Primary Infertility, The Reason You and Your Partner Have Difficulty Having Children

Not all couples can have children easily. Some have primary infertility that can prevent them from having children.

This condition is often a scary specter for a couple who long for the presence of their child. Recognize the various symptoms to find out the right and accurate handling actions.

What is Primary Infertility?

Primary infertility refers to a couple who have not conceived after at least 1 year of unprotected sex. Infertility is a disease that affects the male or female reproductive system. 

Many people experience this condition. At least millions of people of reproductive age around the world experience it. This condition has more or less affected their families and also their communities.

Quoted from the official WHO website , it is estimated that between 48 million couples and 186 million people live with infertility globally.

Reason

In general, the underlying causes of infertility in both men and women are very diverse, ranging from genetic conditions, lifestyle to environmental factors. However, in some cases, sometimes the cause of primary infertility cannot be explained. 

Primary Infertility in Women

Here are some things that may cause infertility in the female reproductive system :

• Tubal disorders such as blocked fallopian tubes , which in turn are caused by untreated sexually transmitted infections (STIs) or complications of unsafe abortion, postpartum sepsis or abdominal/pelvic surgery.
• Uterine abnormalities that can be inflammatory (such as endometriosis ), congenital (such as a septate uterus), or benign (such as fibroids)
• Ovarian disorders, such as polycystic ovary syndrome and other follicular disorders
• Disorders of the endocrine system that cause an imbalance of reproductive hormones. The endocrine system includes the hypothalamus and pituitary glands. Examples of common disorders affecting this system include pituitary cancer and hypopituitarism.
• Autoimmune disorders, such as antiphospholipid syndrome (APS)
• Birth defects affecting the reproductive tract
• Blood clotting disorders
• Diabetes
• Drinking too much alcohol
• Exercising too hard
• Eating disorders or malnutrition
• Consumption of drugs such as chemotherapy drugs
• Hormonal imbalance
• Overweight or underweight
• Older age
• Ovarian cysts and polycystic ovary syndrome ( PCOS )
• Smoke
• Surgery to prevent pregnancy (tubal ligation) or reversal of failed tubal ligation (reanastomosis)
• Have thyroid disease

Primary Infertility in Men

In the male reproductive system, infertility can be caused by:

• Obstruction of the reproductive tract that causes dysfunction in the ejection of semen. This blockage can occur in the ducts that carry semen (such as the ejaculatory ducts and seminal vesicles). Blockage is usually caused by injury or infection in the genital tract.
• Hormonal disorders that cause abnormalities in the hormones produced by the pituitary gland, hypothalamus and testes. Hormones such as testosterone regulate sperm production. Examples of disorders that cause hormonal imbalances include pituitary or testicular cancer.
• Failure of the testicles to produce sperm, for example due to varicocele or medical treatments that damage sperm-producing cells (such as chemotherapy).
• Abnormal sperm function and quality. Conditions or situations that cause abnormalities in the shape (morphology) and movement (motility) of sperm have a negative impact on fertility. For example, the use of anabolic steroids can cause abnormal semen parameters such as sperm count and shape.
• Birth defects
• Cancer treatments, including chemotherapy and radiation
• Exposure to high heat for long periods of time
• Excessive use of alcohol, marijuana, or cocaine
• Hormonal imbalance
• Impotent
• Infection
• Consumption of drugs such as cimetidine, spironolactone, and nitrofurantoin
• Obesity
• Older age
• Retrograde ejaculation
• Scarring due to sexually transmitted infections (STIs), injury, or surgery
• Smoke
• Exposure to toxins from the environment
• Vasectomy or vasectomy reversal failure
• History of testicular infection due to mumps

Healthy couples under the age of 30 who have sex regularly will have about a 20% chance of getting pregnant each month.

In terms of age, a woman is at her most fertile in her early 20s. A woman’s chances of getting pregnant start to decline around age 35 (and especially after age 40). The age at which fertility begins to decline varies from woman to woman. Infertility issues and miscarriage rates increase significantly after age 35.

As a solution, there is now an option to collect and store eggs early for women in their 20s. This will help ensure a successful pregnancy if they don’t want to have children until after the age of 35. 

