Infertility is a common issue for couples trying to conceive, affecting approximately 10 to 15% of couples in the United States. Infertility can cause a great deal of emotional stress, as well as require extensive medical care to rectify. Learn about the types of infertility, the causes and the ways to overcome infertility below.
Identification
Infertility is defined as a couple not being able to conceive while having frequent, unprotected sex for at least a year. There are many causes of infertility in both men and women, as well as possible treatment options to allow for successful conception. When a couple suspects they may be infertile, the first thing to do is to see a doctor. Most likely, the couple will be referred to a reproductive endocrinologist, who specializes in infertility. The RE will proceed to assess the couple and perform tests of their reproductive systems. When the cause of infertility has been identified, the reproductive endocrinologist will propose a course of action for treatment.
Types
The two main types of infertility are:
- Primary Infertility, in which a couple has never been able to conceive.
- Secondary Infertility, in which a couple has already conceived in the past and carried to full term, but is suddenly unable to conceive again.
There are a few more classifications that break down the types of infertility even further. For example, there is "Combined Infertility," which is characterized by both the male and female partner having fertility disorders, thus increasing the difficulty in conceiving. About 15% of infertile couples are said to have "Unexplained Infertility," which means that neither partner has shown any abnormalities in their reproductive system, but still cannot conceive. This can be due to many reasons, such as poor quality of the woman's eggs, sub-optimal ovulation timing and the egg not reaching the fallopian tubes.
Significance
There are many causes for male and female infertility. For males, the most common causes are low sperm count or function, poor delivery of sperm, general health issues (obesity, alcohol/drug abuse and emotional stress, to name a few), and overexposure to certain environmental elements, such as pesticides or lead. For women, most commonly infertility stems from fallopian tube blockage, polycystic ovarian syndrome (PCOS), endometriosis, ovulation disorders and early menopause. A woman may also experience infertility from benign uterine fibroids or pelvic adhesions.
Prevention/Solution
There are many treatments for the variety of fertility issues in men and women that vary from lifestyle changes to medication and/or surgery.
In men, it is common to use hormones or surgery to improve sperm count and function. In extreme cases of blockage or poor ejaculation, sperm can be taken directly from the testicles (called surgical sperm aspiration) and injected into an egg in a laboratory (in vitro fertilization). Removing a toxin from the environment, making lifestyle changes or correcting or managing a medical issue can also improve a man's infertility.
Since female infertility is much more complicated and multi-faceted, there are many possible treatments, depending on the cause of the infertility. For women with disorders that interfere with ovulation, the most common treatment is medication, such as Clomid (a drug that stimulates ovulation) and Metformin (a drug that has been shown to boost ovulation in women with PCOS). Surgery is also an option, especially for blockages or damage to the fallopian tubes. Lastly, many women rely on assisted reproductive technology (ART) to become pregnant. The most common forms of ART are:
- In vitro fertilization: The most effective technique, this consists of removing eggs from a woman and fertilizing them in a laboratory with a man's sperm sample (the male partner's or a donor's). This is commonly used when both fallopian tubes are blocked or endometriosis, unexplained infertility and ovulation disorders.
- Intra-uterine insemination: This procedure injects a man's sperm (the male partner's sperm or a donor's) into the uterus at the time of ovulation to fertilize a waiting egg. In most cases, it is used when a man is incapable of producing viable sperm or has poor sperm motility..
Time Frame
Many couples struggle with the decision of when to seek medical help when they are having difficulty conceiving. According to the American Society of Reproductive Medicine, if the woman is under the age of 35, a couple should seek medical assistance after trying to conceive for 12 months without success. For women over the age of 35, couples should see a doctor if they have been unable to conceive after six months of trying. The reason for the difference in time frame is that, as a female ages, the quality of her eggs decline and she should not wait as long to seek medical advice.
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