Infertility refers to inability to conceive after having unprotected sex for atleast one year. Infertility can also refer to the biological inability of an individual to contribute to conception or to a female who cannot carry a pregnancy full term.In many countries infertility refers to a couple that has failed to conceive after 12months of regular sex intercourse without the use of contraception.
Risk factors of infertility
Age: A woman’s fertility starts to drop after 32yrs of age.Male infertility progressively drops after the age of 40.
Smoking: Smoking significantly increases the risk of infertility in both males and females.
Alcohal consumption: A woman’s pregnancy can be seriously affected by any amount of alcohal consumption. Alcohal abuse may lower male fertility. Moderate alcohol consumption has not been shown to lower fertility ,but it is thought to lower fertility in men who already have a low sperm count.
Being obese and overweight: Overweight, obesity & a sedentary life style are often found to be the principal causes of female infertility. An overweight man has a higher risk of having abnormal sperm.
Eating disorders: Women who become seriously underweight as a result of eating disorder may have fertility problems.
Being vegan: Vegetarians must make sure intake of iron, folic acid, zinc, vitaminB-12, are adequate.
Over exertion: A woman who exercises more than 7hrs each week may have ovulation problems.
Not exercising: Leading a sedentary lifestyle is sometimes linked to lower fertility in both males & females.
Sexually transmitted diseases: Chlamydia can damage the fallopian tubes,as well as making the man’s scrotum become inflammed.Some other sexually transmitted diseases may also cause infertilty.
Exposure to some chemicals: Some pesticides, herbicides, metals(lead) & solvents have been linked to fertility problems in both men & women.
Mental stress: Studies indicate that female ovulation & sperm production may be affected by mental stress.
There are many possible causes of infertility unfortunately in about onethird of cases no cause is ever identified.
Causes of infertility in women:
Ovulation disorders: This is the common cause of infertility in women.
1.Anovulatory cycles: Ovulation doesn’t occur in some women even with regular mensutral cycles.
2.Poly cystic ovarian syndrome: Ovaries function abnormally with high levels of androgen, also called Stein-Leventhal syndrome.
Hyper prolactinemia: If prolactin levels are high the woman will not be pregnant or is breast feeding.It may affect ovulation and fertility.
Luteal phase defect.
Hypo & hyper thyroidism.
Problems in uterus & fallopian tubes.The egg travels from ovary to the uterus (womb) where the fertilised egg grows.If there is something wrong in the uterus or fallopian tubes the woman may not be able to conceive naturally.
1.Pelvic surgery may sometimes cause scarring or damage to the fallopian tubes.Cervical surgery can sometimes cause scarring or shortening of the cervix.
2.sub mucosal fibroids Benign or non cancerous tumours found in the muscular wall of the uterus occuring in 30-40% of women of child bearing age.They may interfere with implantation.
3.Endometriosis -Cells that are normally found in the lining of the uterus start growing elsewhere in the body.
Non steroidal anti inflammatory drugs –Women who take aspirin or ibuprofen long term may find it hard to conceive.
Chemotherapy: Some medications used in chemotherapy can result in ovarian failure.
Radiotherapy: If radiation therapy was aimed near the woman’s reproductive organs there is higher risk of fertility problems.
Illegal drugs: Woman who take marijuana or cocaine may have fertility problems.
Causes of infertility in males
1. Oligospermia : Sperm concentration should be 20millions/ml of semen , if the concentration is less than 20millions then it is termed as oligospermia.
2. Azoospermia: No sperms in semen.
3. Low sperm mobility.
4.Abnormal sperm-Sperm must be in right shape & able to travel rapidly & accurately towards the egg.If the sperm morphology , structure & motility movement are wrong it is less likely to be able to reach the egg & fertilise it.
Causes for abnormal semen
1.Testicular infection .
4.Temperature: Frequent saunas, hot tubs , very hot baths or working in very extremely hot environments can raise the temperature of the testicls.Tight under garments may have the same effect on some people.
5. Ejaculatory disorders.
6.Varicocele: This is varicose vein in scrotum.
7. Undescended testes.
8. Hypogonadism. Testosterone defiency can lead to disorder of the testicle.
9.Genetic abnormality.Kleinfelter syndrome (XXY) ther will be an abnormality in development of testicle s, low soerm count or no sperm at all.
10.Mumps.This viral infection usually affects young children.However if it occurs after puberty inflammation of the testicals may affect sperm production.
11.Hypospadias.The urethral opening is at the underside of penis instead of its tip.This abnormality is usually corrected at the infant stage.If it is not corrected the sperm may find it hard to get to the female’s cervix.
12.Cystic fibrosis.Cystic fibrosis is a chronic disease that affects organs such as liver, lungs, pancreas & intestines.Males with cystic fibrosis commanly have a missing or obstructed vas deferens(tube connecting the testis to the urethra, it carries sperm from the epididymus to the ejaculatory duct & the urethra).
13.Radiotherapy.Radiation therapy can impair sperm production.
14.Other diseases. Some diseases & conditons are linked to lower fertility in males like anemia, cushing syndrome, diabetes etc.
15.Medications.Sulfasalazine –This anti inflammatory drug can significantly lower the man’s sperm count.This drug is often prescribed for patients with crohn’s disease or rheumatoc arthritis.
Anabolic steroids often taken by body builders & athelets after a long term use can seriously reduce sperm count & mobility.
17.Illegal drugs.Consumption of marijuana & cocaine can lower a man’s sperm count.
Tests for males:
1.General physical examination:The doctor will ask the patient about his medical history,medications & sexual habits.The physian will also carry out an examination of his genitals.The testicals will be checked for lumps or deformities while the shape & structure of penis will be examined for any abnormalities.
2.semen analysis:Semen will be analysed in laboratory for sperm concentration,motility, colour, quality, infections & whether ther e is any blood.
3.Blood test:Levels of testosterone and other harmone levels are to be examined.
4.Ultrasound test:To detect whether there is any ejaculatory duct obstruction, retrograde ejaculation, or other abnormalities.
Tests for females:
1.General physical examination:The doctor will ask the woman about her medical history, medications, menstrual cycle & sexual habits.She will also undergo gynecalogical examination.
2.Blood tests:To check for haemoglobin levels , harmone levels like progestrone, FSH, prolactin, thyroid etc.
3. Hystero salpingo graphy:To know the patency of fallopian tubes.
4.Laproscopy:The doctor will be able to detect endometriosis, scarring, blockages & some irregularities of the uterus & fallopian tubes.
5.Genetic testing:To find out whether a genetic abnormality is interfering with the woman’s fertility.
6.Pelvic ultrasound:To check any abnormality of uterus, ovaries & to determine ovulation.
Ayurveda treatments for infertility are based on individual body constitution of the sufferor.Ayurvedic treatments will help to remedy the causative factors of infertility & enhance the capability of ovulation , fertilisation, uterine structures in holding the baby(preventing abortions) sperm production,sperm motility etc.
Treatments are directed at enhancing the self healing mechanism of the body, so that the body can rectify the underlying root cause of the symptoms.
Ayurveda treatments are mainly of two types:
Panchakarma therapy—Therapy for body purification & rejuvenation should be done first.Particularly vasti medicated enema is the treatment of choice due to its wide range of effectiveness on vata dosha.
Specific panchakarma for infertility is uttarvasti.Vasti which is given through uttara marga i.e
through urinary or vaginal route & it is superior in quality thus it is termed as uttara vasti.
The aunthetic Ayurveda texts have given some specific ayurvedic formulations which can achieve tremendous benefits in case of female infertility.