230 Infer tility
➤ Habits such as
smoking or chewing
tobacco, and using
drugs can all affect a
man’s or a woman’s
We say a couple is infertile if they cannot get pregnant after
having sex together a few times a month for a year, without
using a family planning method. A couple may also have a
fertility problem if they have had 3 or more miscarriages (lost
pregnancies) in a row.
A man or woman who has already had a child can also
become infertile. A problem can develop in the years since
the last child was born. Sometimes the problem is not the
man’s or the woman’s alone but a combination of the two. And
sometimes both partners seem to be healthy and no doctor or
test can find out what is causing the problem.
In a man with normal fertility, healthy
sperm are produced in the testicles and
inserted in the woman’s vagina when
the man ejaculates during sex.
In a woman with normal fertility, sperm swim
through the womb and join with a healthy egg.
Infertility in a man
The main causes of infertility in a man are:
1. He does not produce enough sperm. Or his sperm cannot
swim to the woman’s tubes or to fertilize the eggs.
2. He had mumps after puberty that harmed his testicles. He
may still come (ejaculate), but the semen has no sperm in it.
3. His sperm cannot leave his penis because he has scars in
his tubes from a sexually transmitted infection (STI).
4. He has a swelling of the veins in his scrotum (varicocele).
5. Problems during sex because:
• his penis does not get hard.
• his penis gets hard but does not stay hard during sex.
• he comes too quickly, before his penis is deep in the
6. Illnesses such as diabetes, tuberculosis, and malaria.
Where Women Have No Doctor 2012