Infertility: Causes, Diagnosis, and Treatments
Infertility is defined as the inability to conceive or birth a baby. Causes of infertility may involve the female’s health, the male’s health, or both. Other causes are undefined. It is estimated that about one in eight couples struggles with fertility. That breaks down to about six percent of married females dealing with infertility, and nine percent of men seeking testing or treatment for infertility.
What causes infertility?
Many factors can cause infertility. Your symptoms will help your doctor or other provider identify a potential source for your problems. The most common cause of infertility in men is problems with sperm production. For women, the most common cause is an irregularity with ovulation (for example, due to polycystic ovary syndrome). Other causes of fertility issues include:
- Issues with ovulation
- Problems with the uterine lining
- Difficulty with the egg moving through the fallopian tube
- Poor sperm quality or number
- Difficulty staying pregnant
- Being overweight or underweight
- Having had previously untreated chlamydia
Each of these fertility issues is treated differently. Some people experience a combination of factors that lead to their inability to conceive.
When should you seek help?
In general, it’s recommended that you seek help if you have been trying to get pregnant for one year with well-timed intercourse and without birth control. You should seek help after six months of trying if you or your partner is over 35.
What should you do if you think you have a fertility problem?
Start with your regular practitioner who provides your well-woman care. For example, this could be your gynecologist or family doctor. They will already have a baseline set of information about your health and be able to point you to the appropriate specialists for any potential testing. They may also be able to do some of the initial testing and/or treatment themselves.
What can you expect at your first fertility appointment?
Your first appointment will usually take a while. The first thing your doctor will do is ask detailed questions about your medical history and your partner’s medical history, from when you were young until the present. This medical history can shed some light on potential issues with fertility. They will also talk to you about medications you take and any conditions you have, including things like hypothyroidism, high blood pressure, or sexually transmitted diseases.
They will also ask questions about your lifestyle. Simple things like how much you exercise and how often you drink alcohol or smoke can alter your fertility. Be sure to be honest with your doctor.
How is infertility diagnosed?
Because infertility can have multiple causes and be related to both partners, you and your partner are usually tested at the same time. Sometimes your medical professionals will screen your partner first because it is easier and more cost-efficient to run a sperm sample through tests than it is to test female fertility. There is usually blood work done to check the reproductive hormone levels for both partners.
The woman will also have other lab work done, including an ovarian reserve test to give the doctor an idea of how many eggs the woman has left. Some of the blood work must be timed with the woman’s cycle, like the progesterone testing. Other tests, such as thyroid testing, can be done at any point. You may also be asked to track your cycles at home using basal body temperature (BBT), a method of detecting ovulation by taking your temperature daily, or with the use of urine testing kits to monitor your luteinizing hormone (LH) levels. If these tests are all clear, you may also be asked to do slightly more invasive testing like an ultrasound or a hysterosalpingogram (HSG) of your reproductive organs. These tests can help assess the activity in your ovaries or check to see if your fallopian tubes are blocked.
What types of treatments are available for infertility?
There are many treatments for infertility. The treatment recommended for you and your partner will depend on the cause of your fertility issues. For example, sometimes correcting hormone imbalances can be helpful. Medications might be tried to encourage ovulation or to alter the menstrual cycle to be more favorable to conception. There may also be the need for surgery to correct damage to the organs. Some couples may also benefit from in vitro fertilization (IVF).
The good news is that there is help available in both evaluating and treating infertility. Seeking help from your doctor can get you on the right path toward parenthood.
American College of Obstetricians and Gynecologists. Evaluating Infertility. October 2017. Accessed November 2017.
American College of Obstetricians and Gynecologists. Treating Infertility. October 2017. Accessed November 2017.
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