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How Common is Infertility?

By CNY Fertility Updated on
How Common is Infertility?

Infertility is extremely common and affects approximately 48 million couples and 186 million individuals globally.

That means approximately 12% to 15% of couples of reproductive age experience and could be diagnosed with infertility.   

If that’s all the info you were looking for, great, but if you’re hoping to dive into the studies and statistics of how common specific infertility diagnoses are or the frequency of infertility in a specific population then keep reading. The remainder of this article will discuss and explore studies and statistics on how common specific types of infertility are and the frequency of infertility in specific subpopulations.

For example:

  • How common is male factor infertility?
  • How often does is infertility caused by issues of the fallopian tubes?
  • What percentage of those with PCOS also suffer from infertility?
  • How common is endometriosis-related infertility?
  • How common is infertility in those who smoke tobacco and marijuana?
  • and much more

The main point of this article is that we want you to understand that you should not be ashamed. Infertility is a common diagnosis.  While we would never wish your struggles upon anybody, the good news is that there are many medical treatment options and options for emotional support. Furthermore, this article is a good reminder that if you are part of a subpopulation based on lifestyle behaviors that experience infertility more often, we hope this serves as a good reminder of important lifestyle changes you could make to improve your fertility.

Remember, you are not infertile, you are experiencing infertility

Fast Facts  – How Common is Infertility?

  • Infertility is a disease that prevents the conception of a child or the ability to carry a pregnancy to delivery.
  • Infertility affects approximately 48 million couples and 186 million individuals globally.
  • In roughly 1/3 of infertile couples, the problem is the female.
  • In approximately 1/3 of infertile couples, the problem is the male.
  • In roughly 1/3 of infertile couples, the issue is unidentifiable or results from issues with both male and female fertility.
  • After one year of unprotected sex, 12% to 15% of couples cannot conceive.  After two years of trying, 10% of couples are still unable to have a baby.   
  • It is recommended that couples seek care from a fertility specialist after they reach their “time limit.” That is, you should seek the help of a fertility specialist after 6 months of unprotected intercourse 6 months if 35 or older or after 12 months if under 35. If the female partner is over 40, the standard of care is to seek help immediately.

Infertiltiy equal parts graph

What is Infertility?

Infertility, as defined by the American Society of Reproductive Medicine is “the result of a disease (an interruption, cessation, or disorder of body functions, systems, or organs) of the male or female reproductive tract which prevents the conception of a child or the ability to carry a pregnancy to delivery.”

This is expanded on by the notion that the duration of unprotected sex with failure to conceive a pregnancy that results in a live birth should be “about 12 months before an infertility evaluation is undertaken, unless medical history, age, or physical findings dictate earlier evaluation and treatment.”

Research indicates that after one year of having unprotected sex, 12% to 15% of couples are unable to conceive.

For that reason, others like the CDC define infertility “as not being able to get pregnant (conceive) after one year (or longer) of unprotected sex.”

As noted by ASRM, there are instances including age, medical history, and physical findings which warrant more rapid evaluation and treatment by fertility specialists.

For example, the standard of care is for clinicians to recommend that women over the age of 35 seek fertility treatment after only six months of unprotected intercourse and females over 40 arrange a consultation with a fertility specialist immediately.  Similarly, those with blocked tubes or other similar findings would warrant immediate treatment as any effort to attain pregnancy from intercourse would be futile. 

How Common is Female Infertility?

While studies conflict on the exacts, one thing is for certain. Millions of women experience issues with getting pregnant, staying pregnant, and infertility every year.  

According to one large national survey, approximately 11% of reproductive-aged women in the United States have experienced fertility problems.   

The CDC on the other hand claims 6% of married women in the United States between the ages of 15 to 44 are unable to get pregnant after one full year of trying.   

Many different medical issues can cause infertility and a woman’s chances of getting pregnant can be affected by many things including lifestyle choices.

Causes of Female Infertility

Female infertility has many primary causes.  Sometimes conditions which contribute to infertility are multiple or overlapping. 

While studies don’t always agree on exact numbers, the below is an approximate representation of the various primary causes of female infertility.

  • Egg and Ovulatory Disorders – approximately 40%
    • PCOS
    • Endocrine Disorders like hypothalamic amenorrhea, hyperprolactinemia, thyroid disease, adrenal disease, etc.
    • Diminished Ovarian Reserve
    • Premature Ovarian Failure
    • Poor Egg Quality
    • Aneuploidy
  • Tubal disorders – approximately 30%
    • Pelvic inflammatory disease, untreated sexually transmitted infections (STIs)
    • Past pregnancies
    • Abdominal/pelvic surgeries
  • Uterine disorders – 20%
    • Endometriosis
    • Congenital Uterine abnormalities
    • Fibroids
    • Polyps
    • Poor cervical mucus 
  • Other/Unexplained 10%
    • Diet
    • Smoking
    • Alcohol
    • Exercise
    • Toxic exposure
    • Genetics
    • Immunological/inflammation/autoimmune disorders/etc
    • Unknown

While many studies only show other/explained categories contributing to 10% of the primary causes of infertility, it’s important to remember that many of these “primary causes” are better classified as symptoms than causes. In fact, CNY experts and much of the literature agree that a vast majority of “causes,” for example, PCOS, Endometriosis, Egg Quality, and more are the results of poor dietary and lifestyle choices that can be largely remedied with a high-fat low carb diet.

