3 Types of Infertility: Understanding Causes and When to Seek Help

Introduction

Infertility is a medical condition, and it is diagnosed when a couple has been trying to conceive but is facing failure, without a known medical intervention (for either partner), for over a year or longer.

Infertility can affect men or women, or both, and is the result of some type of health concern or lifestyle issue. Early diagnosis is crucial for effective treatment.

Identifying the cause of infertility allows healthcare providers to customise treatment plans to the specific needs of the individual or couple.

Understanding the different types of infertility is essential because each type may require a unique diagnostic approach and treatment.

Primary Infertility

Primary infertility is defined as the inability of couples to get pregnant. It applies to couples who have been trying to conceive for a year without success.

It is the diagnosis given to couples who have never been pregnant before. Primary infertility can be because of either the male or the female. This is the most common type of infertility.

What are the causes of Primary infertility?

Primary infertility is caused by ovulation disorders, poor sperm quality, blocked fallopian tubes, or hormonal imbalances.

Understanding the underlying causes of primary infertility can guide treatment and improve outcomes. The most frequent causes include:

• Ovulation disorders : Thyroid issues and polycystic ovarian syndrome (PCOS) can be the cause of ovulatory problems.
• Poor sperm quality : Low sperm count, poor motility, or aberrant morphology are all signs of poor sperm quality. These can cause infertility in men.
• Blocked fallopian tubes : Fallopian tube blockage is typically brought on by an infection, endometriosis, or surgical history. Blocked fallopian tubes can cause female infertility.
• Hormonal imbalances : Abnormalities in hormones that impact the timing of menstrual cycles and the release of eggs. This can also be a cause of delayed pregnancy.

When to Seek Help

Seek medical help if:

• You haven’t conceived after 12 months of trying (6 months if your age is over 35).
• You have irregular or absent menstrual periods.
• There’s a known history of reproductive health issues.

Unexplained Infertility

When an individual does not become pregnant and all regular fertility testing is normal, the condition is known as unexplained infertility.

Unexplained does not imply there is no cause; it means that it is not known or has not been diagnosed yet through testing.

Possible Factors

There are many reasons for unexplained infertility, although standard fertility tests may not identify any obvious problems:

• Mild hormonal imbalances : Minor disruptions in hormone levels can cause disruption in ovulation or implantation that won't show up on a standard fertility test.
• Reduced egg or sperm quality : Sperm or eggs may be examined and appear normal, but they may not reach the stage of a healthy embryo, travel to the egg, or fertilise the egg.
• Stress and mental health : Both mild and severe forms of stress and anxiety can affect stress hormones, which in turn may affect ovulation, cause ovulatory dysfunction, and impact fertility in general.
• Endometrial receptivity issues : The uterine lining may not be sufficiently ready for embryo implantation, despite ovulation and fertilisation proceeding without any problems.
• Subtle tubal dysfunction : The fallopian tubes may be clearly shown as open on imaging in cases of mild tubal dysfunction, but their ineffective operation may affect the development of the egg or embryo.
• Lifestyle influences : Factors like excessive caffeine or alcohol intake, lack of exercise, smoking, or being underweight or overweight may contribute to fertility challenges, even if not clinically obvious.

What Can Be Done

There are several ways to increase a woman's chances of becoming pregnant, even if we don't know the exact cause:

• Lifestyle modifications : Lifestyle changes include achieving a healthy weight, quitting smoking, and reducing alcohol and/or caffeine consumption.
• Ovulation tracking : Monitoring ovulation via ovulation kits, apps, or basal body temperature.
• Timed intercourse : Synchronised sexual activity according to anticipated ovulation windows.
• Fertility treatments : After a year of trying, fertility therapies like IUI (Intrauterine Insemination) and IVF (In Vitro Fertilisation) are frequently recommended.

Diagnosis and Testing

The process of determining the type of infertility and the best route of therapy begins with a proper diagnosis.

The reason for infertility may also be discovered by a medical history, physical examination, and specialised testing.

Here are some common diagnostic tools used by fertility specialists:

• Hormonal blood tests : These tests measure important reproductive hormones - FSH, LH, AMH and thyroid hormones - crucial to ovulation in a regular menstrual cycle.
• Semen analysis : Tests sperm, including count, shape (morphology), and movement (motility), to see if there is a male factor fertility issue.
• Transvaginal ultrasound : This procedure provides detailed images of the ovaries and uterus, allowing for the identification of cysts, fibroids, or abnormalities of the uterine lining.
• Hysterosalpingography (HSG) : An X-ray procedure helps confirm that the fallopian tubes are patent and the uterine cavity is normal.
• Advanced fertility testing : A fertility doctor may recommend more testing, such as an endometrial biopsy or laparoscopy, if the infertility cannot be explained.

Consulting a fertility specialist after testing allows for prompt decision-making regarding additional treatment and the precise interpretation of the results.

Conclusion

The first step to finding a solution is determining the type of infertility you are dealing with. All types of infertility, including primary, secondary, and unexplained infertility, have their own set of challenges as well as treatments.

Many couples are now able to conceive and raise a family because of advancements in fertility research. If you start early with personalised guidance and intervention from fertility specialists, then you can achieve parenthood early.