Factors Necessary for Successful Conception
Infertility causes and treatment can be quite complicated, due
to the numerous factors that add up to the achievement of a
successful pregnancy. More than 10% of couples do not achieve
this much needed pregnancy after 12 months of unprotected sex
and trying really hard to conceive. This, in most cases is
because one or more of the factors necessary for conception is
absent or malfunctioning
The factors vital for conception include:
- Adequate and viral sperm from the male partner
- Appropriate frequency of sexual intercourse around the woman's
ovulation time
- Optimally free passageway for the eggs to travel down the
fallopian tube, meet with sperm coming up the tube and then
fertilization
- Appropriate and timely transportation of the product of
fertilization down to the uterus for implantation and development
- Adequately free passageway for the sperm to get through the
cervix into the uterus, so they can swim up into the fallopian
tube to meet and fertilize the female egg
- Healthy and sound uterine cavity with adequate uterine lining
conducive to implantation and development of the pregnancy
In evaluating infertility, therefore, or in assessing a couple's
chances at conception, we can sub divide the factors vital for
achieving conception as thus: * Male Factor (Sperm count and
quality) * Ovarian factor (ovulation frequency and regularity) *
Tubal factor (free and clear passage to egg and sperm) *
Cervical factor (clear passage to sperm from the vagina) *
Uterine factor (adequate space and tissue for the fertilized egg
to implant and grow)
Male Factor. The male factor accounts for 40-50% of infertility
problems. Out of this amount only about 10-20% of men have no
mature, motile sperm at all (azoospermia). The others only
happen to have low counts or a fewer number of normal shaped,
mature and motile sperm cells compared to other fertile men. In
normal conditions, an absolute sperm count of 16 million is
perfect, while a count of less than 5 million almost always
result in sterility. Counts between 5 and 16 can in most cases
be overcome with infertility treatments.
Ovarian Factor Women who do not produce eggs each month or those
who only produce eggs every 2-3 months will have problems
getting pregnant. The most common causes of annovulation (menses
without ovulation) or irregular menses are; Polycystic Ovarian
syndrome (PCOS), a condition where follices mature, but the eggs
are arrested and not released and Hypothalamic Amenorrhea, which
is like a stress or medication induced lack of ovulation. There
are other medical conditions that can cause lack of ovulation,
but these occur only in rare occasions. Ovarian factor problems
are usually treated with fertility pills (e.g. clomiphene
citrate) or medications like gonadotropins.
Intercourse around Ovulation Time Women with a regular menstrual
cycle can always predict their ovulation time. Ovulation occurs
midway between the onset of the last menses and the beginning of
the next one. Even for women with an irregular menstrual cycle,
there are several ovulation predictions kits out there that can
provide clues as to when your ovulation occurs. Intercourse
should be more frequent around this period, with a frequency of
at least, every other day. Therefore, for a 28 day cycle,
ovulation will probably occur on day 14, days 11, 13, 15 and 17
should not be missed.
Tubal Factor The fallopian tubes also constitute a vital actor
in conception. The tubes must be free and clear to sweep up eggs
that have been ovulated, free and no obstruction to the passage
of egg and sperm. Fertilization takes place in the tubes and it
is also important that the tubes transport the product of
fertilization to the uterine cavity on time for implantation and
growth. Pelvic surgery, past ruptured ovarian cyst, past pelvic
infections and endometriosis are all conditions that can affect
the ability of the tube to sweep up ovulated egg. PID can also
produce scarring inside the tube that prevents passageway for
ovum.
Uterine Factor The uterus is the final home of the fertilized
ovum and where implantation and growth to full term occurs. Any
condition that affects or alters the amount of space or shape of
the surface area inside the uterus or disturbs the hormonal
sequence that prepares the lining of the uterus for conception
may impair fertility. Conditions like fibroids, polyps,
congenital anomalies of the uterus or past scarring due to
surgery or infection will alter the shape and surface area of
the endometrium and in turn fertility. Also, malfunctioning of
the corpus luteum may hormonally retard the lining of the uterus
and its readiness for implantation.
Cervical Factor. Under most conditions, the cervix does not
constitute a factor in infertility, except when the cervical
mucous glands have been destroyed during some procedures like
Cervical Cryosurgery, conization LEEP etc. The cervical mucous
glands act as a storage for sperm cells, so they can 'shower'
the uterus and the uterine tube with sperms in order not to miss
ovulation. The frequency of intercourse may need to be increased
to achieve conception if these glands have been destroyed.