How Common is Ovulatory Infertility?

Failure to ovulate is the most common female fertility issue and is responsible for approximately 30-40% of female infertility cases.

Ovulation is the part of the menstrual cycle when a mature egg is released from the ovary.  Without ovulation, pregnancy cannot occur because there are no eggs present for the sperm to fertilize.

Ovulatory issues are most commonly caused by PCOS, but they can also be caused by:

  • Other gynecological problems like primary ovarian insufficiency (POI)
  • Aging and diminished ovarian reserve
  • Endocrine disorders like thyroid disease which affect hormone levels
  • Lifestyle or environmental factors

Many different fertility medications can be used to encourage and induce ovulation.  There are also many different lifestyle changes you can make to naturally improve your fertility which may also increase ovulation!

How Common is Infertility in those with PCOS?

Researchers estimate that 5-15% of all women in the United States have Polycystic Ovarian Syndrome (PCOS).

PCOS is a condition in which a woman’s ovaries and sometimes her adrenal glands produce excess androgens.  Excess androgen levels interfere with ovarian follicle development and can prevent ovulation. 

As a result, 70-80% of women with PCOS experience infertility. That means women with PCOS may be 4.5 times more likely to experience infertility.

 

figure - reported infertility PCOS v.s. non

Although PCOS is one of the top causes of infertility, being diagnosed with PCOS doesn’t mean you can’t still get pregnant.  Check out our article on getting pregnant with PCOS for more information!  

How Common is Endometriosis in those Experiencing Infertility?

Endometriosis is an inflammatory disease defined as the presence of endometrial-like tissue (glands and stroma) outside the uterus.  Endometriosis affects 10-15% of all reproductive-aged women and women with infertility are 8x more likely to have endometriosis.

The American Society for Reproductive Medicine (ASRM) reports that between 30-50% of the millions of women who experience infertility have endometriosis.   That doesn’t necessarily mean that 30-50% of cases are 100% caused exclusively by endometriosis, just that it can be found and likely contributes to the fertility struggles in that percentage of women experiencing infertility.

Fortunately, research indicates that laparoscopic surgery to remove endometriosis can significantly improve the odds of having alive birth. In-Vitro Fertilization (IVF) treatment, can greatly increase women with endometriosis’s chances of getting pregnant.

How Common are Uterine Fibroids in those with Infertility?

ASRM reports that uterine fibroids are present in 5-10% of infertile women. As mentioned above, uterine fibroids are non-cancerous clumps of tissue and muscle on the walls of the uterus.

Uterine fibroids don’t always cause infertility, but they can contribute to it, especially if:

  • They block the fallopian tubes
  • They alter the position of the cervix
  • They alter the shape of the uterus
  • They interfere with uterine blood flow

Uterine fibroids can be evaluated via hysteroscopy and they can be treated in various ways including an operative hysteroscopy, myomectomy, and more.  Fibroids may also be treated and controlled via the usage of fertility medications.

As previously mentioned, as women get older their fertility declines.  When women reach their 30s, they are about half as fertile as they were in their early 20s.  Women’s chances of conception also decline rapidly after the age of 35.  

Chances of getting pregnant by age decrease for two main reasons:

  • Reduced ovarian reserve – the number of eggs left in a woman’s ovaries decrease over time
  • Increased genetic abnormalities – the chromosomal makeup of the woman’s eggs & thus embryos deteriorate over time

Figure - odds of female infertility by age

As you can see from the figure above, a woman in her 20s has roughly a 7% chance of experiencing infertility.  When a woman reaches the age of 30 her chances of infertility doubles to about 15% and by 35 her chances of infertility are over 20%.

While age isn’t everything, it is still HIGHLY important so it is often best to seek treatment as soon as possible. 

As demonstrated above, though the majority of studies attribute age as the primary factor in around 10% of cases, the fact is that is likely a gross miscalculation. According to internal data, 64% of CNY Fertility patients are 35 years or older with a median age of 37. The reason is likely due to the fact that as we age, our body deteriorates and medical issues become more likely. So at 25, a specific female may not have had any tubal issues, but at 37, she may have fully blocked tubes for a number of reasons.

How Common is Male Infertility

At least 30 million men worldwide experience infertility and estimated that roughly 10% of the male population suffers from male infertility at some point.

