Conjugal infertility is the term given by the WHO (World Health Organization) for the absence of pregnancy in a couple, fixed partners, after 12 months of attempts without using any contraceptive method or barrier. The causes of infertility are similarly distributed between the couple, with men responsible for about 30% of cases, women for 30% of cases, another 30% being problems in both, and only 10% of infertility has no apparent cause.

As the definition of couple infertility is clinical and it is necessary to wait a period of at least 12 months of attempts for follow-up, during this period some tests may be requested for evaluation and perhaps an early diagnosis. In some cases, the problem is already detected in a simple semen analysis, in the spermogram test, indicating the absence of sperm in the semen. Some pre-existing illnesses and patients who have undergone certain types of treatments and medical procedures may begin a fertility analysis before the 12-month period, depending on case assessment and the specialist’s advice.

Main Causes of Male Infertility

  • Changes in Sperm Production;
  • Hormonal Changes;
  • Varicocele;
  • Obstructions in the male reproductive system;
  • Genetic Alterations.

Changes in Sperm Production

Through the semen analysis exam, the spermogram, it is possible to check the conditions and quality of sperm, as well as the indication of certain diseases. The main changes and indications of infertility identified by semen analysis are:

  • Azoospermia – absence of sperm
  • Oligozoospermia – low sperm count or low number of sperm produced.
  • Asthenozoospermia – low sperm motility.
  • Teratozoospermia – sperm produced with abnormal shapes, outside the norm.

Hormonal Changes

The male reproductive system and semen production are completely influenced by hormonal imbalances. When the hormones testosterone, prolactin, LH hormone, and FSH hormones are altered, sperm production and quality may be affected and cause temporary infertility.

Varicocele

Varicocele is the main and most well-known cause of male infertility. Characterized by the appearance of varicose veins in the scrotal region which begin to affect sperm production and even affect testicular volume, reducing its size. Varicocele has a progressive effect and the longer the diagnosis and treatment are delayed, the worse the condition. Correction of the condition is surgical.

Obstructions in the Male Reproductive System

Male infertility can result from factors such as obstructions in the male reproductive system, like genetic defects that cause anatomical changes in the penis and its internal parts. Some infections, inflammations, or surgical procedures can interrupt or partially or completely block the passage of semen.

Genetic Alterations

Through semen analysis and spermogram, it is possible to detect possible genetic changes, including Y chromosome microdeletions, abnormal karyotype, and even mutant genes associated with cystic fibrosis.

In addition to the factors described above, which are cited as the main causes of male infertility, factors such as erectile dysfunctions, spinal injuries, or men who have undergone radiotherapy, chemotherapy treatment or who have diabetes, some types of neuropathies or cryptorchidism (absence of testicle within the scrotal sac), can lead to male infertility.

Main Causes of Female Infertility

Uterine Alterations

Anatomical changes in the uterus can make it difficult for sperm to enter and travel, for the embryo to develop, as well as for the uterus to adapt and support gestational development and all the transformation it causes.

Tubal Alterations

Tubal alterations can make it difficult for sperm to travel, as well as for the egg, making fertilization and the movement of the embryo to the uterus, where it should implant for development, difficult. It can also affect the membranes covering the uterine tubes, causing adhesions that are very harmful to the capture of the egg to be fertilized, a factor known as peritoneal.

Ovarian Alterations

Alterations, dysfunctions, or even pathological conditions that may affect egg production, development, and maturation, as well as ovarian release, are very common causes of female infertility, which can be caused by hormonal imbalances. It is important to remember that every woman’s ovarian reserve is produced before birth, and is released throughout their fertile life, until menopause. But some factors like genetic problems and unhealthy habits such as drinking and smoking can influence the loss of this ovarian reserve, which already naturally decreases between ages 35 and 40.

Cervical Alterations

Cervical alterations are linked to disruptions in the production of cervical mucus, as well as changes in the mucus itself that hinder the sperm’s movement and their survival to reach the egg. It is one of the main causes of female infertility and can be reversible through specific treatments.

A tip for those who struggle with cervical mucus problems or lack of it is to use fertility-friendly lubricating gels, such as FamiGel. Besides improving vaginal lubrication, it increases pleasure and also acts as cervical mucus, helping sperm reach the egg due to its egg white-like consistency and a pH favorable for their survival. You can purchase your lubricant here in our online store.

Immunological Alterations

A still much-discussed cause with ongoing research, immunological alterations can involve several factors that lead to female infertility. Problems related to the female body’s immunity such as thrombophilia, endometritis, and thyroiditis can be issues. Alloimmunity is also considered, which is immune reaction to the partner. This cause is cited among the main reasons for spontaneous miscarriages, causing the woman’s body to reject the embryo, as it interprets the embryo as an invader and, as a defense, expels it. In this last case, treatment can be done through immunization vaccines produced from the father’s blood lymphocytes, which stimulate the production of antibodies that accept the father’s proteins, allowing the pregnancy to continue in a healthy way, without rejection.

Endometriosis

Endometriosis is a disease that, besides affecting female fertility, causes serious discomfort and symptoms. In terms of fertility, it can cause anatomical changes in the uterus and alter its functions. It also changes the conditions and functionality of the tubes and ovaries, making it difficult for fertilization and implantation of an embryo.

Infertility Without Apparent Cause

It is not uncommon to find couples who report that after one year of attempts, they started their evaluation and even after thorough investigative exams, no cause of infertility was found, in neither the man nor the woman. This situation occurs in about 10% of conjugal infertility cases and often, couples end up giving up on the dream of parenthood because they cannot resolve the issue or sometimes a pregnancy happens unexpectedly after the couple stops trying. In some cases, problems with the gametes, not previously analyzed, are found when couples opt for alternative methods such as assisted reproduction.

How to Deal with Conjugal Infertility

The diagnosis of conjugal infertility, regardless of who is responsible, has a great impact on the relationship. This diagnosis can lead to the postponement of dreams or realization of the couple’s life projects, causing a marital crisis or even developing depressive and guilt-related states. This is the moment when the couple most needs unity and love, so that they can withstand the change of plans together, and so that everything can be recalculated for the new path ahead. The diagnosis of infertility is not the end of the dream of parenthood, but can rather be the door to new possibilities and achievements, such as adoption.

It takes time to process the new information so don’t rush to solve everything in your mind. Everyone needs time for things to fall into place! Family support, the love of your family, and support from your partner are key to moving forward so that new dreams and possibilities can be experienced! Allow yourself!

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