What is infertility?
Infertility means that a couple cannot get pregnant after 1 year of regular, unprotected sex. Infertility can affect both women and men. A woman is considered infertile if she has been trying to get pregnant for 1 year and has not used any contraception. A man is considered infertile if he has too few sperm or his sperm is too weak to fuse with a woman’s egg. Many couples have no trouble getting pregnant. Unfortunately, there are factors that can make it difficult for some people.
Symptoms of Infertility
The main symptom of infertility is the inability to get pregnant. There may be no other symptoms. Sometimes women may experience problems related to their period such as pain or unusual bleeding. Some men may experience erectile dysfunction. However, most couples will have no symptoms other than not being pregnant.
Causes of infertility?
Childbirth (pregnancy) is complicated. Much has to go right for both men and women. So there are many causes of infertility.
A woman’s fertility can be affected by:
- Problems with ovulation. This is the process by which the egg leaves the ovary and travels to meet the sperm. Some women don’t ovulate every month.
- Problems with your reproductive system, including your fallopian tubes, cervix, uterus, or ovaries. This may include blockages, growths, scarring, enlarged ovaries, or abnormal opening of the cervix.
- Early menopause. This will happen before age 40. It could be related to an immune system disease, cancer treatments, or a genetic syndrome.
- Diseases and disorders, including endometriosis, pelvic inflammatory disease, cancer, diabetes, autoimmune diseases (when your body attacks itself), lupus, and celiac disease.
- Late puberty or no period.
- Smoking and substance abuse.
- Overweight or underweight. Even exercising too much or too little can affect a woman’s chances of getting pregnant.
- After the age of 35, it is harder for women to get pregnant.
A man’s fertility can be affected by:
- Unhealthy or poorly functioning sperm. This includes the quality of a man’s sperm as well as how fast they move.
- Infection. This could be an infection inside the man’s testicles. It can also be a sexually transmitted disease.
- Varicose veins of the testicles. This is an enlargement of the veins inside the loose skin surrounding a man’s testicles. It can cause a low sperm count.
- Retrograde ejaculation. This means that a man’s sperm goes into the bladder rather than outside the penis.
- Hidden testicles. One or both of the male’s testicles remain in the abdomen. The testicles are expected to fall from the abdomen into the scrotum at birth.
- Smoking and substance abuse.
- Sexual dysfunction. This may include erectile dysfunction or problems ejaculating too soon or not at all.
- Testicle overheating. This can happen from wearing underwear or pants that are too tight. It can also happen by using hot tubs for long periods of time.
How is infertility diagnosed?
For both men and women, the doctor will conduct a medical examination. They will ask you questions about your general health and how long you have been trying to get pregnant. Although your doctor will decide what additional testing is needed, it will likely start with a blood test. They will check hormone levels and genetics (for both men and women) and egg quality.
Women may have additional tests. They may include:
- Transvaginal ultrasound. A medical technician will insert a small wand, wrapped in latex, into your vagina. The scanner is connected to a monitor, where the technician can view images of the inside of your uterus and fallopian tubes. The technician will send the images to your doctor for review.
- This is an X-ray that involves injecting dye into your uterus to look for blockages inside your fallopian tubes. It does not require anesthesia.
- Pelvic endoscopy. This surgical procedure is done in a hospital. A thin, flexible laparoscope is inserted into your abdomen to give your doctor a better view of your uterus and fallopian tubes. It helps look for polyps, tumors, and blockages.
For men, the first test will be to take a sample of semen (the fluid released from the penis). This is used to check the quantity, quality, and movement of sperm.
Men may undergo further physical exams to look for:
- Past trauma to his testicles or penis
- Discharge, a liquid that should not be in a man’s penis
- A swollen or enlarged prostate
- Varicose veins
- Recent high fever
- History of mumps
A biopsy of the man’s testicles may be needed to get a better sperm sample.
Can infertility be prevented or avoided?
Some causes of infertility cannot be prevented or avoided. But both men and women can take steps to increase their chances of getting pregnant.
Women should:
- Stop smoking.
- Avoid alcohol and street drugs.
- Exercise moderately, but not so much that it affects your menstrual cycle.
- Maintain a healthy weight.
Men should:
- Avoid tobacco, drugs and excessive use of alcohol.
- Avoid high temperatures, such as hot tubs or saunas.
- Avoid industrial or environmental toxins.
- Exercise regularly.
Infertility treatment
Infertility treatment is based on the cause of your infertility. For women, treatment may include medication or surgery. The most common drugs used to treat female infertility stimulate the ovaries. This helps the ovaries produce more eggs and increases the chances of pregnancy. Surgery may be done if there is a blockage or problem with the fallopian tubes. It is also used to remove areas of endometriosis, fibroids, polyps, or scarring, all of which can affect fertility.
Men can be treated with drugs and surgery. If they have erectile dysfunction or difficulty ejaculating, medication may be prescribed. If they have varicocele in their testicles or have a problem with a blockage in the sperm ducts, they can be repaired surgically.
Assisted Reproductive Technology (ART)
ART uses technologies to help a couple get pregnant. It can help people who have gone through many infertility treatments but are still unable to get pregnant. Some options include:
- Artificial insemination (IUI). This procedure places healthy sperm in a woman’s uterus around the time of ovulation. It uses a long, narrow tube to insert sperm. It can be done in the doctor’s office.
- In vitro fertilization (IVF). This is more expensive and complicated than IUI. It requires stimulation of the ovaries with hormones and the removal of eggs from the woman. Eggs are fertilized with sperm in a laboratory. After the embryo develops, it is placed in the woman’s uterus. While they can be successful, there is no guarantee that an IUI or IVF will result in pregnancy.
- ART is supported by a third party. This is when another person helps a couple get pregnant. They can help by donating sperm, donating eggs or donating embryos. They can also act as surrogates or surrogate mothers. This means that someone else has actually held the baby for you.
Living with infertility
Living with infertility is emotionally difficult. The frustration of not getting pregnant after trying each month can make relationships difficult. It can also be difficult on your emotional health. It’s hard to see friends, family, and even strangers having kids when you can’t. For women who try IVF, hormones and fertility drugs can affect your emotional health. Long-term studies show they can also affect your physical health (possibly linked to breast and ovarian cancer).
If you’re struggling with infertility, talk to your doctor about how to deal with frustration each month. Sometimes a support group can help. Some couples turn to adoption after trying unsuccessfully to have a baby through pregnancy