For as many as 15 percent of couples, getting pregnant is not automatic. When a couple fails to conceive after 12 months of regular, unprotected intercourse, or six months for a woman aged 35 or older, it is defined as infertility. But what exactly is infertility, and what are options to overcome it? Keep reading for helpful answers and insights into this surprisingly common condition.
Female infertility can be due to a wide variety of conditions and factors. Some of
the most common causes include:
- Ovulation disorders account for approximately 25 to 30 percent of infertility cases. Women with ovulation disorders ovulate infrequently or not at all. This can be due to many causes, from reproductive hormone regulation issues to problems in the ovaries, to simply being over or underweight. “The easiest way to know if you are ovulating is if you’re having regular monthly cycles associated with ovulation symptoms or confirmed with the assistance of an ovulation predictor kit,” explained Dr. Riely. “If not, and you’re having difficulty conceiving, an ovulation issue may be to blame. There are many relatively simple treatments for lack of ovulation, so don’t hesitate to discuss it with your doctor.”
- Tubal blockage occurs when blockages develop in the fallopian tubes that prevent
the passage of eggs into the uterus to become fertilized. “Tubal blockages can be due to a variety of reasons, including endometriosis, having had pelvic inflammatory disease, scarring from past sexually transmitted diseases such as chlamydia or gonorrhea, and many other factors,” added Dr. Riely. “When blocked tubes are suspected, one of the most common tests performed to evaluate the condition is a Hysterosalpingogram (HSG). It is a radiology procedure that involves injecting dye into the uterine cavity and watching it travel through the fallopian tubes. The test is mostly diagnostic, but we have seen that by forcing the dye through the tubes, it may open the tubes, and pregnancy occurs with the next cycle, after months of trying to conceive.”
- Uterine abnormality, including an abnormally shaped uterus or benign fibroids and polyps within the uterus, can disrupt successful implantation of fertilized eggs. A number of tests can be used to diagnose abnormalities, including ultrasound and hysteroscopy, which is the inspection of the inside of the uterus with a special endoscope.
- Endometriosis is sometimes associated with infertility. Not all women with endometriosis are infertile. This condition occurs when tissue found in the uterine lining grows excessively, both inside and outside the uterus, usually in the ovaries, fallopian tubes, bladder, intestines or rectum. It is marked by painful menstrual cramps, pain during intercourse, intestinal problems during menstruation and painful or frequent urination during menstruation. However, many women experience no symptoms at all. While there is no cure, endometriosis growths can usually be removed during a simple outpatient laparoscopic procedure, which can significantly increase the chances of pregnancy.
— Jacqueline H. Riely, MD, MS | Board Certified OB/GYN | OB/GYN Associates of Southern Indiana
Male fertility depends upon two factors, the ability to produce healthy sperm and the ability for that sperm to reach and fertilize the woman’s egg. While a seemingly simple process, male infertility can be surprisingly complex. Common causes include:
- Environmental factors such as overexposure to certain chemicals, pesticides and radiation, as well as prolonged exposure to heat from laptop computers being held in the lap, hot tubs and wearing tight clothing can reduce sperm count and motility.
- Health and lifestyle factors including illegal drug and steroid use, smoking, alcohol abuse, obesity and excessive stress can affect sperm count and quality.
- Varicocele is a relatively common swelling of the veins that drain the testicle, resulting in reduced sperm count.
- Infection can interfere with sperm production or block the passage of sperm. This is often the result of sexually transmitted diseases such as chlamydia or gonorrhea, inflamed prostate or infection of the urinary tract, and a variety of other potential factors.
- Testosterone deficiency is a hormonal imbalance that affects sperm production and can be due to a number or underlying causes.
Infertility by the Numbers
- 15 percent of couples experience infertility issues
- 90 percent of couples with infertility problems can be successfully treated
- 50 percent of infertile couples will go on to conceive a child without treatment within 24 months of diagnosis
- Age 35 and younger-infertility is defined as one year of frequent unprotected intercourse without conception
- Age 35 and older- infertility is defined as six months of frequent unprotected intercourse without conception
- 25 percent-chance of becoming pregnant during each menstrual cycle without medical assistance in the first three months of trying to conceive
- 10 percent-chance of becoming pregnant during each menstrual cycle without medical assistance after three months of trying to conceive
- One-third of cases are due to male factors
- One-third of cases are due to female factors
- One-third of cases are due to a combination of factors or other unexplained causes