L'infertilité : idées reçues, symptômes et solutions

Infertility: Misconceptions, Symptoms and Solutions

Infertility is difficulty conceiving a child. It results from female factors in ⅓ of cases and from male factors in ⅓ of cases as well. In the final third, the cause is either unknown or a combination of male and female factors.

Infertility is a problem that affects approximately 1 in 6 couples.

If you're having fertility issues, you're actually not alone. More than 5 million people of childbearing age, or one in ten couples, have difficulty conceiving a child. When it comes to fertility, the advice we are given is often not very useful.

Before explaining the causes and symptoms of infertility, here are 5 preconceived ideas on this subject.

Myth 1: Fertility is a women’s issue

Infertility is most often thought to be a woman's problem, but that couldn't be further from the truth. In fact, although 35% of fertility cases are caused by women's problems, an equal number of these cases, also 35%, are caused by men. A number of symptoms in men may suggest infertility, such as pain or swelling of the testicles, changes in desire, or problems maintaining an erection or ejaculating. Also, infertility in men increases with age, just like that in women.

Myth 2: health does not influence fertility

Did you know that one of the main factors of infertility, for both men and women, is health problems? To have the best chance of conceiving, you must adopt a healthy lifestyle, which includes maintaining a healthy weight, taking vitamins for example, not using drugs, not smoking, and drinking alcohol. alcohol in moderation.

Myth 3: Having a child means you don't have to worry

According to data, around 30% of infertility cases occur after the couple has their first child. So, even if you already have one child, you may face infertility when trying to have a second or third child.

Myth 4: If you work hard enough, you will get pregnant

Infertility is a medical problem, so it's not your fault if you can't conceive. Sometimes your infertility problems cannot be treated, no matter how hard you try to resolve them. However, there are many medical advances that can help you conceive, we'll talk about them at the end of this article. According to “The American Society for Reproductive Medicine, more than half of couples who undergo infertility treatment achieve a successful pregnancy. So there is still hope!

1. Female infertility

Each of these factors is essential to getting pregnant:

  • You must be ovulating. To get pregnant, your ovaries must produce and release an egg, a process known as ovulation. Your doctor can help you evaluate your menstrual cycles and confirm ovulation.
  • You must have regular sexual intercourse during your fertile period. Your doctor can help you better understand when you are most fertile.
  • The fallopian tubes should be open (the egg and sperm meet in the fallopian tubes). The embryo also needs a healthy uterus to develop.

    Causes of female infertility

    What are the causes of female infertility?

    The most common causes of female infertility are problems with ovulation, damage to the fallopian tubes or uterus (often due to certain diseases which we will discuss shortly), or problems with the cervix. . Age can contribute to infertility because as a woman ages, her fertility naturally tends to decrease.

    Female infertility is caused by one or more of the factors below.

    • A hormonal imbalance
    • A tumor or cyst
    • Eating disorders such as anorexia or bulimia
    • Use of alcohol or drugs
    • Thyroid gland problems
    • Excess weight
    • The stress
    • Intense exercise leading to significant loss of body fat
    • Extremely short menstrual cycles

    Damage to the fallopian tubes or uterus can be caused by one or more of the following:

    • Pelvic inflammatory disease
    • A previous infection
    • Polyps in the uterus
    • Endometriosis or fibroids
    • Scar tissue or adhesions
    • Chronic disease
    • A previous ectopic (tubal) pregnancy
    • A congenital anomaly

    * Endometriosis occurs when tissue that normally grows in the uterus implants and grows in other places. This extra growth of tissue – and its surgical removal – can cause scarring, which can block the fallopian tubes and prevent an egg and sperm from uniting. Endometriosis can also affect the lining of the uterus, disrupting the implantation of the fertilized egg. The disease also appears to affect fertility in less direct ways, such as by damaging the sperm or egg.

    Can we prevent infertility in women?