Males are solely responsible for 1/5-1/3% of infertility cases and contribute to approximately 1/2 of cases overall. Interestingly because ovulatory infertility is so common and is also the easiest form of infertility to treat with most cases being treated successfully at the OBGYN level, experts like Dr. Paul Magarelli and others believe that up to 70% of cases treated inside a fertility clinic are due to male factors.

While a male is technically only infertile if their female partner is unable to get pregnant, a male infertility diagnosis is usually made after male fertility testing shows abnormal sperm parameters.

Normal sperm parameters as defined by the World Health Organization (WHO) are included below:

Concentration:>20 million sperm per milliliter
Volume:2-5 mL
Motility:>50%
pH:7.2-7.8
White Blood Cells:<5 per high-powered field
Progression:2+-3+
Red Blood Cells:0 per high-powered field
Agglutination:None
Morphology:> 14% normal forms

What Causes Male Infertility?

Causes of Male Factor Pie Chart

Male infertility is caused by:

  • Primary hypogonadism – 30-40%
    • Androgen Sensitivity
    • Androgen Excess State
    • Estrogen excess state
    • Congenital or developmental testicular disorder (e.g., Klinefelter syndrome)
    • Medication
    • Radiation
    • Testicular Trauma
    • Varicocele
  • Altered Sperm Transport – 10-20%
    • Obstruction of the reproductive tract
    • Hormonal disorders
    • Failure to produce sperm
    • Poor sperm function and quality
  • Secondary Hypogonadism 1-2%
    • Androgen excess state (e.g., tumor, exogenous administration)

      Congenital idiopathic hypogonadotropic hypogonadism

      Estrogen excess state (e.g., tumor)

      Infiltrative disorder (e.g., sarcoidosis, tuberculosis)

      Medication effect

      Multiorgan genetic disorder (e.g., Prader-Willi syndrome)

      Pituitary adenoma

      Trauma

  • Other/Unknown Causes – 40-50%
    • Diet
    • Exposure to toxins
    • Smoking/drinking/marijuana use/other lifestyle choices
    • Heat
    • Cancer
    • Testicular Failure
    • Unknown

 

Other Causes and Contributing Factors of Infertility

Smoking

Smoking negatively impacts nearly every aspect of health and decreases both male and female fertility. 

For men, smoking has been associated with reduced sperm density, total sperm count, and the total number of motile sperm.

Sperm DensitySperm CountSperm Motility
-15.3%-17.5%-16.6%

For women, infertility rates are twice as high for smokers compared to non-smokers.

Smoking in Fertile and Infertile Populations graph

Excessive Alcohol Consumption

Excessive alcohol consumption decreases a woman’s chances of getting pregnant and also impairs men’s sperm quality.

For men, alcohol abuse can cause abnormal sperm parameters, impaired testosterone production, shrinkage of the testes, sexual dysfunction, and infertility.

Alcohol Effect on Semen Parameters graph

For women, alcohol has been shown to contribute to ovulatory issues, hormonal imbalances, and decreased ability to get pregnant.

Over- Exercising

Moderate exercise is great for fertility.  On the other hand, over-exercising can impair fertility, reduce men’s sperm quality, and reduce a woman’s chances of getting pregnant.

For men, exhaustive exercises can cause a decrease in thyroid hormones, testosterone levels, and overall sperm quality.

For women, intense aerobic exercise for seven or more hours per week has been shown to increase the risk of ovulatory infertility.

Heat

Heat, mainly from saunas or hot tubs, affects sperm production and overall male fertility. 

For men, heat stress may cause a decrease in motility and increase the percentage of sperm cells with major and minor defects.   One small study even produced results indicating that exposure to hot baths or hot tubs can lead to male infertility.

Marijuana 

Marijuana is being consumed at higher rates than ever and new questions are beginning to emerge about its effects on fertility.

Research on marijuana’s effects on fertility is limited and conflicting studies and results do exist.  But some research indicates that marijuana may negatively impact both male and female fertility.  

In a 2015 study, men who smoked marijuana had a 28% lower sperm concentration and a 29% lower total sperm count compared to those who didn’t.

In a study conducted by the National Institute of Health, non-marijuana users had a 24% greater chance of achieving pregnancy compared to marijuana users.  

Figure - Marijuana and Pregnancy rates

Reducing or eliminating marijuana use may help to boost female fertility

Summary

Infertility affects millions of couples and tens of millions of individuals each year.  Fortunately, fertility treatments are available to help grow families that wouldn’t be able to otherwise.  If you are one of the many people struggling to get pregnant and you are ready to speak with a well-qualified and knowledgeable provider about your options, we highly recommend scheduling a consultation with a member of our team.

If you’re still unsure if it’s time to ask for help, read about preparing for your first visit or consultation, or send us a message on Facebook or Instagram and a member of our team will gladly assist with any questions you have. 

 

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