used the term secondary infertility.
Approximately 30-40% of cases are caused by male factors, such as:
1. Problems with sperm
In adult men, sperm are made continuously in the testes (testicles). The process of making sperm is called spermatogenesis. Specialized cells that have not will take approximately 72-74 days to develop into mature sperm cells.
From the left and right testis, the sperm move into the epididymis (a funnel-shaped coils located on the top of the testicle to the bottom rear of the testes) and stored in the epididymis until ejaculation. From the epididymis, the sperm move into the vas deferens and ejaculatory ducts. In the ejaculatory ducts, the fluid produced by the seminal vesicles and added to the sperm to form semen, which then flows into the urethra and expelled when ejaculation.
A man’s fertility is determined by its ability to deliver a number of normal sperm into the woman’s vagina. There are several factors that influence the process so that it can happen infertility:
* Increasing the temperature in the testes due to prolonged fever or due to excessive heat can cause decreased sperm counts, reduced sperm motility and increase the number of abnormal sperm in the semen.
The formation of sperm is most efsisien temperature 33.5? (lower than body temperature). Testes could remain at these temperatures because it is located in the scrotum (sac balls) which are outside the body cavity.
Other factors that influence the number of sperm is the use of marijuana or drugs (eg cimetidine, Spironolactone, and nitrofurantoin).
* A serious disease of the testis or blockage or absence of the vas deferens (left and right) can cause azospermia (no sperm at all are formed. If in the cement there is no fructose (the sugar produced by the seminal vesicles) that does not have the vas deferens or not there seminal vesicles or there is a blockage in the ejaculatory ducts.
* Varicocele is an anatomical abnormalities most often found in male infertility. Varicocele is a varicose veins (venous dilation) in the scrotum. Varicocele can block drainage of blood from the testes and reduce the rate of formation of sperm.
* Retrograde ejaculation occurs when semen flows against the current, namely the cement to flow into the bladder to the penis instead. The disorder is more often found in men who have undergone pelvic surgery (especially prostate removal) and men who suffer from diabetes. Retrograde ejaculation can also occur due to nerve dysfunction.
2. Impotence
3. Hormone deficiency
4. Environmental pollution.
5. The formation of scar tissue due to sexually transmitted diseases.
40-50% of infertility caused by female factors:
1. Scarring from sexually transmitted disease or endometriosis.
2. Ovulatory dysfunction (abnormalities in the process of egg release by the ovary / egg). Ovulation is the release of eggs from the ovary (ovary). Ovulation usually occurs 14 days before the first day of menstruation. The egg is released ready to be fertilized by sperm from men.
If a woman has a menstrual cycle is irregular or no periods (amenorrhea), then find the cause first and then do the treatment to stimulate ovulation. Sometimes ovulation does not occur due to the release of GnRH (donadotropin-releasing hormone) by the hypothalamus.
3. Hormone abnormalities.
4. Malnutrition.
5. Ovarian cyst.
6. Pelvic infection.
7. Tumors.
8. Abnormalities of cervical mucus
Cervical mucus acts as a filter that blocks the entry of bacteria from the vagina into the uterus. This mucus also serves to extend the viability of sperm.
Cervical mucus is thick and can not be penetrated by sperm except at folikuler phase of the menstrual cycle.
During phase folikuler, an increase in estradiol hormone that is more clear mucus and elastic and can be penetrated by sperm. Furthermore sperm into the uterus and then into the fallopian tubes and fertilization occurs in the fallopian tube.
9. Transport system abnormality from the cervix to the fallopian tubes (oviduct).
10. Abnormalities in the fallopian tubes.
Structural abnormalities can occur and fallopian tube function.
The main causes are:
- Infection
- Endometriosis
- Binding of tubal sterilization on the action.
An estimated 10-20% of couples experiencing infertility. Is important not to postpone pregnancy for more than 1 year; possibility of a pregnancy in healthy couples both aged under 30 years old and had sexual intercourse regularly is only for 25-30% / month. A woman’s peak fertility is at age 20 years; if women over the age of 30 years (especially over 35 years), then the possibility of pregnancy is less than 10% per month. In addition to factors associated with age, increased risk of infertility also in:
* Flitting sexual partners (because of increased risk of sexually transmitted diseases)
* Sexually transmitted diseases
* Have you ever suffered from pelvic inflammatory disease (after suffering from this disease, 10-15% of women become sterile)
* Have you ever suffered from orchitis or epididymitis (men)
* Mumps (men)
* Varicocele (men)
* Exposure DES (diethyl stilbestrol) (male or female)
* Anovulatory menstrual cycle
* Endometriosis
* Abnormalities of the uterus (uterine) or cervical obstruction
* Chronic disease (eg diabetes).