    There is usually nothing that can be done to prevent female infertility caused by genetic problems or disease. However, there are several things women can do to reduce the possibility of infertility:

    • Take steps to prevent sexually transmitted diseases
    • Avoiding illicit drugs and tobacco
    • Avoid excessive or frequent alcohol consumption
    • Adopt good personal hygiene and health practices
    • Have annual checkups with your gynecologist when you are sexually active.
    Here are the main symptoms that you may encounter if you are in this situation of infertility.

        When to consult a doctor ?

        When to consult sometimes depends on your age:

        • Up to age 35 , most doctors recommend trying to get pregnant for at least a year before having a test or treatment.
        • If you are between 35 and 40 years old , discuss your concerns with your doctor after six months of trying.
        • If you are over 40 , your doctor will probably suggest that you start treatments immediately.

        Your doctor may also want to start testing or treatment immediately if you or your partner have known fertility problems, or if you have a history of irregular and/or painful periods, pelvic inflammatory disease, repeated miscarriages, treatment history of cancer or endometriosis.

        2. Male infertility

        Male infertility

        What are the causes of male infertility?

        Male infertility can be caused by low sperm production, abnormal sperm function, or blockages that prevent sperm delivery. Illnesses, injuries, chronic health conditions, lifestyle choices and other factors can contribute to male infertility.

        To understand better: you need to produce healthy sperm for your partner to get pregnant. Initially, it involves the growth and formation of the male reproductive organs during puberty. At least one of your testicles must function properly, and your body must produce testosterone and other hormones to trigger and maintain sperm production.

        Sperm must be transported in semen. Once sperm are produced in the testicles, delicate tubes transport them until they mix with semen and are ejaculated through the penis.

        There must be enough sperm in the semen, otherwise the chances of one of your sperm fertilizing your partner's egg decrease. The sperm must be functional and able to move. If the movement or quality of your sperm is abnormal, the sperm may not be able to reach or penetrate your partner's egg.

        Environmental causes:

        Overexposure to certain environmental elements such as heat, toxins and chemicals (pesticides, paint materials, high doses of radiation, lead, etc.) can reduce sperm production or function.

        Health, lifestyle and other causes:

        Here are some other additional causes of male infertility:

        • Drug use. Anabolic steroids taken to boost muscle strength and growth can lead to shrinkage of the testicles and decreased sperm production. Using cocaine or marijuana can also temporarily reduce the number and quality of your sperm.
        • Alcohol consumption. It can lower testosterone levels, cause erectile dysfunction and reduce sperm production. Liver disease caused by excessive alcohol consumption can also lead to fertility problems.
        • Smoking. Men who smoke may have lower sperm counts than those who don't smoke. Passive smoking can also affect male fertility.
        • The weight. Obesity can harm fertility in several ways, including directly affecting the sperm themselves and causing hormonal changes that reduce male fertility.

        What are the symptoms of male infertility?

        In some cases, an inherited disease, hormonal imbalance, dilated veins around the testicle, or a condition that blocks the passage of sperm, causes signs and symptoms. Signs and symptoms you may notice include:

        • Problems with sexual function - for example, difficulty ejaculating or small volumes of fluid ejaculated, decreased sexual desire or difficulty maintaining an erection (erectile dysfunction).
        • Pain, swelling, or lump in the testicle area.
        • Recurrent respiratory infections
        • Inability to feel
        • Abnormal growth of the mammary glands (gynecomastia)
        • Decreased facial or body hair or other signs of a chromosomal or hormonal abnormality

        When to consult a doctor ?

        See a doctor if you have failed to conceive after a year of regular, unprotected sex and have any of the following symptoms:

        • Erection or ejaculation problems, decreased libido, or other problems with sexual function.
        • Pain, discomfort, lump, or swelling in the area of ​​the testicles.
        • History of problems related to the testicles or prostate.
        • If you have had surgery on your groin, testicles, penis or scrotum.

        3. Stress can also be the source of infertility: how to manage this stress?

        to manage stress

        The majority of couples who fail to conceive first turn to infertility treatment. But if the cause is psychological, this treatment will obviously not be effective. Paradoxically, in certain cases, the woman can become pregnant when psychologically, she has decided to abandon the idea with her partner (after a long battle to remedy this infertility). Could returning to a normal state, without stress, resolve the problem? Maybe ! But how not to stress?

