Basic Facts of Fertility

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About 25% of infertility cases are due to the male issues; near 30% are due to female factors; and 33%, due to combined problems in both male and female. In 10-20% of cases, no known causes can be found.

In women, infertility increases significantly over 35 years old.

In younger women (34 and younger), the infertility evaluation and treatment is typically initiated after 1 year of trying to conceive.

In advanced female (35 years and older), diagnostic evaluation and treatment is recommended to start after 6 months of inability to conceive.

Common infertility factors in male

  • Low sperm count (<20millions/ml) or lack of viable sperm)
  • Sperm abnormality:
    • Morphology (<50%)
    • Motility (<50%)
  • Semen factors:
    • Low semen volume (< 1 ml/ejaculation)
    • Abnormal pH (normal 7.2~7.8)
    • Prolonged liquefaction time (normal within 20 min after ejaculation)
  • Some sexual functional disorders (such as, retro ejaculation, ED).

Symptoms of male infertility

The underlying causes of infertility in male can be suggested by the following symptoms or conditions:

  • Fatigue, low libido, erection or ejaculation difficulty
  • Depressed or anxious mood, insomnia, dry mouth or thirsty, hair loss, sexual addiction, premature ejaculation
  • Pain, lump, or swelling in the testicles; small testicles, overweight
  • Medications (chemo/radiation), illicit drug usage, too much alcohol drink, smoking
  • Unhealthy diets, environmental toxin exposure such as pesticides and heavy metals

Common infertility factors in female

  • Anovulation (no egg released from ovary), commonly seen in:
    • Polycystic ovary syndrome (PCOS)
    • Hypothyroidism
    • Hyperprolactinemia
  • Blocked Fallopian tubes; abnormal cervical mucus (interferes sperms entering the uterus cavity
  • Uterine and endometrial diseases
    • Uterine fibroid
    • Often causes painful menstruation and intercourse.
  • Pelvic inflammatory diseases (PID).
    • Common cause of infertility in women with normal menstruation under 30 years old
    • Can cause a tubal problem
  • Anti-sperm antibody formation
  • Advanced age (mostly affects the egg quality)
  • Stress, athletic training
  • Medicine, poor diet, smoking, alcohol, environmental toxins
  • Unknown causes

Symptoms of infertility in women

  • Irregular periods, or no period; too long or too short periods
  • Menstruation is too heavy or too light; painful menstruation
  • Changes in sex drive and desire
  • Feeling cold, fatigue, dry skins, hair loss, weight gain
  • Dark hair growth on the lips and chest, more acne, insomnia, night sweating
  • Milky white discharge from nipples unrelated to breastfeeding
  • Pain during sex

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