What Is Infertility? – Symptoms, Causes and Treatment
Introduction: What is Infertility?
According to the World Health Organization (WHO), infertility is the inability to achieve pregnancy after 12 months of regular, unprotected intercourse. Infertility is a common issue, affecting about 1 in 7 couples worldwide and impacting both men and women. Importantly, infertility is not solely a “female problem”; it can arise due to factors affecting one or both partners. Additionally, infertility can be classified into two types: primary and secondary infertility. (WHO – Infertility)
Primary vs. Secondary Infertility
Primary Infertility refers to the inability to conceive or carry a pregnancy to term for couples who have never had a child. This is the most common form of infertility, and it encompasses individuals who are unable to achieve a successful pregnancy from the start of their journey to conceive.
Secondary Infertility occurs when a couple has successfully conceived and given birth to one or more children in the past but is now unable to conceive again or carry a subsequent pregnancy to term. Although less common than primary infertility, secondary infertility can be just as emotionally and physically challenging.
Causes of Infertility
Infertility can stem from various causes that may affect either the male or female partner, or sometimes both. Here’s an overview of some common factors:
Causes in Women:
- Ovulation Disorders: Conditions such as polycystic ovary syndrome (PCOS) or hormonal imbalances that disrupt ovulation.
- Fallopian Tube Blockages: Blocked or damaged fallopian tubes can prevent sperm from reaching the egg, impeding fertilization.
- Endometriosis: Tissue similar to the uterine lining grows outside the uterus, often affecting the reproductive organs.
- Age: Fertility naturally declines with age, especially after age 35, as egg quality and quantity decrease.
- Hormonal Imbalances: Disorders like thyroid issues or hyperprolactinemia can disrupt fertility.
- Uterine or Cervical Issues: Abnormalities like fibroids, polyps, or structural irregularities can interfere with embryo implantation.
Causes in Men:
- Low Sperm Count: A lower-than-average sperm count reduces the likelihood of successful fertilization.
- Poor Sperm Motility: Sperm that cannot swim properly may struggle to reach and fertilize the egg.
- Hormonal Imbalances: Abnormal levels of testosterone or other hormones can impact sperm production and quality.
- Structural Issues: Conditions like varicocele (enlarged veins in the scrotum) or blockages can hinder sperm transport.
- Lifestyle Factors: Smoking, alcohol use, stress, and exposure to toxins can negatively affect sperm health.
Unexplained Infertility
In some cases, no specific cause can be identified even after thorough medical evaluation. Known as unexplained infertility, this condition can be particularly frustrating for couples. However, various treatment options are available to help increase the chances of conception despite an unclear diagnosis.
Treatment Options for Infertility
Treatment for infertility varies depending on the cause and can include:
Lifestyle and Natural Approaches
- Diet and Exercise: A balanced diet and regular exercise can improve fertility in both men and women.
- Reducing Stress: High stress levels can impact fertility, and stress management techniques such as meditation or yoga can help.
- Avoiding Toxins: Limiting exposure to tobacco, alcohol, and certain chemicals can improve reproductive health.
Medical Treatments
- Medications: Fertility drugs like Clomiphene or Letrozole can stimulate ovulation in women, while medications to balance hormones may help men.
- Surgery: Procedures to correct anatomical issues like blocked tubes, endometriosis, or varicocele.
- Intrauterine Insemination (IUI): Sperm is placed directly into the uterus around the time of ovulation to facilitate fertilization.
- In Vitro Fertilization (IVF): Eggs are retrieved from the ovaries and fertilized with sperm in a lab, and then the resulting embryo is implanted in the uterus.
- Intracytoplasmic Sperm Injection (ICSI): A single sperm is injected directly into an egg, often used when male infertility is a factor.
Assisted Reproductive Technologies (ART)
ART options can help those unable to conceive naturally. ART includes techniques like IVF and ICSI, and may also involve third-party reproduction options like egg or sperm donation. Couples considering ART may need to undergo counselling to understand the emotional, ethical, and financial implications.
Alternative Paths to Parenthood
For those who are unable to conceive through ART, other family-building options may include:
- Adoption: A fulfilling path to parenthood legally permitted in Singapore.
