What are the causes of male infertility and female infertility?
Strictly speaking, couples living together after marriage, not using contraception, having normal sex life, and those who have not conceived a woman for more than one year are called "infertility". Couples of childbearing age who get pregnant after marriage and cohabitation, but cannot get a baby due to spontaneous abortion and other reasons, are called "infertility". Sometimes infertility and infertility are indistinguishable and are often referred to generically as infertility. Traditionally, infertility caused by female causes is called female infertility, and male infertility caused by spouses is called male infertility.
Both men and women are at risk of infertility!
Infertility is mainly divided into primary infertility and secondary infertility; primary infertility is never conceived; secondary infertility is infertility after pregnancy. According to this strict definition, infertility is a common problem affecting at least 10% to 15% of couples of reproductive age. The causes of infertility are divided into male infertility and female infertility.
Female infertility is mainly due to ovulation disorders, fallopian tube factors, and abnormal endometrial receptivity.
1. Abnormal fallopian tubes
Obstructed fallopian tubes or blocked fallopian tubes account for 1/3 of female infertility factors. Abnormal vulvovaginal development and vulvovaginal inflammation can prevent sperm from entering the uterus, or change the local environment, which is not conducive to sperm survival; abnormal cervical mucus function, cervical inflammation and abnormal cervical immunological function can affect the passage of sperm and can cause infertility; uterine Malformation, submucosal fibroids, endometritis, endometrial tuberculosis, endometrial polyps, intrauterine adhesions and other uterine factors can affect the implantation of fertilized eggs and lead to infertility; chronic salpingitis can cause fimbrial atresia or fallopian tube mucosa When destroyed, the fallopian tubes are blocked causing infertility. In addition, tubal hypoplasia and pelvic adhesions can also lead to infertility.
2. Ovarian dysfunction:
Ovulation disorders account for 20% to 25%. Mainly due to ovarian dysfunction leading to inability to ovulate or release normal eggs. Congenital ovarian dysplasia, premature ovarian failure, polycystic ovary, oophoritis, ovarian tumors, ovarian endometriosis, etc. can cause anovulation and ovulation disorders. Hypothalamic-pituitary-ovarian axis dysfunction, mental stimulation, anxiety, and sudden changes in environment and climate can lead to hypothalamic ovulation disorders; other systemic diseases such as thyroid and adrenal cortex hyperfunction or hypofunction, severe diabetes, and obesity Or severe malnutrition, chronic poisoning, etc. can affect the normal ovulation function of the ovary and cause infertility.
3. Uterine diseases:
Congenital absence of uterus or uterine dysplasia, endometrial tuberculosis, intrauterine adhesions, endometrial polyps, uterine submucosal or intramural fibroids, and uterine malformations can all affect pregnancy.
4. Cervical factor
Severe cervicitis, cervical stenosis, cervical polyps or cervical fibroids can affect the survival and passage of sperm.
5. Vulvar and vaginal diseases
Hymen atresia, vaginal septum, congenital absence of vagina and vulvar malformation, vaginitis, etc. can all affect conception by hindering the passage of sperm or reducing sperm motility.
6. Immune factors
About one-fifth of infertility patients are caused by autoimmunity or alloimmunity of reproductive system antigens. Therefore, it is also called immune infertility.
1. Sexual dysfunction
Including loss of libido, erectile dysfunction, premature ejaculation, non-ejaculation and retrograde ejaculation, etc., semen cannot be injected into the vagina normally. Severe sexual dysfunction can cause the man to be unable to ejaculate semen into the woman's vagina and thus not be able to conceive naturally.
2. Abnormal semen
Such as azoospermia or low sperm count, decreased motility and abnormal morphology.
Common reasons are:
① Hypothalamus-pituitary-testicular gonadal axis dysfunction, such as congenital atesticular or cryptorchidism, testicular hypoplasia, chromosomal abnormalities, testicular feminization syndrome.
② Local reasons, such as juvenile mumps complicated by orchitis lead to testicular atrophy, testicular tuberculosis damages testicular tissue, varicocele, local high temperature stimulation of testis, etc. affect sperm production.
3. Immune factors
Generally divided into two categories, anti-sperm autoimmunity produced by men and anti-sperm alloimmunity produced by women. Sperm and the immune system are isolated due to the role of the blood-testis barrier, so sperm antigens are foreign antigens and have strong antigenicity for both men and women. Factors such as blood-testis barrier and immunosuppressive factors in seminal plasma have jointly established a complete immune tolerance mechanism. The mechanism is disrupted, i.e. an antisperm immune response may occur.
4. Systemic factors
●Mental and environmental factors, sudden changes in living environment lead to long-term mental stress, high altitude, high temperature, super-intensive labor and radiation work.
Nutritional factors, severe malnutrition, vitamin A, vitamin E deficiency, trace elements such as zinc, manganese deficiency, calcium, phosphorus metabolism disorders, mercury, arsenic, lead, ethanol, nicotine, cottonseed oil and other toxic substances chronic poisoning, Chemotherapy, etc.
●Endocrine diseases, pituitary dwarfism, obesity, reproductive incompetence syndrome, hypopituitarism, congenital hypogonadism, congenital infertility syndrome, hyperprolactinemia, etc.
5. History of drug surgery
Opioids, anticancer drugs, chemotherapy and antihypertensive drugs can directly or indirectly affect spermatogenesis. History of previous pelvic surgery, bladder, prostate surgery may cause ejaculation hypofunction; orchiopexy may affect spermatic cord or testicular blood supply.
6. Unexplained infertility
About 31.6% of male infertility patients can't find out the exact cause through the current commonly used examination methods.
In addition, lack of knowledge of sexual life or abnormal sexual life of both men and women; and excessive mental tension caused by anxiety of both men and women, will cause impotence, premature ejaculation, vaginal spasm or sexual intercourse pain in the woman. Recently, the influence of psychological factors on infertile patients has attracted more and more attention.
There are many reasons for infertility. Both men and women should go to a regular hospital for a systematic infertility check to determine whether the infertility is caused by the male factor, the female factor or both.