{"paper_id":"188c888b-fc72-4950-96e9-76346b46a3c5","body_text":"Clinical Research and Clinical Trials                                                                                                                                                                             Copy rights@ PD Gupta \n \n \nAuctores Publishing LLC – Volume 7(3)-129 www.auctoresonline.org  \nISSN: 2693-4779   Page 1 of 4              \n \n \nNo One is Immune to Infertility \nPD Gupta * \nFormer Director grade Scientists, Centre for Cellular and Molecular biology, Hyderabad, India. \n*Corresponding Author: PD Gupta, Former Director grade Scientists, Centre for Cellular and Molecular biology, Hyderabad, India. \nReceived date: May 2, 2023; Accepted date: May 12, 2023; Published date: May 19, 2023 \nCitation: PD Gupta, (2023), No One is Immune to Infertility, Clinical Research and Clinical Trials, 7(4) ; DOI:10.31579/2693-4779/129 \nCopyright: © 2023, PD Gupta, This is an open access article distributed under the terms of the Creative Commons Attribution License, which \npermits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. \nAbstract:  \nBoth primary and secondary infertility affects millions of person’s world over.  There are several factors that can contribute to \ninfertility in women and men however about 1 in 5 cases of infertility are identified as unexplained. There’s a time frame to  \nfertility in human life span; child bearing age is defined in females but not in males in general. Infertility has significant negative \nsocial impacts particularly on women. Infertility is regarded as a negative force in population dynamics because there is no \nbiological replacement, and the continuation of human society.  Infe rtile couples might experience social and psychological \ndistress such as depression, anxiety, social isolation, and sexual dysfunction. Infertile couples suffer from an impaired health-\nrelated quality of life.  Women in particular are at greater risk of violence, divorce, social stigma, emotional stress, depression, \nanxiety and low self -esteem.  In women, cause of infertility can include endometriosis, uterine fibroids and thyroid disease. \nMen with fertility problems may have a low sperm count or low testosterone. The risk of infertility increases with age. \nKeywords: social stigma; quality of life; child bearing age; fertility window; microbiota; y chromosome infertility \nAddressing infertility is important \nInfertility affects millions of people worldwide. It is estimated that \napproximately one in every six people of reproductive age experience \ninfertility in their lifetime. [1]. Infertility can be primary or secondary. \nPrimary infertility is when a pregnancy has never been achieved by a person, \nand secondary infertility is when at least one prior pregnancy has been \nachieved.   Infertility has significant negative social impacts on the lives of \ninfertile couples and particularly women, who frequently \nexperience violence, divorce, social stigma, emotional stress, depression, \nanxiety and low self -esteem in the society and particularly in the family. \nAddressing infertility is therefore an important part of realizing the right of \nindividuals and couples to found a family Infertility may result from an issue \nwith either male or female or both, or a combination of factors that prevent \npregnancy. [2,3]. Studies have shown that infertile couples \nexperience significant anxiety and emotional distress. When a round of \nfertility treatments proves to be unsuccessful, for instance, women and \ncouples can experience deep feelings of grief and loss. [4]. \nThere’s a time limit to fertility in human life span. If the menstrual cycle lasts \n28 days and the menstrual cycle is clockwork, it's likely that ovulation will \nbe halfway through the cycle. The fertile window begins on day 10.   