Most experts define infertility as not being able to get pregnant after at least one year of trying. Women who are able to get pregnant but then have repeat miscarriages are also said to be infertile.Pregnancy is the result of a complex chain of events. In order to get pregnant:
- A woman must release an egg from one of her ovaries (ovulation).
- The egg must go through a fallopian tube toward the uterus (womb).
- A man’s sperm must join with (fertilize) the egg along the way.
- The fertilized egg must attach to the inside of the uterus (implantation).
Infertility can result from problems that interfere with any of these steps.
About 12% of women (7.3 million) in the United States aged 15-44 had difficulty getting pregnant or carrying a baby to term in 2002, according to the National Centre for Health Statistics.
No, infertility is not always a woman’s problem. In about one-third of cases, infertility is due to the woman (female factors). In another third of cases, infertility is due to the man (male factors). The remaining cases are caused by a mixture of male and female factors or by unknown factors.
Infertility in men is most often caused by:
- Problems making sperm — producing too few sperms or none at all
- Problems with the sperm’s ability to reach the egg and fertilize it — abnormal sperm shape or structure prevent it from moving correctly
Sometimes a man is born with the problems that affect his sperm. Other times problems start later in life due to illness or injury. For example, cystic fibrosis often causes infertility in men.
The number and quality of a man’s sperm can be affected by his overall health and lifestyle. Some things that may reduce sperm number and/or quality include:
- Environmental toxins, including pesticides and lead
- Smoking cigarettes
- Health problems
- Radiation treatment and chemotherapy for cancer
Problems with ovulation account for most cases of infertility in women. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.Less common causes of fertility problems in women include:
- Blocked fallopian tubes due to pelvic inflammatory disease, endometriosis, or surgery for an ectopic pregnancy
- Physical problems with the uterus
- Uterine fibroids
More and more women are waiting until their 30s and 40s to have children. Actually, about 20% of women in the United States now have their first child after age 35. So age is an increasingly common cause of fertility problems. About one-third of couples in which the woman is over 35 have fertility problems.Ageing decreases a woman’s chances of having a baby in the following ways:
- The ability of a woman’s ovaries to release eggs ready for fertilization declines with age.
- The health of a woman’s eggs declines with age.
- As a woman ages, she is more likely to have health problems that can interfere with fertility.
- As a women ages, her risk of having a miscarriage increases.
Most healthy women under the age of 30 shouldn’t worry about infertility unless they’ve been trying to get pregnant for at least a year. At this point, women should talk to their doctors about a fertility evaluation. Men should also talk to their doctors if this much time has passed.In some cases, women should talk to their doctors sooner. Women in their 30s who’ve been trying to get pregnant for six months should speak to their doctors as soon as possible. A woman’s chances of having a baby decrease rapidly every year after the age of 30. So getting a complete and timely fertility evaluation is especially important.
Infertility can be treated with medicine, surgery, artificial insemination, or assisted reproductive technology. Many times these treatments are combined. About two-thirds of couples who are treated for infertility are able to have a baby. In most cases, infertility is treated with drugs or surgery.Doctors recommend specific treatments for infertility based on:
- Test results
- How long the couple has been trying to get pregnant
- The age of both the man and woman
- The overall health of the partners
- Preference of the partners
Doctors often treat infertility in men in the following ways:
- Sexual problems: If the man is impotent or has problems with premature ejaculation, doctors can help him address these issues. Behavioural therapy and/or medicines can be used in these cases.
- Too few sperms: If the man produces too few sperm, sometimes surgery can correct this problem. In other cases, doctors can surgically remove sperm from the male reproductive tract. Antibiotics can also be used to clear up infections affecting sperm count.
Various fertility medicines are often used to treat women with ovulation problems. It is important to talk with your doctor about the pros and cons of these medicines. You should understand the risks, benefits, and side effects.
Doctors also use surgery to treat some causes of infertility. Problems with a woman’s ovaries, fallopian tubes, or uterus can sometimes be corrected with surgery.
Intrauterine insemination (IUI) is another type of treatment for infertility.IUI is known by most people as artificial insemination. In this procedure, the woman is injected with specially prepared sperm. Sometimes the woman is also treated with medicines that stimulate ovulation before IUI.
IUI is often used to treat:
- Mild male factor infertility.
- Women who have problems with their cervical mucus.
- Couples with unexplained infertility.