        • First, don't focus on the problem. Thinking only about him will fuel this anxiety.

        • Don't let possible social pressures influence you. Act according to your own desires.

        • Start practicing breathing techniques or meditation to channel stress and generate positive emotions.

        • There are very effective ovulation tests on the market today. Know how to identify your ovulation days during your menstrual cycle without obsessing about them.

        • Communicate with your partner. Difficulties conceiving should not break the bond that unites you.

        • Free your mind by engaging in recreational activities. Your life shouldn't be about wanting to have children.

        • If you feel overwhelmed by the problem, do not hesitate to seek help from a specialist (psychologist, psychiatrist).

        • You must feel secure in your relationship to have a child. We must define and raise the fears and blockages which may be linked to the history we have had with our own family, which may be linked to the relationship we have as a couple. Sometimes you just need to find the key to open the doors and make the couple feel free from certain things.

        4. Solutions

        Once the causes of infertility have been identified, solutions can be proposed.

        • Hormonal treatment is offered to women who have ovulation disorders, which are manifested by insufficient or no egg production. By administering hormones, ovulation is encouraged and closely monitored to determine when intercourse is most likely to be effective.
        • Intrauterine insemination . Intrauterine insemination (IUI) involves introducing sperm into a woman's uterus during ovulation. Less technological and intrusive methods, such as IUI, are becoming more common, but their success rate depends on the cause of the infertility. This technique is used in certain cases of endometriosis , or in cases of unexplained infertility .

        • In vitro fertilization. This medically assisted procreation (MAP) technique consists of bringing into contact, in the laboratory, an egg produced by the ovaries and a sperm. The embryo begins its development in vitro and is then transplanted into the uterus. Practiced in cases of fertility disorders (tubal obstruction, lack of oocyte production, early menopause, failure of artificial insemination or idiopathic infertility).

        • Egg donations. Consists of collecting an oocyte produced by a healthy woman, who agrees to give it to the person who needs it.

        • Clomid . This inexpensive and widely prescribed pill tricks the body into thinking that estrogen levels are low, causing more eggs to be produced.

        • Adoption. This method can be expensive and cause many problems. Its success depends largely on external factors. For example, should you adopt a child born domestically or abroad? How long are you willing to wait? Are you able to consider another person's child as your own?

        • Surgery. But in what cases?

        - For women - certain tubal problems, linked to the fallopian tubes, can be resolved by surgery. For example, if the fallopian tubes are blocked, surgery can clear them. Surgery also offers solutions for benign tumors, or certain congenital uterine malformations. Microsurgery can resolve endometriosis laparoscopically. This technique allows foci of endometriosis to be removed very precisely, without damaging healthy tissue.

        - For men - Surgery is effective in the treatment of varicocele, which is a permanent varicose dilatation of the veins of the spermatic cord. Varicocele reduces the number of sperm and reduces their mobility. Certain tubal obstacles, present in the vas deferens and in the epididymis, can prevent the free circulation of sperm. They can be removed by microsurgery.

        ...In short, don't be impatient: conceiving a child can take time. To put all the chances on your side, adopt a healthy lifestyle, avoid endocrine disruptors as much as possible, prepare your body for a future pregnancy, and take care of yourself. For more tips on how to eat healthily, or how to avoid endocrine disruptors, go here , and here .

        Endocrine disruptorsEat healthy

        Source :

        https://www.ameli.fr/assure/sante/themes/sterilite-pma-infertilite/comprendre-sterilite#:~:text=On%20parle%20de%20st%C3%A9rilit%C3%A9%2C%20ou , the%2C%20man explains%20the%20st%C3%A9rilit%C3%A9 .
        https://www.nouvelobs.com/sante/20150519.OBS9207/ cinq-conseils-pour-lutter-contre-l-infertilite.html