What is infertility?
Infertility can be caused by a variety of diseases and medical conditions and affects about one in six men and women of reproductive age. Regardless of the cause, the American Society for Reproductive Medicine and other leading reproductive professional organizations recommend seeing an infertility specialist if you meet the following conditions or circumstances:
- You are a woman under 35 years of age and have been unsuccessful getting pregnant after one year of unprotected sexual intercourse.
- You are a woman over 35 and have been trying to conceive for six months or more.
- You have experienced two or more miscarriages.
- You have been diagnosed with a medical condition such as endometriosis or polycystic ovarian syndrome (PCOS) or have a male partner with a low sperm count that might impair your ability to get pregnant.
The longing to have children is one of human nature’s most natural and basic desires. There is no reason to feel ashamed or embarrassed because you can’t get or stay pregnant or to avoid seeking timely treatment. In fact, more than 7 million men and women in the U.S. are affected by infertility as are millions around the globe. The causes of infertility equally impact men and women; some couples have multiple diagnoses affecting both partners and others are faced with what many consider the most perplexing reason: unexplained infertility.
The causes of infertility are numerous, but can be categorized around these issues: ovulation and egg quality; sperm production, transport and function; fertilization; and implantation.
Some Common Causes/Reasons for Infertility
Problems with menstruation and ovulation
Irregular or abnormal ovulation, called anovulation, is one of the biggest reasons for female infertility and can be attributed to 25% of all female infertility problems.
Blocked fallopian tubes/tubal disease
Blockages or scarring of the fallopian tubes, a pair of hollow structures leading from the area of the ovaries to the uterus where fertilization occurs. In its early days, in vitro fertilization initially was used to help women with this condition.
Endometriosis can be a painful and chronic condition that is characterized by uterine lining tissue found outside the uterus, often inside the peritoneal cavity on the ovaries, fallopian tubes, uterus, bowels and bladder. The scar tissue formed from this condition can cause infertility. Surgery and in vitro fertilization have been found to be effective treatments for infertility patients with endometriosis.
Polycystic Ovarian Syndrome (PCOS)
PCOS is a hormonal imbalance resulting in lack of ovulation, irregular periods and infertility. It is characterized by the appearance of many small cysts in the ovary as seen on an ultrasound. It also is often associated with insulin resistance. Weight loss, medication therapy and techniques like IUI and IVF can help PCOS sufferers.
Fibroids are non-cancerous, estrogen-dependent benign tumors growing in the uterus that can cause pelvic pain and heavy menstrual bleeding. They also can cause infertility and recurrent miscarriages. A physician might recommend a myomectomy as the best surgical intervention to remove fibroids for women who want to get pregnant.
Premature Ovarian Failure
Women are diagnosed with premature ovarian failure (POF) if they are 40 years old or younger and their ovaries no longer function to ovulate eggs. Not only will these young women potentially lose their reproductive capabilities, but they also are at greater risk for heart disease and osteoporosis. A variety of medical conditions can cause POF, but doctors can not always identify one. POF is not premature menopause.
Older Intended Mothers
No matter how good she looks or feels, a woman's ovarian function declines in both quantity and quality as she ages. This is why it is important for women over 40 to seek help after three months of trying to get pregnant. Just because you are ovulating and having a period does not mean you are capable of getting pregnant.
After successfully having one or two children, many couples are perplexed by their inability to conceive again. Secondary infertility can be just as emotionally devastating as primary infertility and couples often do not get the support they need because of fear and guilt.
Azoospermia (complete absence of sperm) and oligospermia (few sperm cells produced) are two of the most common causes of male factor infertility. Other causes include malformed sperm cells or sperm cells that die before they reach the egg. In rare cases, male factor infertility can be attributed to a genetic disease or chromosomal abnormality.
Other reasons for male infertility include congenital absence of the vas deferens that transport sperm for ejaculation; cryptorchidism or hidden testicles, which also is congenital; varioceles, enlarged varicose veins in the scrotum that prevent normal function; and a previous vasectomy that needs to be reversed.