Exploring Scientific and Analytical Perspective of Infertility

Infertility is caused by the reproductive system of a person. There has been a big misconception that infertility is sorely caused by females only, “only 35% of infertility cases are caused sorely by female factors, another 35% results from factors of the male reproductive system, 20% come from both and 10% is undetermined”.

Anatomy of Male and Female Reproductive Systems

The anatomy of the female reproductive system is divided externally and internally. This is to explain the causes and effects of infertility both physically and mentally and why there is the need to have routine checkups when planning to conceive. The external parts consist of the Labia majora also known as the big lips; this is where hair growth starts when one hits puberty. There is labia minora which is said to vary in sized but are found right under the labia majora and around the opening of the vagina. Bartholin's glands are also found next to the vagina opening and are responsible for mucus production and secretion. Finally, the clitoris is a small and sensitive protrusion which sensitive to  stimulate and can erect. The internal parts of the female reproductive system are the vagina also known as birth canal joins the cervix to the other part of the reproductive system. Uterus (womb) this is where the fetus develops for about nine months, it has two parts the cervix which is the lower part of the uterus and the corpus which has great expansion for the development of a baby, the canal through the cervix allows sperms to come in and menstrual period go out. There are the fallopian tubes located on the upper part of the uterus, this serves as a path for an ovum to travel from the ovaries to the uterus and it is best known as the site for fertilization. Lastly, there is ovaries which sits on the top of the fallopian tubes, it is known to produce eggs and hormones; estrogen and progesterone. The anatomy male reproductive system consists of the internal and external parts. The external parts are the penis, the organ used in sexual intercourse, it has three parts; root, body and glans.

The scrotum is loosely hanged pouched behind the penis, it contains testicles, it has the primary function of keeping normal sperm development under temperature cooler than the body. Testicles is the production site for sperms and hormones; testosterone. Epididymis functions as storage and carrying of sperms from the testes. The internal parts consist of vas deferens, ejaculatory ducts, urethra, seminal vesicles, prostate gland and the bulbourethral gland. They all have major roles they play in the production of healthy sperms and hormones.

There are many issues and concerns that can happen in the reproductive system that put one in high risk of infertility. There are ovulation issues like hormonal imbalance, a tumor/cyst, eating disorder, alcohol or drug use, thyroid problems, stress and many more. There could also be issues concerning the fallopian tubes and uterus, pelvic inflammatory disease, endometriosis or fibroids, scar tissue, chronic medical illness and a birth defect. “Hormones are your bodies chemical messengers, produced in the endocrine glands, these powerful chemicals travel around your bloodstream telling tissues and organs what to do, they help control many of your body’s major processes including metabolism and reproduction”. When there is a hormone imbalance, that means something in the body will be insufficient and could affect one’s metabolism and reproduction system. A disease like gonorrhea could potentially lead to pelvic inflammatory disease when left untreated, “This is infection of the female reproductive system, left untreated can cause scar tissues which develop into collection of fluid in the fallopian tubes leading to the damage of the reproductive system”. Endometriosis happens when similar tissues that lines the inside walls of the uterus grow outside of uterus causing cysts around ovaries which could lead to scar tissues. It causes adhesions and can be the worst pain during menstrual period. Males with low sperm count, poor sperm quality, hypogonadism and other abnormalities are factors that cause infertility. 

