Infertility is a condition that causes couples to be fraught with disappointment, frustration and heartbreak. Defined as the inability to conceive after one year of frequent, unprotected intercourse, infertility affects approximately one in six couples. Throughout North America, infertility is on the rise, possibly due to the increase in sexually transmitted diseases and the decision of a growing number of women to delay having children until later in life.
Once thought to be solely a woman’s problem, failure to conceive can be caused by reproductive difficulties in both men and women. Thirty percent of all cases of infertility originate with the woman, 30 percent originate with the man, 30 percent are the result of combined factors and the remaining cases are unexplained.1
For women, infertility is often associated with ovarian disorders, and for men it is usually linked to problems with sperm production. Treatment for infertility varies, depending on the reproductive problems involved. Over 80 percent of all infertility cases are treated with either drugs or surgery. In recent years, assisted reproductive technologies (ART), such as in vitro fertilization, have been providing effective solutions for many couples struggling with the emotional distress of infertility.
What Causes Infertility?
The discovery of infertility usually comes as an unexpected shock, and both partners suffer from the tension, disappointment, anger and grief that accompany a failure to conceive.
For a woman, the basis of her future conception is established while she is still in the womb. By the fifth month of her development before birth, a woman’s lifetime supply of more than seven million eggs, or ova, has been created and stored in her tiny fetal ovaries. As she grows and matures, millions of these eggs disintegrate, leaving her with about 300,000 eggs available for fertilization by the time she reaches puberty. A woman becomes fertile once her menstrual cycle begins, usually sometime between the ages of nine and sixteen. From this point onwards, an egg will ripen inside her ovaries once every month until she reaches menopause.
Stimulated by a sequence of hormones, the egg matures inside a tiny, saclike structure called a follicle and is released into one of the two fallopian tubes. For conception to take place, a sperm must fertilize the egg as it travels from the ovaries and through the fallopian tubes to reach the uterus.
A man produces sperm in his testicles on a continuous basis throughout his lifetime. Sperm are shaped like tadpoles, carrying genetic material in their “heads” and capable of moving by lashing their “tails” in a swimming motion. During intercourse, a man will ejaculate millions of these sperm into a woman’s vagina. Ideally, the sperm will fertilize the egg within 24 hours of ovulation, because both sperm and egg deteriorate fairly quickly. To reach the egg, the sperm must travel through the acidic environment of the vagina into the uterus and up to the fallopian tubes. Although millions of sperm make this difficult journey, only one will penetrate the tough outer membrane of the egg.
Once the first sperm has entered the egg, a chemical reaction takes place, making the egg impenetrable to other sperm. The genetic material in the head of the sperm then combines with the genetic material contained within the egg, completing the process of conception. The fertilized egg travels down through the fallopian tubes into the uterus, where it implants on the thickened lining of the uterine wall, called the endometrium. The woman’s body will nurture this tiny collection of cells for nine months within the protective environment of the uterus, as it grows and develops into a fully formed fetus.