NAYA| What to know about causes and treatments for infertility

There are several factors that impact the fertility of a couple, and contrary to popular belief, infertility in males is just as likely as that in females.
by Fatima Dia

31 October 2019 | 14:51

Source: by Annahar

  • by Fatima Dia
  • Source: Annahar
  • Last update: 31 October 2019 | 14:51

(AP Photo)

BEIRUT: Infertility has become quite a common issue between couples worldwide. According to a study published in in 2010, infertility is most prevalent in South Asia, Sub-Saharan Africa, North Africa, Central and Eastern Europe, Central Asia, and the Middle East. Unfortunately, studies on the topic are limited, and due to differences in methodologies and capabilities in different countries, the results are inconsistent.

What is consistent, however, is that infertility is present, and thanks to the ever-evolving technological world of medicine, there are solutions.

As per the World Health Organization, the clinical definition of infertility is “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.”

In an interview with Annahar, Dr. Toufic Nakad, OB-GYN, highlighted the importance of understanding the particulars of that definition— just like everything else, there are exceptions. For instance, a couple who lives in separate places, and only meet a few times over the given duration, wouldn’t be considered infertile if they don’t get pregnant within a year.

“Trying to get pregnant means they [the couple] should have intercourse at the time of ovulation more than one time, over several months,” said Nakad. “If they’re doing that every month for a year, it means they are seriously trying to get pregnant.”

Another case where the given duration wouldn’t be suitable would be that of an older couple. Taking into consideration the biological clock a woman has, fertility doctors would need to act much earlier to help the couple conceive. According to Nakad, the time period would be shortened to six months, sometimes three.

There are several factors that impact the fertility of a couple, and contrary to popular belief, infertility in males is just as likely as that in females.

Nakad gave the example of examining a 100 couples who are dubbed as clinically infertile. According to him, “40 percent of the time it’s the woman, 40 percent it’s male infertility, and 20 percent it’s a combined factor.”

A combined factor simply means that there are issues both in the female reproductive system, and that of the male simultaneously. As per singular factors, the female’s can be categorized into four areas, while the male’s primary issues happen in two areas.

Female infertility can stem from ovarian, tubal, uterine, and cervical factors. The Middle-East has a significantly high percentage of Polycystic Ovarian Syndrome; one of the problems PCOS causes is difficulty getting pregnant. That’s an example of an ovarian factor.

For cases in males, difficulty in pregnancy stems from issues with spermatogenesis, essentially the production of sperm in the male reproductive system. These can be caused by different factors; for instance, genetic disorders such as Y-chromosome microdeletion, or mumps. YCM is a family of genetic disorders caused by missing genes in the y-chromosome.

“There’s a difference between hereditary and genetic,” pointed Nakad. “The lack of sperm, or reduced quantity, is not hereditary, it’s genetic.” He added that on top of genetic issues, lifestyle is a major impact on spermatogenesis; such as exposing testicles to high heat and the food that is consumed.

However, it’s important to highlight the fact that difficulty is not impossibility.

With the growing development of medical technology, couples with cases of infertility, although several, don’t all end up without a pregnancy. Treatments vary from case to case, depending on factors such as age and how long the couple has been trying. Often, treatment consists of medication that helps with the necessary hormones to incite ovulation or increase the production of sperms.

In more complicated cases, Planned Parenthood highlights two of the most common forms of treatment: intrauterine insemination, and in vitro fertilization. IUI is when healthy sperm is collected and directly inserted in the uterus when the woman is ovulating. IVF is when eggs are taken out of the ovaries and fertilized with sperm in a lab. Once the fertilized egg develops into an embryo, it is then inserted back into the uterus of the woman.

When it comes to the statistics however, numbers are not as promising. Women have a chance of only 10 to 20 percent of getting pregnant with one IUI. IVF has a bigger number of 40 percent. Of course, these percentages are subject to change depending on each case, keeping in mind things like age and severity of the case of infertility.

In truth, the study of fertility and the reproductive system is incredibly intricate and needs a lot more explanation; after all, it is an entire field of medicine. But learning the basis allows a couple to be more aware of their circumstances. The future of fertility? Stem cells specific to sex cells.

“I think there’s a lot of work on this, and maybe they will get there,” said Nakad.

Although, for now, the process of getting these stem cells is incredibly difficult, the same benefits from stem cells for other organs would be possible for the reproductive system; such as recreating the cells that would then benefit spermatogenesis, or better the quality of eggs, for example. Such a new and innovative approach to dealing with fertility issues might just be the best case scenario for mamas and papas to be.


Welcome to “NAYA”, the newest addition to Annahar’s coverage. This section aims at fortifying Lebanese women’s voices by highlighting their talents, challenges, innovations, and women’s empowerment. We will also be reporting on the world of work, family, style, health, and culture. NAYA is devoted to women of all generations-NAYA Editor, Sally Farhat:

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