Infertility


Infertility is defined as a failure to get pregnant after one year of unprotected intercourse. About 40% of infertility cases are due to a female factor and 40% to a male one. The remaining 20% are the result of a combination of male and female factors, or are of unknown causes. If you have been trying to conceive a child for one year without success, a visit to your physician for an infertility work-up and evaluation is very important. There are numerous potential causes of infertility and many can be treated with proper diagnosis.

Infertility in Women

There are many different causes of female infertility. The most frequent cause is an ovulation disorder. Ovulation disorders are often accompanied by absent, sparse, or irregular periods. Hormonal imbalances, insufficient or excessive weight, excessive exercise, and thyroid disorders are a few of the most common causes of ovulation disorders.

Other common causes of infertility in women include blocked fallopian tubes due to scarring from endometriosis, pelvic inflammatory disease, or certain sexually transmitted diseases, hormone imbalances, poor nutrition, ovarian cysts, pelvic infections, tumors, and abnormalities of the cervix, uterus, or fallopian tubes. Age also has a marked effect on women's fertility. By the age of 40, half a woman's eggs are no longer viable. Older women are also at higher risk of miscarriage, birth defects, and many kinds of pregnancy complications.

Environmental factors such as prolonged exposure to high stress, high temperatures, radiation, and certain drugs or chemicals can also affect fertility, as can lifestyle choices such as smoking and drinking.

When you visit the doctor for your infertility work-up, he or she will likely ask many questions about your past medical, menstrual, sexual, and surgical history, as well as the possibility that you were exposed to DES or similar drugs or chemicals that may cause infertility. He or she will likely perform a thyroid, breast, and pelvic evaluation initially, and if the results from these examinations do not reveal a probable cause for your infertility, he or she may do an ovulation evaluation, measure hormone levels, or request an x-ray, ultrasound, or other examination of your reproductive organs.

Infertility in Men

The most frequent cause of male infertility is a decreased sperm count due to environmental pollutants, radiation, heavy marijuana use, smoking, certain prescription drugs, or other factors. Frequent or prolonged exposure to elevated temperatures may also lower sperm count. Other possible causes of male infertility include impotence, retrograde ejaculation, hormone deficiencies, scarring from sexually transmitted diseases, or congenital abnormalities of the reproductive tract.

For men, the infertility work up will likely include a discussion of your past medical and sexual history as well as a physical examination and semen analysis. Your hormone levels may also be tested.

Treatment

Following your evaluations, the doctor may prescribe treatment ranging from simple education and counseling to hormonal treatments, ovulation induction and Intrauterine insemination to more advanced and expensive technologies like in vitro fertilization, ICSI to surrogacy, egg/sperm donation and even embryo donation, which are usually only tried after more basic treatments have failed.

Depending on the diagnosis, lifestyle changes such as quitting smoking (wise for those considering pregnancy and parenthood anyway, due to increased risks of birth defects and other complications for unborn children of smokers and asthma and other health problems for young children exposed to second-hand smoke), gaining or losing weight, and reducing exposure to stress, radiation, or environmental pollutants may also be encouraged.

Infertility can be one of the most difficult and heartbreaking challenges a couple can face, but proper diagnosis and treatment of the causes of infertility is an important step to a happy ending.

By Kerry Given           


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