Infertility is a much more common condition than is often recognized. In fact, about 6.1 million couples in the United States, or roughly 10% of the population who are of reproductive age, are affected by the inability to conceive naturally. Because of the personal nature of infertility, it’s not talked about as much as other human ailments. But the emotional trauma of infertility can be just as devastating.
Infertility is defined as the inability to conceive after one year of regular unprotected intercourse. Couples who are truly serious about conceiving children should see a fertility specialist. While there have been dramatic advances in the field of fertility treatments, age is still a major determining factor to the success of any treatment. In simple terms, don’t wait.
There are four main contributing factors to infertility: Ovulatory factors; Tubal & Uterine factors; Male factors; and Unexplained factors. A couple facing infertility may be experiencing one or more of these obstacles in both the male and female partners.
Infertility due to a woman’s inability to regularly release eggs, or produce sufficient progesterone, accounts for about 25% of all cases. Progesterone is a hormone produced by the ovaries that transforms the uterine lining allowing a fertilized egg to implant and grow. Progesterone is produced only after ovulation. A woman’s menstrual cycle is an important indicator of ovulation – a regular period every 21 to 35 days may indicate normal ovulation. A woman with irregular cycles is probably not ovulating. Of course, the only true sign that a woman is ovulating is a pregnancy.
Uterine & Tubal Factors
Uterine and Tubal factors account for about 25% of the causes of infertility. A woman who has a history of pelvic or abdominal surgery, appendicitis, endometriosis and uterine/tubal surgery may have her fertility chances adversely affected. Also, pelvic infections (such as gonorrhea or chlamydia) and the use of an IUD contraceptive device is known to cause infertility. Defects in the uterus, scar tissue and dilated or closed tubes may all be a result of the above conditions. Even if a woman has not had any of these conditions, a thorough evaluation may still be in order.
Abnormal sperm accounts for another 25% of infertility factors. Abnormally shaped sperm, low motility and low count are all signs that a man’s sperm may have difficulty fertilizing the woman’s egg.
The remaining 25% of infertility causes may involve subtle problems with the immune system, genetic disorders, endometriosis, implantation or fertilization defects or may even remain unexplained. The most frustrating case is when all tests come back normal and the couple still cannot seem to conceive naturally. Yet, many of these subtle problems are likely responsible for the “unknown cases.” Sometimes, factors which contribute to infertility can be less quantifiable. It has been determined that age plays a significant role in the ability to conceive. As a woman approaches 40 and beyond, her chances of conceiving with her own eggs reduce dramatically. Smoking, sexually transmitted diseases (STDs), excess body weight and a stressful lifestyle also factor prominantly in a woman’s ability to produce eggs and carry a pregnancy. It is very important to identify which factors may be contributing to infertility. The tests described on this site will help determine which course of action should be taken and which can be ruled out – saving the infertile couple the frustration and costs of unnecessary or ineffective treatments. The basic infertility evaluation should include a midlutel progesterone blood test, HSG and semen analysis – all of which can be performed in one cycle or month.