Marriage, having children, and building a family are the desires of every couple. The arrival of a long-awaited child often brings joy and warmth to a family. It is not uncommon for couples to plan and prepare for the arrival of a child along with their marriage.

However, it is not uncommon for the eagerly awaited child to not arrive, even for couples who have been preparing for it for a long time. One of the factors that can affect this is infertility.

Infertility is a condition where there is a disruption in the reproductive system that makes it difficult for a couple to conceive. It is a cause for concern if the wife does not become pregnant after one year of regular and unprotected intercourse, as it may be a sign of infertility. However, infertility can occur not only in women as the wife but also in men as the husband, or even in both.

In men, infertility is influenced by disorders in sperm production (quantity, shape, and movement), which affect the quality of sperm. Some factors that contribute to male infertility include:

• Genetic abnormalities or hormonal disorders that lead to an inability to produce sperm or produce an insufficient quantity of sperm.
• Ejaculation problems (premature ejaculation, testicular abnormalities or damage).
• Health conditions that can affect the male reproductive system.

In women, infertility is influenced by factors that prevent the fertilization of eggs, including:

• Polycystic Ovarian Syndrome (PCOS).
• Blockage or damage to the fallopian tubes due to inflammation.
• Cancer and medications that affect the female reproductive system.
• Hormonal disorders.

In addition to these factors, there are other factors that can contribute to infertility, such as having a history of sexually transmitted infections, an unhealthy lifestyle (alcohol consumption and smoking), being underweight or overweight, being over the age of 35, and experiencing high levels of stress.

Before a definitive diagnosis of infertility is made, couples can undergo various examinations to determine the cause of their inability to conceive. For men, a sperm analysis can be conducted to assess the shape, movement, and quantity of healthy sperm. Hormone tests, such as testosterone levels, can also be performed to check for abnormalities. Another examination that can be done is a testicular ultrasound to identify any abnormalities or disorders that may affect sperm production in men. For women, tests such as Anti-Mullerian Hormone (AMH) assessment can be performed to evaluate the number of healthy eggs that can be fertilized and to help determine if there are any hormonal disorders affecting menstruation, such as PCOS. In addition to AMH testing, a Hysterosalpingography (HSG) can be conducted to check for any abnormalities in the uterus or fallopian tubes.

Author: Dr. Anisa Faradila (Medical Consultant, PRAMITA Clinic Laboratory, Jl. Cik Ditiro No. 17, Yogyakarta)