- Surrogacy: Currently not legal in Singapore, but available internationally.
Impact of Infertility on Emotional and Mental Health
The journey through infertility can be profoundly challenging, often marked by cycles of hope, disappointment, and resilience. Stress, depression, and a sense of despair are common responses, and many individuals grappling with infertility experience these in varying intensities. In fact, a 2015 study found that the incidence of major depressive disorder was notably elevated in people undergoing infertility therapy.
Common emotions include:
Grief and Loss: A deep sense of loss may emerge regarding the envisioned path to parenthood, including the potential loss of biological connection and the anticipated, natural journey to parenthood.
Stress and Anxiety: The uncertainty of treatment outcomes, coupled with the emotional and financial demands, can lead to significant stress and anxiety.
Shame and Guilt: Societal and cultural pressures can create feelings of inadequacy, often intensified by interactions with family or social circles.
Strain on Relationships: Infertility can test relationships, leading to intimacy challenges and communication difficulties as each partner copes in their own way.
So, what should you do regarding anxiety and depression on this journey? Infertility counselling offers a solution. With compassionate, non-judgmental support, infertility counselling provides a safe space to explore emotions, develop coping strategies, and find clarity. At Listening Ear Counselling & Consultancy, we specialise in helping individuals and couples navigate the emotional, relational, and psychological aspects of infertility. To learn more about how counselling can support you, visit our What is Infertility Counselling? page.
Coping with Infertility: Practical Tips
Infertility can be a long and difficult journey, but there are strategies to help you manage the stress:
- Seek Emotional Support: Talking to a trusted friend, support group, or infertility counsellor can provide relief and perspective.
- Set Realistic Expectations: Recognize that treatments can take time and may not be immediately successful.
- Focus on Self-Care: Prioritize activities that bring you joy and relaxation, helping to reduce stress.
- Educate Yourself: Understanding the medical aspects of infertility can empower you to make informed choices.
- Consider Counselling: Infertility counselling can help address emotional stress and strengthen your relationship with your partner.
FAQs about Infertility
What is infertility?
- Infertility is the inability to conceive a child after 12 months of regular, unprotected intercourse (or six months for women over 35). It can be due to various factors affecting one or both partners.
What are the common causes of infertility?
- Causes include hormonal imbalances, ovulation disorders, fallopian tube blockages, male sperm issues, and unexplained factors.
How is infertility diagnosed?
- Diagnosis involves tests for both partners, including hormone levels, imaging studies, semen analysis, and sometimes genetic testing.
What treatments are available for infertility?
- Treatment options range from lifestyle changes and medications to assisted reproductive technologies like IVF and IUI.
Is surrogacy an option in Singapore?
- No, surrogacy is not legally permitted in Singapore. However, couples may explore international options with proper legal and counselling support.
How can infertility affect mental health?
- Infertility often leads to stress, anxiety, grief, and feelings of inadequacy. Counselling can help manage these emotions and provide support.
Final Thoughts
Infertility is a deeply personal and often challenging journey that touches every aspect of life—from relationships and self-identity to emotional well-being. With a variety of medical treatments, alternative family-building options, and supportive counselling services, individuals and couples facing infertility can find a path forward that aligns with their values and dreams.
At Listening Ear Counselling & Consultancy, we’re here to support you every step of the way. Our services encompass a holistic approach to infertility, offering specialised support through:
- IVF Counselling: Guiding you through the emotional and relational aspects of in vitro fertilisation and its unique demands.
- Adoption Counselling: Helping you explore adoption as a meaningful path to parenthood, providing emotional support and preparation.
- Sperm and Egg Donation Counselling: Addressing the complexities and emotional considerations involved in third-party reproduction.
- Pregnancy Counselling: Offering support for expectant parents, addressing both the joys and concerns that accompany pregnancy.
- Miscarriage and Pregnancy Loss Counselling: Providing compassionate guidance through grief and helping you navigate the healing process.
Our infertility counselling services are designed to provide you with a safe space to process emotions, build resilience, and make informed, thoughtful family-building decisions. For more information on each of these services, visit our Infertility Counselling page to explore how we can support you on your journey.