Infertility
மலட்டுத்தன்மை
Infertility is not just a social label; it is a clinical failure of the reproductive system to achieve conception despite unprotected coitus. Do not confuse this with sterility. Sterility is permanent; infertility is often a physiological or pathological hurdle that medical intervention can bypass.
The idea
Infertility is defined as the inability of couples to produce children in spite of unprotected sexual co-habitation. The etiology is multifactorial, involving physical, congenital, or immunological factors. It may also stem from chronic diseases, drug abuse, or psychological stress. In India, the social stigma often unfairly blames the female, but clinical data confirms the male partner is responsible in nearly 50% of cases.
Why it matters
It is a biological condition resulting from failures in gametogenesis, fertilization, or implantation processes, often requiring medical intervention.
NEET lens
NEET focuses on the 'causes' listed in NCERT. Expect matching-type questions or 'Select the incorrect statement' formats. Memorize the list: physical, congenital, diseases, drugs, immunological, and psychological. Do not over-analyze the treatment methods here; save that for the Assisted Reproductive Technologies (ART) section.
Clinical significance
When the reproductive axis fails, the biological imperative of species propagation is halted. Conditions like PCOS in females or oligospermia in males are common clinical manifestations. If left unaddressed, these underlying pathologies can indicate broader systemic endocrine imbalances or genetic anomalies.
Introduction
Infertility is defined as failure to achieve pregnancy after 12 months of regular unprotected intercourse (6 months if woman >35 years), affecting ~15% of couples, with roughly equal distribution between male, female, and combined/unexplained causes.
Core concept
Causes — Female: Ovulatory disorders (PCOS, hypothalamic amenorrhoea, POI = premature ovarian insufficiency, thyroid disorders). Tubal factors (PID, endometriosis, previous ectopic, surgery). Uterine factors (fibroids, polyps, Asherman syndrome). Cervical factors (mucus hostility, stenosis). Endometriosis: endometrial tissue outside uterus → inflammation → adhesions → tubal/ovarian damage. Male factors: Oligospermia (low count), asthenospermia (low motility), teratospermia (abnormal morphology), azoospermia (no sperm). Causes: varicocele (most common correctable cause), hormonal (hypogonadism), genetic (Y deletion, Klinefelter), obstruction (post-vasectomy, post-infection). Combined: both partners. Unexplained: normal investigations in both (~30%). PCOS: polycystic ovary syndrome — most common female infertility cause. Irregular ovulation, androgen excess, multiple small follicles on ultrasound.
Go deeper
PCOS (Polycystic Ovary Syndrome): affects 5-15% of women of reproductive age. Insulin resistance → hyperinsulinemia → excess LH → excess androgen from theca cells → follicle development arrests → polycystic ovaries. Anovulation → infertility. Treatment: weight loss (improves insulin sensitivity), clomiphene citrate (ovulation induction), metformin, IVF.
From Class 10
Infertility is the inability to conceive a child after one year of regular unprotected sexual intercourse. It affects both men and women and has many causes.