Prevalence and Incidence of Male infertility

Prevalence/Incidence of Male infertility: Online Medical Books

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Male infertility: Causes and incidence
(Professional Guide to Diseases (Eighth Edition))

Some factors associated with male infertility include:

❑ varicocele, a mass of dilated and tortuous varicose veins in the spermatic cord

❑ semen disorders, such as volume or motility disturbances and inadequate sperm density

❑ proliferation of abnormal or immature sperm, with variations in the head’s size and shape

❑ systemic disease, such as diabetes mellitus, neoplasms, hepatic and renal diseases, and viral disturbances, especially mumps-related orchitis

❑ genital infections, such as gonorrhea, tuberculosis, and herpes

❑ disorders of the testes, such as cryptorchidism, Sertoli-cell-only syndrome, and ductal obstruction (caused by absence or ligation of vas deferens or infection)

❑ genetic defects, such as Klinefelter’s and Reifenstein’s syndromes

❑ immunologic disorders, such as autoimmune infertility and allergic orchitis

❑ endocrine imbalances that disrupt pituitary gonadotropins, inhibiting spermatogenesis, testosterone production, or both (as in Kallmann’s syndrome, panhypopituitarism, hypothyroidism, and congenital adrenal hyperplasia)

❑ chemicals and drugs that can inhibit gonadotropins or interfere with spermatogenesis, such as arsenic, methotrexate, medroxyprogesterone, nitrofurantoin, monoamine oxidase inhibitors, and some antihypertensives

❑ sexual problems, such as erectile dysfunction, ejaculatory incompetence, and low libido.

Age, occupation, and traumatic injury to the testes can also contribute to male infertility. Approximately 30% to 40% of infertility problems in the United States are attributed to the male.

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Source: Professional Guide to Diseases (Eighth Edition), 2005

Female infertility: Causes and incidence
(Professional Guide to Diseases (Eighth Edition))

The causes of female infertility may be functional, anatomic, or psychosocial:

❑ Functional causes: complex hormonal interactions determine the normal function of the female reproductive tract and require an intact hypothalamic-pituitary-ovarian axis — the system that stimulates and regulates the hormone production necessary for normal sexual development and function. Any defect or malfunction of this axis can cause infertility due to insufficient gonadotropin secretions (both luteinizing hormone [LH] and follicle-stimulating hormone). The ovary controls, and is controlled by, the hypothalamus through a system of negative and positive feedback mediated by estrogen production. Insufficient gonadotropin levels may result from infections, tumors, or neurologic disease of the hypothalamus or pituitary gland. Hypothyroidism also impairs fertility.

❑ Anatomic causes include the following:

– Ovarian factors are related to anovulation and oligo-ovulation (infrequent ovulation) and are a major cause of infertility. Pregnancy or direct visualization provides irrefutable evidence of ovulation. Presumptive signs of ovulation include regular menses, cyclic changes reflected in basal body temperature readings, postovulatory progesterone levels, and endometrial changes due to the presence of progesterone. Absence of presumptive signs suggests anovulation. Ovarian failure, in which no ova are produced by the ovaries, may result from ovarian dysgenesis or premature menopause. Amenorrhea is often associated with ovarian failure. Oligo-ovulation may be due to a mild hormonal imbalance in gonadotropin production and regulation and may be caused by polycystic disease of the ovary or abnormalities in the adrenal or thyroid gland that adversely affect hypothalamic-pituitary functioning.

– Uterine fibroids or uterine abnormalities rarely cause infertility; however, uterine abnormalities may include congenitally absent uterus, bicornuate or double uterus, leiomyomas, or Asherman’s syndrome, in which the anterior and posterior uterine walls adhere because of scar tissue formation.

– Tubal and peritoneal factors are due to faulty tubal transport mechanisms and unfavorable environmental influences affecting the sperm, ova, or recently fertilized ovum. Tubal loss or impairment may occur secondary to ectopic pregnancy.

Frequently, tubal and peritoneal factors result from anatomic abnormalities: bilateral occlusion of the tubes due to salpingitis (resulting from gonorrhea, tuberculosis, or puerperal sepsis), peritubal adhesions (resulting from endometriosis, pelvic inflammatory disease [PID], diverticulosis, or childhood rupture of the appendix), and uterotubal obstruction (due to tubal spasm).

– Cervical factors may include malfunctioning cervix that produces deficient or excessively viscous mucus and is impervious to sperm, preventing entry into the uterus. In cervical infection, viscous mucus may contain spermicidal macrophages. Cervical antibodies have also been found to immobilize sperm.

❑ Psychosocial problems probably account for relatively few cases of infertility. Occasionally, ovulation may stop under stress due to failure of LH release. The frequency of intercourse may be related. More often, however, psychosocial problems result from, rather than cause, infertility.

About 10% to 20% of couples will be unable to conceive after 1 year of attempting to become pregnant. Healthy couples who are younger than age 30 and having intercourse regularly only have a 25% to 30% change of getting pregnant each month. A woman’s peak fertility is in her early 20s. As a woman ages beyond 35 (and particularly beyond 40), the likelihood of conception is less than 10% per month.

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Source: Professional Guide to Diseases (Eighth Edition), 2005

About prevalence and incidence statistics:

The term 'prevalence' of Male infertility usually refers to the estimated population of people who are managing Male infertility at any given time. The term 'incidence' of Male infertility refers to the annual diagnosis rate, or the number of new cases of Male infertility diagnosed each year. Hence, these two statistics types can differ: a short-lived disease like flu can have high annual incidence but low prevalence, but a life-long disease like diabetes has a low annual incidence but high prevalence. For more information see about prevalence and incidence statistics.