What is infertility?

Infertility is the inability to get pregnant after trying for one year. About 12 percent of couples in the United States have trouble conceiving or sustaining a pregnancy.

Infertility may be caused by male infertility, female infertility, or a combination of both. Male infertility accounts for about 40% of all cases, while female infertility accounts for 40% and unknown causes account for 20%. Male factor infertility can be caused by low sperm count, poor sperm quality (e.g., abnormal shape or motility), blocked ejaculation, hormonal problems and other causes. Female infertility can be caused by irregular ovulation (the release of an egg from the ovary), blocked fallopian tubes and other causes.

In both men and women, fertility declines with age — but it isn’t necessarily obvious until you try to start a family. According to data from the Centers for Disease Control and Prevention (CDC), over 6 million American women between ages 15 and 44 have difficulty getting pregnant or carrying a baby to term because they are infertile or subfertile.

A woman can’t get pregnant if she doesn’t ovulate regularly. Ovulation is the release of an egg from one of her ovaries. An egg must be released so that it can be fertilized by sperm. If you have not yet reached puberty, you may not be able to get pregnant until you begin menstruating (having periods). In most women, menstrual cycles are established by age 16 or 17. But some girls start their periods as early as age 12 or 13, while others don’t begin until they are older than 18.

A woman’s menstrual cycle includes two phases: the follicular phase and the luteal phase. Follicles are small sacs in the ovary that contain immature eggs. During the first part of this cycle (the follicular phase), one follicle develops within each ovary and becomes dominant — that is, it grows larger than all of its competitors and eventually releases an egg into the fallopian tubes at ovulation time

Symptoms of infertility

Infertility is defined as the inability to get pregnant after 12 months of unprotected sex. Infertility can affect both men and women, but most often it occurs in women.

Here are some common symptoms of infertility:

• Irregular periods
• No periods in a year, or periods that stop for several months
• Painful periods
• Post-coital bleeding (bleeding after intercourse)
• Painful ovulation (ovulation pain)
• Bloating and cramping before and during your period
• Clotting when you wipe or urinate (blood clots)

What causes infertility?

Age: As you age, your reproductive system changes and becomes less efficient. By the time you reach 35, your fertility is naturally reduced. After 40, your chance of getting pregnant naturally is only about 20%.

Infections: Infections in the reproductive organs may cause scarring or damage to the fallopian tubes, ovaries and uterus. These infections can reduce your chances of becoming pregnant even if they are treated successfully.

Endometriosis: Endometriosis occurs when tissue that lines the uterus grows outside the uterus and on other organs in the pelvic cavity. This tissue reacts to hormones just like the lining of the uterus does and can cause pain or bleeding during periods.

Polycystic ovarian syndrome (PCOS): PCOS makes it difficult for an egg to travel down the fallopian tube because it causes small cysts to form on your ovaries that produce male hormones (androgens). These male hormones affect ovulation and make it difficult for an egg to become fertilized after it has been released from an ovary during ovulation.

How is infertility diagnosed?

In some cases, it may be possible to diagnose infertility before you try to conceive. This is known as early diagnosis.

The following tests can help diagnose infertility:

Blood tests – these help determine your hormone levels and your egg count.

Pelvic ultrasound – this is a painless test that uses sound waves to create an image of the internal organs in your pelvis.

Hysterosalpingogram (HSG) – this test checks for abnormalities in your uterus and fallopian tubes using dye and X-rays. It’s often performed after a miscarriage or surgery on the reproductive system.

Chromosomal analysis – this checks for genetic problems that may cause infertility, such as Down syndrome.

Can infertility be prevented or avoided?

Infertility can be caused by many factors and can be either male or female. There are also many factors that can contribute to infertility that are external to the body, such as the environment, lifestyle, diet and stress levels.

In order to avoid infertility, it is important to take care of yourself and your partner. The following tips may help you prevent infertility:

• Take care of your reproductive health
• Avoid alcohol consumption
• Get enough exercise
• Maintain a healthy weight
• Eat a balanced diet rich in vitamins and minerals

Some people blame their infertility on a problem with the man’s sperm count, or on the woman’s ovulation cycle. But many other factors can contribute to infertility — from age to lifestyle choices, from gynecological issues to stress and anxiety.

The good news is that many cases of infertility are treatable and preventable. The key is knowing how to handle these problems before they become a problem. Here are some things you can do:

• Have regular sex during your fertile window
• Avoid alcohol, drugs and smoking
• Get enough sleep
• Quit using birth control pills or intrauterine devices (IUDs)

Infertility treatment

Infertility treatment refers to the actions taken to increase the probability of a woman becoming pregnant. In the United States, the National Infertility Association reports that infertility affects approximately 1 in 6 couples.

There are many different types of infertility treatments, including:

Hormonal therapy: This form of fertility treatment involves using medications to regulate hormone levels. Hormonal imbalances, such as an overproduction of estrogen or testosterone, can prevent ovulation, which is necessary for conception.

In vitro fertilization (IVF): IVF involves mixing sperm and eggs in a laboratory dish and transferring them back into the uterus. This procedure is used if there are problems with sperm production or if the woman’s fallopian tubes are blocked or damaged.

Surgery: Surgery is sometimes needed when other treatments don’t work and may involve removing scar tissue from the fallopian tubes or repairing damage caused by endometriosis (when tissue similar to uterine lining grows outside the uterus).

Living with infertility

Living with infertility can be a very difficult experience. It can also be a time of great growth and learning.

Infertility is a medical condition that affects approximately 15% of couples trying to conceive, so you are not alone. The first step in dealing with infertility is to talk about it. This will relieve some of the stress and anxiety that comes from feeling alone in the situation.

You may need support from family members and friends as well as from your healthcare team. It’s important to establish relationships with doctors and nurses who have experience dealing with infertility patients, as they will know how to help you through this difficult time.