Inability to conceive or induce conception. Of all cases of infertility, 35% may be attributed to the male and 55% to the female. In much of the world an estimated 6 per cent of couples are involuntarily childless, excepting Africa, where the proportion is about 10 per cent, and the Middle East and Latin America , where the proportion is about 3 per cent. Investigating and treating infertility is complex and costly and is largely confined to wealthy industrialized countries.

Symptoms

§         they have not conceived after 12 months of unprotected intercourse, or after 6 months if the woman is over 35 years of age. The reduced duration for women over 35 is because there is a rapid decline in fertility after this age and help should be sought sooner.

§         there is incapability to carry a pregnancy to term.

The cause of increasing rates of infertility

§         the postponement of pregnancy:

§         Adverse effects of increasing age on reproductive capacity include decreased conception rates and increased pregnancy losses.

§         The increasing incidence of pelvic inflammatory disease is also thought to be a major cause.

There are fertility problems with both the man and the woman

• Male Factors

The male contribution to fertilization and the establishment of pregnancy is the sperm. Sperm are small cells that carry the father's genetic material. Male infertility can be caused by a number of different characteristics of the sperm. To check for these characteristics, a sample of semen is obtained and examined. Four basic characteristics are usually evaluated:

·         Sperm count refers to the number of sperm present in a semen sample. The normal number of sperm present in just one milliliter (ml) of semen is over 20 million. An individual with only 20 million sperm per ml of semen is considered subfertile; an individual with less than 5 million sperm per ml of semen is considered infertile.

·         Sperm are also examined to see how healthy they swim and to be sure that most have normal structure.

·         Not all sperm within a specimen of semen will be perfectly normal. Some may be immature, and some may have abnormalities of the head or tail. A normal semen sample will contain no more than 25% abnormal forms of sperm.

·         Volume of the semen sample is significant. An unusual amount of semen could affect the ability of the sperm to successfully fertilize an ovum.

• Female Factors

The female makes many contributions to fertilization and the establishment of pregnancy. The ovum is the cell that carries the mother's genetic material. These ova develop within the ovaries. Once a month, a single mature ovum is produced, and leaves the ovary in a process called ovulation. This ovum enters a tube leading to the uterus. The ovum needs to meet up with the sperm in the fallopian tube if fertilization is to occur.

• Ovulatory problems

The first step in diagnosing ovulatory problems is to make sure that an ovum is being produced each month. Ovulation is dependent on the timely secretion of the two gonadotropic hormones from the pituitary gland, follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Gonadotropic hormone release can be impeded by certain medications and by many disease states, including stress, anorexia nervosa, weight loss, and thyroid disease.

• Pelvic adhesions and endometriosis

Pelvic adhesions cause infertility by blocking the fallopian tubes and preventing the sperm from reaching the egg. These scars can be the result of past infections, such as pelvic inflammatory disease, or infections following abortions or prior births. Previous abdominal surgeries can also leave behind scarring. Endometriosis may lead to pelvic adhesions. Endometriosis is the abnormal location of uterine tissue outside of the uterus. This leads to irritation within the pelvis around the site of this abnormal tissue and bleeding, and may cause scarring.

• Cervical factors

The cervix is the opening from the vagina into the uterus through which the sperm must pass. Mucus produced by the cervix helps to transport the sperm into the uterus. Injury to the cervix or scarring of the cervix after surgery or infection can result in a smaller than normal cervical opening, making it difficult for the sperm to enter. Injury or infection can also decrease the number of glands in the cervix, leading to a smaller amount of cervical mucus.

Cervical mucus can be examined under a microscope to diagnose whether cervical factors are contributing to infertility. This procedure is called a post-coital test.

Treatment

The treatment for infertility usually involves invasive and, expensive procedures. There are many alternative treatments available that can increase the chance of conception. Some have been proven effective in clinical studies.

General measures to increase fertility include:

·               monitoring ovulation

·               timing intercourse

·               quitting smoking

·               quitting excessive drinking

·               quitting drug use

·               to improve sperm quality, men can wear boxer shorts instead of briefs.

Both men and women can increase fertility by:

·               eating a well-balanced diet

·               good food choices include legumes (especially soy)

·               dark-colored vegetables

·               fruits, seeds, nuts

·               good quality protein including meat, fish, and eggs

·               Some people think that refined sugar, processed cheeses, foods made with white flour, and chemical preservatives should be avoided

·               enough sleep is also important