A \nwoman more likely get  pregnant, if she has sex at least every other day \nbetween days 10 and 14 of the 28 -day menstrual cycle. Generally, females \nare most fertile at the time of ovulation, which usually occurs  12 to 14 days \nbefore the next period starts. While  ovulation itself only  lasts for 12 to 24 \nhours, most likely to get pregnant in the days before and after ovulation, The \nfertilization window is open only for 6 days. If one knows the average \nmenstrual cycle length, one can work out when to ovulate this is the time of \nthe month when one most likely to get pregnant. [4-6]. It's unlikely that one \nget pregnant just after the period though endocrinological support is there \nbut ovum is not available for fertilization.  (mother). Menopause is a phase \nwhere human females life is associa ted with   the  permanent, nonpathlogic, \nage-associated cessation of ovulation in a strict sence a non -fertile period. \n[6]. A released egg life for  less than 24 hours. The highest pregnancy rates \nhave been reported when the egg and sperm join together within 4 to 6 hours \nof ovulation. [7]. Here's why sperm can live inside the female reproductive \ntrack for up to 5 days. The fluid in a woman's reproductive tract has all of \nthe nutrients that sperm need for their survival during that time.  That means \nthe woman  can get pregnant via intercourse that happens anywhere from \nabout 5 days before ovulation until 24 hours afterwards. Women can't \nconceive after their menstrual cycles stop usually sometime in the late 40s or \nearly 50s. [8]. Men produce sperm throughout th eir lives, but women are \nborn with a set number of eggs that decreases as one ages. [4-6]. \nEjaculated sperm are capable Fertilization as long as the sperm remain alive \nin the female genital tract. Sperm can also be preserved for decades when \nthey are cryopreserved. [9]. Therefore, there's a chance of getting pregnant \neven if sperm are deposited before ovulation. Once the sperm enters the \nreproductive system, it can take about 30-45 minutes to reach the egg. [4,5]. \nFor this, it is important to have a healthy  sperm which has the right kind of \nmotility to reach the egg and fertilize it.   \nCauses infertility \nInfertility is caused in either the male and/or female reproductive systems by \na number of different factors; some are common to both and many of them \n  Open Access  \n     Review Article \n          Clinical Research and Clinical Trials \n                                                                                                  PD Gupta *                                                                                                                                                        \nAUCTORES \nGlobalize your   Research \n\nClinical Research and Clinical Trials                                                                                                                                                                             Copy rights@ PD Gupta \n \n \nAuctores Publishing LLC – Volume 7(3)-129 www.auctoresonline.org  \nISSN: 2693-4779   Page 2 of 4              \nare g ender based, however, sometimes it is not possible to pin point the \ncauses of infertility.  Common risk factors for both male and female \ninfertility are mentioned below. \nAge: \nHuman female's fertility window is well defined; they cannot conceive \nbefore their menstrual cycle starts and not after menopause. Their fertility \ngradually declines as they age, in their mid-30s it drops rapidly. As they age \nthe physiology of the ovary changes, the quality and quantity of eggs decline. \nDue to age fertility of men also decline; though men generally can produce \nsperm lifelong, after age 40 motility of sperm changes. More so percentage \nof abnormal sperm number also increases in the semen. Therefore, aging man \nmay be less fertile than younger men. [10].  \n Use of Tobacco: \nEven if either partner smoking tobacco or marijuana there are less chances \nof conceiving a baby. Smoke of tobacco and/or marijuana contains toxic \nchemicals such as nicotine, cy anide, and carbon monoxide affect adversely \nthe production of gametes. This means that menopause occurs 1 to 4 years \nearlier in women who smoke Male smokers are also suffer with decreased \nsperm quality, by the way of lower counts and motility.[11]. Smoking might \nalso decrease the sperm’s ability to fertilize eggs because of more abnormally \nshaped sperm. [12].  