What is Infertility? |
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Infertility is defined as the inability to conceive or carry a pregnancy to term after 12 months of trying to conceive. If you are over the age of 35, the time of trying to conceive is reduced to 6 months. It is important to see a specialist, or a Reproductive Endocrinologist, or in some cases your OB/Gyn or urologist for a complete fertility work-up and diagnosis. |
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Infertility refers to an inability to conceive after having regular unprotected sex. Infertility can also refer to the biological inability of an individual to contribute to conception, or to a female who cannot carry a pregnancy to full term. In many countries infertility refers to a couple that has failed to conceive after 12 months of regular sexual intercourse without the use of contraception. |
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Studies indicate that slightly over half of all cases of infertility are a result of female conditions, while the rest are caused by either sperm disorders or unidentified factors. Many cases of apparent infertility are treatable. Infertility may have a single cause in one of the partners, or it could be the result of a combination of factors. |
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Causes of Infertility in Women |
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There are many possible causes of infertility. Unfortunately, in about one-third of cases no cause is ever identified. |
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Ovulation Disorders |
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Problems with ovulation are the most common cause of infertility in women, experts say. Ovulation is the monthly release of an egg. In some cases the woman never releases eggs, while in others the woman does not release eggs during come cycles. |
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Ovulation disorders can be due to: |
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• Premature ovarian failure - the woman's ovaries stop working before she is 40. |
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• PCOS (polycystic ovary syndrome) - the woman's ovaries function abnormally. She also has abnormally high levels of androgen. About 5% to 10% of women of reproductive age are affected to some degree. Also called Stein-Leventhal syndrome. |
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• Hyperprolactinemia - if prolactin levels are high and the woman is not pregnant or breastfeeding, it may affect ovulation and fertility. |
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• Poor egg quality - eggs that are damaged or develop genetic abnormalities cannot sustain a pregnancy. The older a woman is the higher the risk. |
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• Overactive thyroid gland |
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• Underactive thyroid gland |
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• Some chronic conditions, such as AIDS or cancer. |
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Problems in the uterus or fallopian tubes |
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The egg travels from the ovary to the uterus (womb) where the fertilized egg grows. If there is something wrong in the uterus or the fallopian tubes the woman may not be able to conceive naturally. This may be due to: |
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• Surgery - pelvic surgery can sometimes cause scarring or damage to the fallopian tubes. Cervical surgery can sometimes cause scarring or shortening of the cervix. The cervix is the neck of the uterus. |
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• Submucosal fibroids - benign or non-cancerous tumors found in the muscular wall of the uterus, occurring in 30% to 40% of women of childbearing age. They may interfere with implantation. They can also block the fallopian tube, preventing sperm from fertilizing the egg. Large submucosal uterine fibroids may make the uterus' cavity bigger, increasing the distance the sperm has to travel. |
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• Endometriosis - cells that are normally found within the lining of the uterus start growing elsewhere in the body. |
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• Previous sterilization treatment - if a woman chose to have her fallopian tubes blocked. It is possible to reverse this process, but the chances of becoming fertile again are not high. However, an eight-year study showed tubal reversal surgery results in higher pregnancy and live birth rates and is less costly than IVF. |
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Causes of Infertility in Men |
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The following are common causes of infertility in men. |
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Semen |
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Semen is the milky fluid that a man's penis releases during orgasm. Semen consists of fluid and sperm. The fluid comes from the prostate gland, seminal vesicle and other sex glands. |
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The sperm is produced in the testicles. During orgasm a man ejaculates (releases semen through the penis). The seminal fluid helps transport the sperm during ejaculation. The seminal fluid has sugar in it - sugar is an energy source for sperm. |
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Abnormal semen is responsible for about 75% of all cases of male infertility. Unfortunately, in many cases doctors never find out why. The following semen problems are possible: |
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• Low sperm count (low concentration) - the man ejaculates a lower number of sperm, compared to other men. Sperm concentration should be 20 million sperm per milliliter of semen. If the count is under 10 million there is a low sperm concentration (subfertility). |
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• No sperm - when the man ejaculates there is no sperm in the semen. |
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• Low sperm mobility (motility) - the sperm cannot "swim" as well as it should. |
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• Abnormal sperm - perhaps the sperm has an unusual shape, making it more difficult to move and fertilize an egg. |
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Sperm must be the right shape and able to travel rapidly and accurately towards the egg. If the sperm's morphology (structure) and motility (movement) are wrong it is less likely to be able to reach the egg and fertilize it. |
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