Is Infertility Really a Genetic Issue?

Is Infertility Really a Genetic Issue?

On June 24, 2023, a popular media company “Wazaa FM” posted a video on their Facebook page titled “L’infertilité : Quelles sont les causes?” [which may be translated as “Infertility: what are its causes?”]. In the video, the doctor, Hemraz Palawan from the fertility clinic of the SSRN hospital stated that “beaucoup ban facteur de infertilite c’est ban problem genetique” [which may be translated as “Many infertility factors are due to genetic issues.”]

Genome medical is a genomic medicine delivery company operating as an independent virtual care provider powered by a digital health technology platform. They partner with health systems, labs and biopharmaceutical companies to expand the reach and impact of precision medicine through genetics. According to their studies, “10 to 15 percent of couples experience infertility, with more than half of these cases being due to an underlying genetic issue. In these instances, the genetic cause could have been inherited. However, infertility is a complex condition, and most cases are not due to a known inherited cause.” For the case of female infertility, the Genome Medical website indicates that “Female infertility can have multiple causes, including hormone changes, issues with ovulation, endometriosis or structural changes of the reproductive system. Additional components may influence female infertility, including age, exposures, weight, or a history of sexually transmitted diseases. Lastly, genetics are known to contribute to approximately 10% of female infertility.” However, the Pacific Fertility Center of Los Angeles states that “Infertility can rarely be attributed solely to genetic factors. In most cases, there are multiple causes of infertility.”

Among the causes of infertility that the Doctor Hemraz Palawan mentions are: Advanced age, PCOS (Polycystic Ovary Syndrome) and Endometriosis, but are these diseases caused by genetic disorders?

PCOS (Polycystic Ovary Syndrome)

According to Mayo Clinic, a non-profit healthcare center focusing on research, PCOS is a hormonal syndrome which happens mainly during the reproductive years. The symptoms involving PCOS are: very irregular period or periods lasting too long, excessive growth of facial hair or male-pattern baldness, acne and Ovarian cysts.

The National Library of Medicine of the USA qualifies the syndrome as common among young women in the age of reproduction and is the main cause of infertility.

Is PCOS genetically transmitted?

Based on various Medically qualified websites such as Mayo Clinic, American College of Obstetricians and Gynecologists (ACOG) and the National Institutes of Health, we found that PCOS tends to be genetically transmitted through genes.

They state that PCOS is most commonly acquired through genes as the presence of PCOS in the family increases the risk of developing the condition. However, they made it clear that it does not guarantee the occurrence.

Studies carried out

The National Library of Medicine of the USA states that the contribution of genes to the occurrence of PCOS is still undetermined. They also mention various studies carried out to determine the real cause of PCOS in the years 1972, 1844 and 1968 respectively : Women with small ovaries, studies on degenerative ovaries, and studies on genetic transmission of PCOS.

The study carried out based on genetic issues was named the Twin studies. It involved Identical twins and non-Identical twins. The studies concluded that PCOS was more likely to be transmitted when it concerns identical twins than the non-identical twins. According to the study, the risk of PCOS being genetically transmitted, is approximately 72%.

Endometriosis

The World Health Organization (WHO) defines endometriosis as “a disease in which tissue similar to the lining of the uterus grows outside the uterus. It can cause severe pain in the pelvis and make it harder to get pregnant.” Around 10% of women of reproductive age are affected by this chronic condition. Endometriosis is attributed to both environmental and genetic factors. However, according to research by Loukia Vassilopoulou et al (2019), the causes of the condition are not fully understood.

Here are some causes of endometriosis (Mayo Clinic):

Retrograde menstruation: During menstruation, part of the endometrial blood travels backward via the fallopian tubes and into the pelvic cavity rather than leaving the body. These displaced endometrial cells have the ability to implant and develop in locations other than the uterus.
Environmental factors: They may play a role in the development of endometriosis. Certain pollutants, such as dioxins and polychlorinated biphenyls (PCBs), can disrupt hormonal action in the body.
Hormonal imbalances: Endometriosis is an estrogen-dependent disorder, which means it is affected by hormonal swings, particularly high estrogen levels. Endometriosis may develop and spread as a result of hormonal imbalances such as excessive estrogen or decreased progesterone.
Genetic factors: Endometriosis appears to have a hereditary component. Endometriosis runs in families, which raises the likelihood of having the ailment. However, the specific genetic pathways are still unknown.

Non-genetic factors of Infertility

According to some research done by Qualified Medical institutions such as the Mayo Clinic and the World Health Organization (WHO), infertility can be caused by various other factors, such as:
Complications of an Unsafe abortion – MSI Reproductive Choices website made it clear that over 9 million women are victims of unsafe abortion consequences such as life-long injuries, heavy bleeding, physical disability, and becoming infertile.

Sexually transmitted diseases – According to the Healthline website, diseases such as chlamydia or gonorrhea can negatively affect fertility.

Early menopause – Early menopause happens when the woman’s periods stop before the age of 45 years old. It happens when the ovaries stop reproducing, leading to low estrogen levels.

Cancer treatments – According to Mayo Clinic, radiation due to chemotherapy can lead to infertility. FertilityTips.com states that UV lights can lead to a decrease in B9 vitamin, leading to fetal mortality.

Testicular Trauma – According to the Urology Care Foundation testicular trauma – any blunt force or penetrating force on the testicles (kicks, punches, stabs, etc.) – can lead to lasting damage or even the loss of them , thus affecting fertility.

Trauma – According to MayoClinic, trauma caused by accident or even violence can be a main cause of disability to get pregnant in 15-20% of cases.

Conclusion

Based on our research from medical sources, we came to the conclusion that the doctor’s statement is indeed true as the conditions causing infertility might be higher if they are inherited. However, they are not the sole cause of infertility, other factors such as hormonal imbalances, physical trauma, and unhealthy lifestyles can also contribute to the increase in infertility chances. In conclusion after the fact-check, it can be seen that the statement of the doctor is indeed valid.

Hannah Korimboccus, Julia Bernard & Rohan Thevenet

Submitted as part of an assignment for the module Digital Journalism in Year 3 of the BSc (Hons) Journalism taught at the University of Mauritius by Mrs Christina Chan-Meetoo