12.4  Factors associated with infertility

In many societies people, believe that infertility comes from natural processes. However, you should understand that there are known socio-cultural factors that are associated with the occurrence of infertility, either directly or indirectly, in addition to the established causes listed previously.

As you have learnt, fertility markedly decreases in women over 35 because they will have older and/or fewer eggs. As they have lived longer, they may have had increased exposure to STIs, or have had induced abortions leading to the development of PID, which can cause tubal damage. As their ovulation becomes less frequent, the eggs produced may be defective, resulting in pregnancy wastage. Untreated gonorrhoea and chlamydia in women can spread into the pelvic area and infect the uterus, fallopian tubes and ovaries leading to PID.

Other factors may include having sexual intercourse less frequently than two to three times per week, due to a husband having more than one wife (polygamy), and having more frequent and multiple sexual partners which can predispose a couple to acquiring sexually transmitted infections.

In developing and poorly resourced countries, where the level of malnutrition is high, the onset of menstruation may be delayed, resulting in menstrual irregularities and even preventing ovulation altogether, thus limiting opportunities for conception.

12.3.3  Unexplained infertility

12.5  Approaches to help an infertile couple