The Causes, Cost and Challenges of Fertility Treatments

Stress and infertility have been a big debate over the years, some think it is a misconception, but there have been reports regarding infertility that’s shows elevated levels of depression and anxiety on men and women trying to conceive. One can experience either physical stress like illness and surgery or psychological stress like wanting to conceive desperately and worrying about an upcoming quiz/exam. For women “Stress can compromise every aspect of fertility, including libido, ovulatory capacity and implantation, it interferes with the hypothalamic gonadotropin releasing hormone pulse generator, luteinizing hormone and follicle stimulating hormone release from the anterior pituitary which suppresses oocyte maturation, ovulation at the level of gonads as well as increasing the likelihood of ovarian cysts affecting both ovarian and testicular steroidogenesis, it may also reduce the likelihood of successful blastocyst implantation'. Stress also affects men’s spermatogenesis “The hypothalamic-pituitary-adrenal axis has a direct inhibitory action on the hypothalamic-pituitary-gonadal axis and Leydig cells in the testes”. Stress has been proven to not only cause infertility in both men and women but also other parts of the body system. Allostasis does its role to bring body back to homeostasis after or during stress but depending on the intensity, duration and the person’s physical health, stress can do more damage than expected. When there is the decision made to start trying to conceive, it is very important for both man and women to have thorough check on hormonal levels, disclose any family history disorders or past illness that may increase likelihood of affecting the reproduction system. This process could save a lot of anxiety, stress and money spent on treatment options. “Infertility affects an estimated number of 15% of couples globally, amounting to 48.5 million couples, males are found to be sorely responsible for 20%-30% of infertility cases and contribute to 50% of cases overall”. In U.S. “out of 100 couples about 12-13 have trouble getting pregnant, About 10 in 100 (6.1 million) women in the united states ages 15-44 have trouble becoming pregnant or staying pregnant, one third of infertility cases are caused by women, another third by men and the last third by a mixture of both men and women or cannot be determined”. Depending on the severity of the disease or illness that caused infertility determines the treatment options. If it is a hormone related disorder, there are various therapy treatments available to regulate hormones for better chances to conceive, some are drugs which are clomiphene citrate which stimulates ovulation, metformin which promotes insulin secretion for women suspected to have insulin resistance which inhibits ovulation and Letrozole which plays a similar role to clomiphene citrate. But the risks or possible side effects of these drugs are conceiving with twins, triplets or more and a higher risk of ovarian tumors. Most health insurances cover this type of treatments but not all with infertility related disorders will benefit from these drugs. Infertility can be caused by tumors or fibroids found in the reproductive system of a women, therefore depending on the severity there might be a need for surgery to remove these tumors or fibroids, unfortunately not all health insurance covers costs of this procedure and even if they do it will be partial coverage. “Although advances in infertility treatments have helped thousands of couples become parents, such procedures can be quite expensive, according to the Iowa stead family children’s hospital each cycle of IVF (in vitro fertilization) costs about $12,000 - $17,000 on average and there is still an ongoing debate on whether insurance plans should cover them”. Another option a couple or one could do to have a child or be parents is to explore the surrogacy option. It is by far the most expensive method to explore. There are some couples who are given the bad news of never being able to conceive and are out of fertility treatments options so the last resort if possible, will be surrogacy. “Surrogacy is used by approximately 2% of embryo transfer cycles in the USA, the indication for surrogacy is include absence of uterus, recurrent pregnancy loss, repeated IVF failure, etc'. This process does not have health insurance coverage, so everything is paid out of pocket by the soon to be parents. Surrogacy process can cost up to a $100,000 depending on many factors, for instance lost wages for surrogate if she is put on bed rest and will have to stop working, providing health insurance, extra cost on twin/triplet pregnancy, IVF process cost, living situations and many more. Not all who seek to have a child can afford this process, which then brings up the topic about adoption. Even though there is a decreasing rate of adoption due to difficulty of finding infants in the US, prospective parents are hopeful and may result in adopting an older child. This process could cost up to $45,000, not very affordable but it is till done. In general, fertility treatments are expensive and can also cause more stress on a person who wants to conceive or have a child, there are financial institutions that can assist with a loan for these treatments and options with good interest rates and monthly payments.

Conclusion

There should be more affordable assistance programs that could help infertility treatments and options for those who may not be able to afford a loan or pay out of pocket. Health insurances should assist in covering more infertility treatments like IVF.

References

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• Fertility Specialists Medical Group (FSMG) | Infertility, IVF + | San Diego. Infertility Myths & Misconceptions | Fertility Specialists Medical Group. Retrieved February 04, 2020, from http://ivfspecialists.com/fertility/infertility-myths-misconceptions/ (2019, February 21).
• HHS.gov. Female Infertility | HHS.gov. Retrieved February 11, 2020, from http://www.hhs.gov/opa/reproductive-health/fact-sheets/female-infertility/index.html (2019, June 12).
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• Sedeghi, M.R. (2019, June 20). National Center for Biotechnology Information. Surrogacy, an Excellent Opportunity for Women with More Threats. Retrieved February 11, 2020, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6486566/
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