Infertility is a common condition that affects millions of American men and women of reproductive age. After one year of unprotected sex, studies suggest as many as 12% to 15% of couples can’t conceive.
Simply put, the term “infertility” is used when a couple isn’t able to become pregnant after one year of regular, unprotected sex (or six months if the woman is older than 35). The causes of infertility are varied and can originate from either the man or woman or both.
Male infertility is determined through semen analysis. There are three main categories that could influence a man’s fertility. They include disruption of testicular or ejaculatory function, hormonal disorders, and genetic disorders.
First and foremost, women need functioning reproductive organs to become pregnant. If there is anything affecting these organs negatively, it can contribute to infertility.
Infertility and ovarian function
The main reason a woman can’t get pregnant, though, is through disruption of her ovarian function. Typically, a woman’s menstrual cycle is about 28 days long, with Day One starting on the first day of full flow. If she has regular periods every 24 to 32 days, she’s likely ovulating; if she has irregular periods, she’s likely not.
If a woman doesn’t ovulate during her menstrual cycle, it can be caused by a variety of conditions and requires a doctor’s attention. Some possible causes are listed below:
- Polycystic ovary syndrome (PCOS);
- Diminished ovarian reserve;
- Functional hypothalamic amenorrhea;
- Improper function of the hypothalamus and pituitary glands;
- Premature ovarian insufficiency; and
Other possible reasons for female infertility are an abnormal uterine contour or fibroids, as well as fallopian tube obstruction.
Symptoms of infertility
The number one symptom of infertility is, of course, not becoming pregnant. Usually there aren’t any other symptoms. Occasionally an infertile woman will have irregular or absent menstrual cycles. Rarely an infertile man will have hormonal symptoms, like changes in sexual function or hair growth.
Most of the risk factors for male and female infertility are the same, and include:
- Age: fertility declines as we grow older, more so in women than men;
- Tobacco use: decreases the likelihood of pregnancy and increases miscarriages in women smokers;
- Alcohol use: there’s no safe alcohol level for women, and heavy use in men can decrease sperm count and motility;
- Being over/underweight: too much and too little weight can affect your fertility; and
- Exercise issues: not enough exercise contributes to obesity.
While you can’t prevent some types of infertility, there are some things you can do to increase your chances of pregnancy.
As a couple, you should have regular intercourse several times around ovulation time for your highest chance of pregnancy. Start at least five days beforehand and continue until at least a day after ovulation.
For men, avoid drug and tobacco use, as well as excessive alcohol consumption. Avoid high temperatures that can affect sperm production and motility. Avoid exposure to industrial or environmental toxins. Limit any medications that may impact your fertility and exercise moderately.
For women, quit smoking, and avoid alcohol and street drugs. Limit caffeine, exercise moderately, and avoid weight extremes.
If you or your partner has been diagnosed with infertility, there are several treatment options. They include medications, surgery, intrauterine insemination, or assisted reproductive technology.
Specific medications used to treat the various types of infertility are listed below:
- Menopur, Repronex, Pergonal;
- Gonal-F, Follistim;
- Gonadotropin-releasing hormone (GnRH) analogs and antagonists;
- Parlodel; and
While using these medications, oftentimes a woman’s chances of having twins, triplets, or even more multiples increases. It’s important to discuss this likelihood with your infertility specialist and with your partner.