And therefore, smoking such substances disrupts blood \nvessels in the reproductive organs and causes erectile dysfunction and even \nfertility treatment  becomes ineffective. More miscarriages are reported in \nwomen who smoke. [11,13]. \nUse of Alcohol \nAlcohol use may also contribute to infertility, in women alcohol interferes \nconception or pregnancy; survey indicated no safe levels. Because of \nestrogenic effect, in men, heavy alcohol use can decrease sperm count and \nmotility. [14].   \nObesity: \nDue to obe sity, one adopts an inactive lifestyle which in turn impair \nreproductive function. In obese women, gonadotropin secretion is affected \nbecause of the increased peripheral aromatization of androgens to estrogens \nand also endometrial receptivity and implantation Obesity impairs endocrine \nfunction, oocyte and sperm and embryo quality. Pregnancy and live birth \nrates are lower, and miscarriage rates are higher in the setting of obesity. In \nmen due to alteration in the hypothalamic-pituitary-gonadal axis, disruption \nof testicular steroidogenesis and metabolic dysregulation take place due to \nthis hormonal imbalance takes place and spermatogenesis is affected. \nBeing underweight: \n(BMI under 18.5)  Women at risk of fertility problems include those with \neating disorders, such as anorexia or bulimia, and those who follow a very \nlow-calorie or restrictive diet. [16].  \nExercise: \n A lack of exercise contributes to obesity, which increases the risk of \ninfertility. Less often, ovulation problems may be associated with frequent \nstrenuous, intense exercise in women who are not overweight.[17]. \nStress: \nFall outs of stress   can cause infertility and not the stress per se. \nEpidemiological studies show that   women with a history of depression are \ntwice as likely to experience infertility compared to those who do not have \nstress of any sort. Another mental condition, anxiety, arises due to \ncombination of genes and environmental stresses. Anxiety also can prolong \nthe time needed to achieve pregnancy. We can be fairly c ertain that, even if \nstress may impact ovulation or implantation for women trying to conceive \nnow. [18- 22]. \nMicrobiota:  \nAltered milieu of endometrial and vaginal microbiota may the hidden cause \nof female infertility. Now this factor should also be considered for infertility \ntreatment. [23].  \nIn the female reproductive system: \nInfertility in females may be due to Structural abnormalities such as, tubal \ndisorders such as blocked fallopian tubes, which are in turn, caused by \nuntreated sexually transmitted in fections (STIs) or pelvic surgery; uterine \ndiseases such as, endometriosis (inflammatory) septate uterus (congenital) \nfibroids (benign) Sometimes it may be ovarian disorders, such as polycystic \novarian syndrome and other follicular disorders. [24 -26]. Disorders of the \nendocrine system causing imbalances of reproductive hormones PCOS and \nmenstrual irregularity or severe menstrual cramps and ovulation \nirregularities and disorders marked by a hormone imbalance.[27]. The \nendocrine system includes hypothalamus a nd the pituitary glands \ndysfunctioning due to pituitary cancers and hypopituitarism. \nMale infertility may be caused by: \nIn the male reproductive system, infertility is most commonly caused by \nproblems in the ejection of semen such as, premature ejaculation, delayed \nejaculation; these can be caused by psychological and physical factors. \nPossible psychological causes of delay ed ejaculation are similar to those of \npremature ejaculation – for example, relationship problems, stress or \ndepression  Physical causes of delayed ejaculation include: Absence or low \nlevels of sperm, or abnormal shape (morphology) and movement (motility) \nof the sperm obstruction of the reproductive tract causing dysfunctionalities \nin the ejection of semen can also be the cause of infertility.