▶ What is infertility?
Infertility is commonly defined as not being able to get pregnant after at least one year of trying. Specialists suggest that assistance is requested when a woman under 35 has tried to conceive for a year without success or a woman over 35 has tried to conceive for 6 months. Of course, anyone can ask for help at anytime in the process but these are the basic guidelines. Couples that have repeat miscarriages are also said to be infertile but obviously their problem is not achieving a pregnancy but maintaining one. A complex chain of events must occur for a successful pregnancy to occur: A woman must release an egg from her ovaries, this is called ovulation. The egg is released into the pelvic fluid and must be picked up by a fallopian tube. The egg must travel through the fallopian tube toward the uterus. A man’s sperm must meet with the egg and fertilize it. The fertilized egg must continue to develop properly traveling through the fallopian tube. The fertilized egg must implant itself to the inside of the uterus. The corpus luteum must support the uterine lining. Interference with any of these steps can result in problems getting pregnant or staying pregnant.
▶ Is fertility a woman’s problem?
According to the National Women’s Health Information Center about 1/3 of infertility cases are due to female factors. In another 1/3 of the cases it is due to the male factor, the remaining cases are caused by a combination of male and female factors and unknown factors. Common causes of infertility in women are ovulation dysfunction, blocked fallopian tubes, endometriosis and uterine fibroids. Common causes of infertility in men are problems making sperm, or the sperm’s ability to reach the egg and fertilize it.
▶ What increases the risk of infertility?
In both women and men, infertility can be affected by overall health and lifestyles. The most common things that reduce the chance of becoming parents include: alcohol, drugs, cigarettes, age, stress, poor diet, being overweight or underweight, STDs, excessive exercise and exposure to environmental toxins (ex: pesticides and lead).
▶ What are the most common tests for infertility?
A full fertility evaluation must be done on the couple to get a picture of what might be going on. This evaluation consists of physical exams and history. If poorly timed intercourse or absence of ovulation is not obvious, other tests might be needed. These tests might include a HSG or hysterosalpingogram. This x-ray checks for anatomical problems with the uterus and fallopian tubes. The doctor will inject a dye that shows up on x-ray to identify any blockages that might be preventing the egg from moving to the uterus or keep the sperm from reaching the egg. Laparoscopy is a surgery to see inside the abdomen with a laparoscope. The doctor will make a small cut in the lower abdomen to evaluate the tubes, ovaries, and uterus; to look for disease and physical problems such as scarring and endometriosis. Semen analysis will look at the number, shape and movement of the sperm.
▶ What is the treatment for infertility?
Treatment can be a combination of medicine, surgery and techniques to transfer sperm to eggs (IUI or IVF). Specific treatments for infertility are based on test results, history, age and overall health. Intrauterine insemination (IUI) or artificial insemination is a procedure where prepared sperm is placed inside the woman’s uterus. IUI is used due to mild male factors, cervical mucus factors or unexplained infertility. IVF allows for the fertilization of eggs outside the body with subsequent transfer into the uterus.