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What Is Subfecundity In Couples? Causes, Symptoms, Risk Factors, Treatments And Management
According to a study, subfecundity is defined as a pregnancy time of more than 7.8, 9.5, or 12 months. The time to pregnancy is calculated from the date the couple began having intercourse without using contraception until the last menstrual period. [1]
It is estimated in many studies that regular unprotected sex will help conceive after one year in people aged 19 to 26 years, while in people aged 35-39 years, the conception may take two years.
Subfecundity, also known as subfertility, is often interchangeably used with infertility, however, they are not the same thing. Subfecundity is defined as a delay in conceiving or failure to conceive in spite of unprotected intercourse for a year, while infertility is the inability to conceive naturally after a year of trying. [2]
The possibility of conceiving naturally exists in subfertility, but it takes longer than usual. In infertility, the chances of conceiving without medical assistance are narrow.
Take a look at the details.
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Possible Causes Of Subfecundity
Some of the possible causes of subfecundity may include:
- Problems in ovulation: It includes conditions like polycystic ovary syndrome, premature ovarian insufficiency and dysfunction of the pituitary gland or hypothalamus. [3]
- Abnormalities of the uterus: It includes certain disorders of the uterus that may cause problems in conception. Some of them may be a septate uterus, fibroids and double uterus.
- Problems in the fallopian tube: Fallopian tube serves as a pathway for the transfer of egg from the ovaries to the uterus. Problems or blockage in the fallopian tube due to conditions like endometriosis, ectopic pregnancy or pelvic inflammatory disease can lead to subfecundity. [4]
- Problems related to sperm: The insufficiency of the sperm can also cause problems in conception. Disorders like HIV, diabetes, premature ejaculation or any damage to the male reproductive system can cause problems in the production and delivery of sperm, leading to subfertility.
Symptoms Of Subfecundity
Inability to get pregnant is the main symptom of subfecundity. If certain underlying conditions such as HIV, diabetes or PCOS are causing subfecundity, the symptoms could be according to the pre-existing ones.
Risk Factors Of Subfecundity
Some of the risk factors for subfecundity may include: [5]
- Long working hours
- Overweight couples
- Mother's age.
- Partner's age
- Irregular periods.
- Intercourse frequency of one day a week.
- Chronic consumption of caffeine, like more than four cups a day.
- Smoking. [6]
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Complications Of Subfecundity
The main complications related to subfecundity are infertility and higher levels of psychological distress. The latter is mainly caused due to the stress of not having a child and also as a side effect of medications taken to treat subfecundity. [7]
Some studies suggest that the risk of neonatal death or low birth weight in children [8] could be due to increased time of pregnancy.
Diagnosis Of Subfecundity
Some of the diagnostic methods for subfecundity may include:
- Medical history of both the partners: To get an understanding of any underlying conditions.
- Transvaginal ultrasound: To get a detailed image of reproductive organs and check for any abnormalities.
- Ovarian reserve testing: It helps check for the quality and quantity of an egg.
- Blood tests: It helps measure hormonal levels like progesterone levels in women and testosterone levels in men.
- Semen analysis: To check for total sperm count and health of the sperm.
Treatments For Subfecundity
In subfecundity, the possibility of conception is there, which is why, experts often suggest managing the condition with the help of lifestyle changes rather than medications, which may further lead to certain side effects on fertility.
Some of the treatment methods may include: [9]
- Surgery: In the case of blockage in the fallopian tube of women and varicocele in men.
- Fertility drugs: To regulate the menstrual cycle and induce fertility.
- Intrauterine insemination: It allows the placing of healthy sperm in the uterus for successful conception.
- Sperm retrieval techniques: In conditions related to problems with ejaculation.
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Management Of Subfecundity
- Quitting smoking and drinking alcohol
- Regular exercise
- Maintaining a healthy weight.
- Tracking the body temperature to detect the most fertile days.
- Avoiding stressful activities.
- Decreasing caffeine consumption.
To Conclude
Subfecundity could be an indication of infertility, but is not infertility. With proper treatment methods and lifestyle changes, the chances of pregnancy can be increased.
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