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Causes of infertility. Dr. Ciprian-Andrei Morariu: "Everyone tried to point the finger at women. There has been an observed increase in male infertility" / PHOTO: freepik.com @The Yuri Arcurs Collection

However, discussions about this delicate issue have often revolved around the female factor, emphasizing the pressure and stigma associated with women in this regard. Yet, recent observations suggest a significant shift in the landscape, with a noticeable increase in male infertility.

Dr. Ciprian-Andrei Morariu, a specialist in obstetrics and gynecology at SANADOR with a special interest in vitro fertilization and assisted reproduction, highlighted on "Părinți Prezenți," a program hosted by the editor-in-chief of Părinți și Pitici, Loredana Iriciuc, that currently, the proportion of infertility causes is distributed roughly equally between male and female factors. Infertility is not solely a problem specific to men or women but often a complex combination of biological, behavioral, and socio-economic factors.

"Until now, infertility has been discussed more in terms of the female factor, and everyone has tried to blame the woman: 'It's your fault, go, figure it out.' This is not necessarily normal or fair.

Unfortunately, there has been a significant increase in male infertility, so the proportion has become: one-third, one-third, one-third, meaning that one-third of infertility cases are mixed, one-third are female, and one-third are male.

In the discussion or dialogue we have with patients regarding infertility, the malefactor should also be involved. Therefore, we should consider the malefactor in even simple things: a simple varicocele. How many men do not go to the gym, or lift weights, and some may use steroids to gain muscle mass, which dramatically decreases the number of quality sperm.

We also have patients who, following various internet advice, do not know when they ovulate and have intercourse at other times besides ovulation, and then wonder why it doesn't happen.

That's why visiting a gynecologist ensures the necessary explanations to improve the chance of getting pregnant", explained dr. Ciprian-Andrei Morariu on "Părinți Prezenți" a program by ParintisiPitici.ro.

PHOTO: freepik.com @user25451090

Dr. Ciprian-Andrei Morariu: "Semen analyses are becoming increasingly poor"

"When it comes to the malefactor, unfortunately, semen analyses are becoming increasingly poor, and this even leads to special in vitro fertilization procedures with sperm injection into the ovum.

As for the female factor, here we have a whole range of factors, from infections, some of which are considered infertility factors, a history of infection with ureaplasma, Mycoplasma, Chlamydia, to factors that can lead to tubal blockage, uterine factors, various uterine malformations, the presence of a uterine septum, the presence of uterine fibroids, a polyp, all of which can hinder fertility. Or ovarian causes such as cysts, endometriotic cysts, ovarian conditions related to inflammation, and of course, endometriosis as a general factor due to the presence of lesions in the peritoneum or specifically in the female organs", the doctor added.

Infertility, the signals that should send you to the doctor and when is it "too late"? Dr. Ciprian-Andrei Morariu: "Time NEVER works in anyone's favor!"

Dr. Ciprian-Andrei Morariu on endometriosis

Contrary to the perception that endometriosis is a relatively new pathology, Dr. Ciprian-Andrei Morariu emphasized that its identification and treatment have a longer history than believed. The doctor highlighted that over time, physicians have identified the presence of endometriosis, but the approach to it has often been less pragmatic. Lesions were frequently ignored, and cysts were simply treated by removing the ovary, an intervention that does not promote optimal fertility solutions.

"The pathology of endometriosis is not relatively new; what's new is the active search for fertility solutions. For a long time, doctors discovered the presence of endometriosis, and the approach was much less pragmatic, in the sense that the lesions were ignored, and cysts were treated simply by removing the ovary, which is not an approach I try to promote.

For this specific aspect of endometriosis and the treatment of endometriosis specifically related to infertility, we turn to minimally invasive procedures, laparoscopy. We try to remove the lesions laparoscopically, attempt to only remove the cyst and the cyst's lining, and preserve as much of the ovary as possible so that patients have an extra chance to conceive", the doctor explained.

Is Stress a Cause of Infertility?

PHOTO: freepik.com @freepik

In the infertility discussion, dr. Ciprian-Andrei Morariu brought to light a harsh reality often overlooked: stress can play a significant role in fertility issues for both women and men. Additionally, Dr. Morariu highlighted the social pressure that couples facing infertility experience. Well-intentioned questions and comments from those around them can add a level of stress and anxiety to an already existing burden.

"Stress is a cause. You know very well, that any woman has experienced a delayed period during a more stressful period where she worked harder or was involved in more projects. It's a cause for the male factor as well.

Usually, when they come to discuss in the clinic, men are very inhibited about everything about to happen to them. An explanation like 'let's have intercourse every two days' seems... even though it might seem a bit strange for a man to refuse. It seems inconceivable to them.

Even the idea of coming to the doctor and saying when you should come, what you should do, and how you should do it, is a stress factor. Infertility is a stress factor.

The people around the patients constantly put pressure with 'When are you having a child?' 'Why can't you?' 'What happened?' 'Have you tried?' 'Where have you been?' 'What have you done?'

And everyday stress is a major factor in changing us. Stress hormones change much of what the hormones in the rest of the body mean", dr. Morariu pointed out.

Faced with this reality, the inevitable question arises: should we detach ourselves from stress to increase the chances of conception? Dr. Morariu acknowledged that this may seem easy to say but difficult to achieve in practice.

"It's easy to say, hard to do. It's easy to say to detach yourself from stress, hard to do, because in reality, stress is a daily presence, we can't detach ourselves as easily as we think", the doctor concluded.

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