However, this option demands a significant cost consequence. However, if you really need it, then this option can be a consideration. 

Symptom 

The obvious symptoms of primary infertility are difficulty in having children in general, and in getting pregnant for women. Here are some other symptoms of infertility in women:

• Irregular menstrual periods or no menstruation at all
• Prolonged menstrual period more than 35 days 
• Menstruation occurs in or less than 20 days
• Heavy menstrual flow with excessive menstrual cramps
• Pain during sexual intercourse
• Hormonal variations with less sex drive

Unlike women, symptoms of infertility in men are related to low sperm count and poor sperm quality. In addition, there are several symptoms of infertility in men, including: 

• Problems related to ejaculation
• Erectile dysfunction
• Small and firm testicles
• Swelling or formation of a lump with pain in the testicular area
• Hormonal fluctuations with decreased sex drive

Difference Between Primary and Secondary Infertility

Primary infertility is when a person is unable to get pregnant at all, or has not gotten pregnant after at least 1 year of having unprotected sex. 

Meanwhile, secondary infertility is when someone has previously been pregnant but is no longer able to. At least, the woman has had one successful pregnancy. 

Diagnosis and Tests

If you and your partner have not been able to have children, you may want to make sure by taking some tests. Typically, doctors will recommend that women under the age of 30 try to get pregnant first by having unprotected sex for 1 year before taking the test.

The recommendations may be different if you are older than that. Women over 35 should try to conceive for 6 months. If you are still having trouble getting pregnant, talk to your doctor.

To test for infertility, the most important thing is to look at the medical history and do a complete physical examination of both partners. Blood tests are the most common tests needed. In women, other tests may include:

• Blood tests to check hormone levels, including progesterone and follicle-stimulating hormone (FSH)
• Urinary ovulation detection at home
• Measuring body temperature every morning to see if the ovaries are releasing eggs (ovulation)
• Clomid and FSH challenge test
• Antimullerian hormone (AMH) test
• Hysterosalpingography (HSG) to look for blockages in the fallopian tubes
• Pelvic ultrasound to check egg quality
• Laparoscopy
• Thyroid function test

While tests in men may include:

• Sperm test
• Examination of the testicles and penis
• Ultrasonography of the male genitalia (sometimes performed)
• Blood tests to check hormone levels
• Testicular biopsy (rarely done)

Primary Infertility Treatment

A diagnosis of primary infertility is not something that cannot be changed. There are various methods to treat this condition depending on the cause. These treatments include: 

• Education and counseling about the condition
• Fertility treatments such as taking medication to induce ovulation, intrauterine insemination (IUI), and in vitro fertilization (IVF)
• Medicines to treat infections and blood clotting disorders
• Drugs that help the growth and release of eggs from the ovaries
• Women and men who are underweight or overweight can increase their chances of getting pregnant by achieving a healthier and ideal body weight

In addition, to deal with this infertility, couples should increase their chances of getting pregnant every month by having sex at least every 2 days before and during ovulation. This occurs about 2 weeks before the next menstrual cycle begins. 

Therefore, if your period is every 28 days, then you and your partner should have sex at least every 2 days between the 10th and 18th day after your period starts. Having sex before ovulation occurs is very helpful.

Sperm can live inside a woman’s body for at least 2 days. However, a woman’s egg can only be fertilized by sperm within 12 to 24 hours after it is released.

Primary Infertility Prevention

For those of you who are already waiting for the presence of your baby, of course you hope that this condition does not happen to you or your partner. Here are some ways that you and your partner can do to prevent primary infertility:

• Preventing sexually transmitted infections, such as gonorrhea and chlamydia, can reduce the risk of infertility. The way to do this is by practicing safe and healthy sex.
• Maintaining a healthy diet, weight, and lifestyle can increase your chances of getting pregnant and having a healthy pregnancy.
• Avoiding the use of lubricants during sex can help improve sperm function.

Primary infertility can be the cause of a couple’s difficulty in having children. If you experience this, consult a doctor immediately to find the best solution. Hopefully this is useful.

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Republished with permission from theAsianparent Indonesia