Infertility is defined as the inability to conceive after one year of unprotected intercourse. It affects an estimated 10-15% of couples worldwide. The causes of infertility are complex and can involve both men and women.
Some common causes in women include:
- Ovulation disorders - failure to ovulate or irregular ovulation accounts for 30-40% of infertility cases. This can be caused by problems with the regulation of reproductive hormones by the hypothalamus and pituitary gland.
- Damage to the fallopian tubes - can prevent the egg from traveling from the ovary to the uterus. This can be caused by pelvic inflammatory disease, prior surgeries, or endometriosis.
- Uterine or cervical issues - abnormalities in the structure or function of the uterus and cervix can affect implantation and growth of the embryo. This includes uterine fibroids, polyps, or scarring.
- Primary ovarian insufficiency - when the ovaries stop functioning normally before age 40. This leads to low estrogen levels and absent periods.
In men, common causes include:
- Varicocele - enlarged veins in the scrotum which can overheat the testicles and reduce sperm production.
- Hormone imbalances - problems with testosterone or other reproductive hormones due to disorders affecting the hypothalamus, pituitary gland, or testicles themselves.
- Sperm problems - reduced sperm count, abnormal sperm motility (movement) or morphology (shape). This can be due to genetic defects, infections, toxins, injuries, or unknown causes.
- Ejaculation issues - sexual problems preventing delivery of sperm into the vagina. This includes erectile dysfunction or retrograde ejaculation.
Infertility can also be
unexplained in up to 30% of cases. Contributing factors may include
age, stress, being overweight, alcohol/tobacco use, and environmental toxins.
Diagnosis typically involves examinations and testing for both partners to identify the underlying cause. Common tests check ovulation, uterine abnormalities, blocked fallopian tubes, and semen analysis. Treatment depends on the cause but may include:
- Medications to induce ovulation, improve sperm production, or correct hormone imbalances. Our hormone specialists at Balance Hormone Specialist can provide targeted treatment plans to balance your reproductive hormones.
- Surgery to repair damage to the reproductive organs or structures obstructing fertilization.
- Intrauterine insemination (IUI) involves placing washed sperm directly into the uterus around the time of ovulation. This gets sperm closer to the egg.
- In vitro fertilization (IVF) retrieves eggs from the ovaries, fertilizes them with sperm in a lab dish, then transfers the embryos into the uterus. IVF bypasses fallopian tube damage and can improve success rates.
- Third party reproduction uses donor eggs, sperm or embryos. This is an option when infertility is untreatable.
The emotional impact of infertility can be
devastating. It is important for couples to get support from their partner, loved ones, support groups and mental health professionals. With patience and perseverance, many couples are ultimately able to build the family they desire, whether through treatment or alternate means like adoption. The key is to explore all options and find the path forward that is right for you.