What Is Infertility?

Infertility is clinically defined in men and women who cannot achieve pregnancy after a year or more of having unprotected sex.

What Causes Infertility?

Many medical conditions and other factors can affect a person’s infertility. Someone may have a single or several infertility causes, while others will be diagnosed with no identifiable reason. One-third of infertility cases are caused by conditions affecting male reproductive health, while one-third are due to female reproductive issues. Another one-third of causes of infertility are due to both genders’ reproductive issues and unknown factors.

Infertility in men is typically evaluated through semen analysis, where the sperm’s number, movement and shape are assessed. Results from this analysis can help determine how certain male factors contribute to infertility. Other male infertility causes may include:

• Disruption of ejaculatory or testicular function
  • Varicocele – abnormal vein enlargement within the testicle
  • Trauma to the testicles
  • Smoking, heavy alcohol consumption, anabolic steroid use and illicit drug use
  • Cancer treatment
  • Certain medical conditions
• Hormonal disorders such as improper functioning of the pituitary glands and hypothalamus, which both produce hormones that regulate testicular function
• Genetic conditions that may cause low to zero sperm production

On the other hand, conditions affecting a woman’s ovaries, uterus and fallopian tubes can contribute to infertility. A regular menstrual cycle occurs every 21 to 35 days and averages 28 days, likely indicating ovulation. Irregular periods may indicate a lack of ovulation, which can be caused by other conditions and requires a doctor’s evaluation. Possible causes of anovulation or the lack of ovulation during a menstrual cycle may include:

• Polycystic ovary syndrome (PCOS) - a condition that causes anovulation or irregular ovulation
• Diminished ovarian reserve (DOR) - happens when fewer eggs are remaining in the ovaries than expected for a woman’s given age
• Functional hypothalamic amenorrhea (FHA) - a condition caused by excessive exercise, stress, weight loss or a combination of these
• Improper functioning of the pituitary glands and hypothalamus
• Premature ovarian insufficiency (POI) - sometimes referred to as premature menopause, POI occurs when a woman’s ovaries fail before she is 40
• Menopause - a natural decline in ovarian function which is usually around 50 years of age and has not menstruated for at least one year

Fallopian tube obstruction and abnormalities in the uterus can also contribute to infertility. Your doctor may recommend imaging exams to check these organs for other problems.

How Common Is Infertility?

In the United States, about 9% of men and 11% of women of reproductive age have experienced fertility issues. One out of five women aged 15 to 49 who haven’t given birth cannot conceive. Within this group, 1 in 4 have difficulty carrying a pregnancy to full term.

What Are Signs of Infertility?

The main infertility sign is being unable to conceive after six months to one year of regular sex without birth control. While some people may not show other symptoms, others may experience:

• Abdominal or pelvic pain
• Irregular periods or vaginal bleeding
• No periods
• Ejaculation issues
• Penile disorders

How To Know if You Are Infertile?

Determining if you’re experiencing infertility requires a thorough evaluation by a doctor. In men, infertility diagnosis may include the following:

• Sperm count or semen analysis
• Blood tests
• Testicular biopsy

Physicians have several tests and procedures to confirm a diagnosis when a woman is suspected of being infertile. These include:

• A blood test
• An endometrial biopsy
• Additional diagnostic tests to determine if scar tissue or fallopian tube obstruction is present, such as:
  • Hysterosalpingography – a procedure that uses either ultrasound or X-ray images of the reproductive organs to determine if the fallopian tubes are blocked.
  • Laparoscopy – a minimally invasive procedure where a laparoscope is inserted into the abdomen through a small incision near the belly button to view the outside of the uterus, ovaries and fallopian tubes to detect abnormal growths (endometriosis).
  • Ovarian reserve testing – a test to determine a woman’s ovarian reserve to predict whether she can produce an egg or eggs of good quality and how her ovaries are responding to hormonal signals from her brain.
  • Urinary luteinizing hormone (LH) testing – a specialized urinary test to help define the times of peak fertility by predicting ovulation before it occurs.

What Is Infertility Treatment?

Depending on the underlying cause, infertility treatments may include medications, intrauterine insemination (IUI), surgery or assisted reproductive technology (ART). Some injectable and oral medications gynecologists may recommend as fertility treatments in women include:

• Bromocriptine
• Clomiphene Citrate
• Gonadotropin-Releasing Hormone
• Follicle-Stimulating Hormone or FSH
• Human Menopausal Gonadotropin or hMG
• Metformin

It is necessary to be aware that fertility treatment drugs can increase the potential of having twins, triplets or other multiples. Women should be aware that pregnancies with multiple fetuses may have more complications during pregnancy, such as having a high risk of premature birth and an increased risk of health and developmental issues.

Often, medication and IUI are used simultaneously. IUI is often used to treat mild male factor infertility as well as a recommendation for couples with unexplained infertility. This procedure involves inserting a specially prepared sperm into the woman’s womb.

On the other hand, ART involves harvesting mature egg cells from a woman and combining them with sperm in the laboratory, resulting in embryos. The embryos are returned to the woman’s body or donated to another woman. ART includes:

• In vitro fertilization (IVF)
• Intracytoplasmic sperm injection (ICSI)
• Zygote intrafallopian transfer (ZIFT)
• Gamete intrafallopian transfer (GIFT)

Schedule an Appointment

We strive to create a supportive environment where our patients and couples feel accepted, empowered and encouraged to seek the help they need. If you and your partner have been trying to conceive naturally for a year or more without success, infertility treatments may help you start a family. Contact the caring team at our practice to schedule an appointment.

Call 833-349-6636 Now