[28,29].The \nblockage of sperm can occur in the tubes that carry semen (such as \nejaculatory ducts and seminal vesicle s). Blockages are commonly due to \ninjuries or infections of the genital tract. [30]. Abnormalities in hormones \nsecretion and production by the pituitary gland, hypothalamus and testicles \nare responsible for infertility too. Examples of disorders that resul t in \nhormonal imbalance include pituitary or testicular cancers. [31]. Testicular \nfailure to produce sperm, for example due to varicoceles or medical \ntreatments that impair sperm -producing cells (such as chemotherapy) or \nabnormal sperm function shape and movement of the sperm negatively affect \nfertility. For example, the use of anabolic steroids can cause abnormal semen \nparameters such sperm count and shape in some cases immune problems in \nwhich own sperm or to proteins in semen act as antigen and make antibodies \nagainst them.[32]. Semen allergy causes a change in skin colour, burning and \nswelling where semen contacts the skin or vaginal tissues.[33]. Some people \nnot only contact points but may have a whole -body response, including \nhives, itching and difficulty breathing.   \nIn addition to above mentioned lifestyle factors, environmental pollutants \nand toxins can be directly have toxic effects on gametes (eggs and sperm), \nresulting in their decreased numbers and poor quality. \n Y chromosome Infertility: \nMales with Y chromosome infertility usually have no symptoms other than \ninfertility. A physical examination may reveal small testes in those with \nSertoli cell-only (SCO) syndrome. Y chromosome infertility is a condition \nthat affects the production of sperm and causes male infertility, which means \nit is difficult or impossible for affected men to father children. [34]. Physical \nexamination is normal in approximately 30% of males with Y chromosome \ninfertility. [35]. \nWhat can be done? \nFertility care includes the prevention, diagnosis and treatment of infertility. \nChallenges to fertility arise from genetic abnormalities, infectious or \nenvironmental agents, delayed childbearing, behaviour, and certain diseases \nand systems structural abnormalities. Awareness of th e potential risks may \n\nClinical Research and Clinical Trials                                                                                                                                                                             Copy rights@ PD Gupta \n \n \nAuctores Publishing LLC – Volume 7(3)-129 www.auctoresonline.org  \nISSN: 2693-4779   Page 3 of 4              \nlead some people to adopting corrective behaviours and maintain fertility. \nPlan for infertility prevention, detection, and management medically assisted \nreproduction can certainly help in the improvement of the quality of life of \nwho live with infertility, through better diagnosis, safe and effective \ntreatment of infertility, and improved access to modern assisted reproductive \ntechnologies Equal and equitable access to fertility.[36]. \nReferences \n1. Mascarenhas M N, et al. (2012). National, regional, and global \ntrends in infertility prevalence since 1990: a systematic analysis \nof 277 health surveys. PLoS Med;9(12): e1001-1356. \n2. Rutstein SO,and Shah IH.( 2004). Infecundity infertility and \nchildlessness in developing countries. Geneva: World Health \nOrganization. \n3. Zegers‐Hochschild F et al. 2013, Human rights to in vitro \nfertilization. International Journal of Gynecology & \nObstetrics,123(1):86-89. \n4. Gupta PD and Iino A. (2002).  Mothering a cause. Oxford and \nIBH Publication, New-Delhi. \n5. Gupta P D. (2020). Menstrual Cycle and its Importance Archives \nof Reproductive Medicine and Sexual Health,3 (2): 51-54. \n6. Giacobbe M, et al.  (2004).  Ovarian volume, age, and \nmenopausal status. \n Menopause,11:180–185. \n7. Wilcox A J, et al. (2000). The timing of the \"fertile window\" in \nthe menstrual cycle: day specific estimates from a prospective \nstudy. BMJ,18:321(7271):1259-1262.  \n8. Gold E B. (2011). The timing of the age at which natural \nmenopause occurs. Obstet Gynecol Clin North Am,38(3):425 -\n440. \n9. Reed, ML; et al. (2009). \"Soy lecithin replaces egg yolk for \ncryopreservation of human sperm without adversely affecting \npostthaw motility, morphology, sperm DNA integrity, or sperm \nbinding to hyaluronate\".  Fertility and Sterility,  92(5):1787–\n1790.  \n10. Gupta, P D. (2022). Effe cts of aging on pregnancy J Cell and \nTissue Res, 22(1): 7149-7153. \n11. Oboni J B, et al.  (2016). Impact of smoking on fertility and age \nof menopause: a population-based assessment. BMJ \nOpeN,18:6(11): e012-015.   \n12. Rehman Rehana  et al. (2019). Relationship Between Smoking \nHabit and Sperm Parameters Among Patients Attending an \nInfertility Clinic Front. Physiol., Sec. Reproduction,10.   \n13. Tang Q, et al. (2019).  Semen quality and cigarette smoking in a \ncohort of healthy fertile men. Environ Epidemiol,3(4): e05-55. \n14. Van Heertum K, and Rossi B. (2017). Alcohol and fertility: how \nmuch is too much? Fertil Res Pract,10:(3) 10. \n15. Parihar M. (2003).  Obesity and infertility.  Reviews in \nGynecological Practice,3:120–126. \n16. Boutari C, et al. (2020). The effect of underweight on female and \nmale reproduction. Metabolism,107:154-229. \n17. Gupta P D. (2014).  Exercise for beauty and health,.Chaitanya -\nVikas publications, Bangalore. \n18. Simionescu, G.et al. (2021).\"The complex relationship between \ninfertility and psychological distress (Review)\". Experimental \nand Therapeutic Medicine 21(4):30-36. \n19. Rooney KL, and Domar AD. (2018). The relationship between \nstress and infertility. Dialogues Clin Neurosci,20(1):41-47. \n20. Cardwell MS. (2013). Stress: Pregnancy considerations. Ob-stet \nGynecol Surv, 68: 119-129. \n21. Hobel CJ, et al. (2008). Psychosocial stress and pregnancy \noutcome. Clin Obstet Gynecol,51: 333-348. \n22. Gupta P D. (2021). Neuropsychology of Expectant Mothers. J \nClinical Surgery Res,2(3). \n23. Gupta P D and K Pushkala. (2020).  “Hidden Reasons of \nWoman’s Infertility: Microbiota Milieu”. Acta Scientific \nWomen's Health ,2.2 :01-03. \n24. Tsevat DG, et al. (2017). Sexually transmitted diseases and \ninfertility. Am J Obstet Gynecol,216(1):1-9. \n25.  Singh S.  (2010).  Complic ations of unsafe abortion: Global \nconsequences of unsafe abortion Women’s Health, 6(6): 849 –\n860.  \n26. Almudena Devesa -Peiro, et al. (2020). Uterine disorders \naffecting female fertility: what are the molecular functions \naltered in endometrium? Fertility and Sterility, 113(6): Pa ges \n1261-1274. \n27. Marques-Pinto A, and Carvalho D. (2013). Human infertility: \nare endocrine disruptors to blame? Endocr Connect,17:2(3): \nR15-29. \n28. Kondoh N. (2011). Ejaculatory dysfunction as a cause of \ninfertility. Reprod Med Biol,    11(1):59-64. \n29. Abdel-Hamid IA, and Ali OI. (2018).  Delayed Ejaculation: \nPathophysiology, Diagnosis, and Treatment. World J Mens \nHealth,36(1):22-40. \n30. Babakhanzadeh E, et al. (2020). Some of the Factors Involved in \nMale Infertility: A Prospective Review. Int J Gen Med,13:29-41. \n31. Sengupta P, et al. (2021). Endocrinopathies and Male Infertility. \nLife (Basel), 22:12(1):10.  \n32. Kumar, N. and, Singh, A.K. (2022). Impact of environmental \nfactors on human semen quality and male fertility: a narrative \nreview. Environ Sci Eur, 34-36. \n33. John E. Schjenken  and Sarah A. Robertson  .(2020). The Female \nResponse to Seminal Fluid Physiological review, 100 (3):1077-\n1117. \n34.  Colaco S and, Modi D. (2018). Genetics of the human Y \nchromosome and its association with male infertility.  Reprod \nBiol Endocrinol,16:14. \n35. Pizzorno J. (2018).  Environmental Toxins and Infertility. Integr \nMed (Encinitas),17(2):8-11.  \n36. P. P. Sood, and P D Gupta. (2021). Tube Babies in Past, Present \nand Future J. Cell Tissue Research,21(1):1. \n \n \n \n \n \n \n \n \n \n\nClinical Research and Clinical Trials                                                                                                                                                                             Copy rights@ PD Gupta \n \n \nAuctores Publishing LLC – Volume 7(3)-129 www.auctoresonline.org  \nISSN: 2693-4779   Page 4 of 4              \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n \n This work is licensed under Creative    \n   Commons Attribution 4.0 License \n \n \nTo Submit Your Article Click Here: Submit Manuscript \n \nDOI:10.31579/2693-4779/129 \n \n \n \nReady to submit your research? 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