Preferred Consumer | Healthy Living | Family Health | Reproductive Health, Pregnancy | Infertility

Infertility

Infertility is the inability of a couple to achieve a pregnancy after 12 months of unprotected intercourse.

Primary infertility is the term used to describe a couple that has never been able to conceive a pregnancy, after a minimum of 1 year of attempting to do so through unprotected intercourse. Secondary infertility is the term used to describe couples who have previously been pregnant at least once, but have not been able to achieve another pregnancy.

Causes of infertility include a wide range of physical as well as emotional factors. Approximately 30% to 40% of all infertility is due to a "male" factor. A "female" factor is responsible for 40% to 50% of infertility in couples. The remaining 10% to 30% may be caused by contributing factors in both partners, or no cause can be adequately identified.

How can infertility be prevented?

Because infertility is frequently caused by sexually transmitted diseases, practicing safer sex behaviors may minimize the risk of future infertility. Gonorrhea and chlamydia are the two most frequent causes of STD-related infertility.

These diseases are often initially asymptomatic, until PID or salpingitis develops. These inflammatory processes cause scarring of the fallopian tubes and subsequent decreased fertility, absolute infertility, or an increased incidence of ectopic pregnancy.

Mumps immunization has been well demonstrated to prevent mumps and its male complication, orchitis. Immunization prevents mumps-related sterility.

Some forms of birth control carry a higher risk for future infertility (such as the IUD - intrauterine device). However, IUDs are not recommended for women who have not previously had a child.

Women selecting the IUD must be willing to accept the very slight risk of infertility associated with its use. Careful consideration of this risk, weighed with the potential benefits, should all be reviewed and discussed with both partners and the health care provider.

There are multiple treatment options available to help couples with infertility problems. Listed below are just a few of these options:

  • Medications - medications are used to stimulate ovulation, block production of competing hormones, regulate female and/or male hormones, treat conditions such as endometriosis, and support ovulation and/or pregnancy.
  • Surgery - surgery is used to correct structural problems including congenital abnormalities. Surgery is also used as a diagnostic tool in uncovering the cause for infertility in a given situation.
  • Intrauterine Insemination - in this procedure, the doctor manually places partner's sperm directly into the patient's uterus.
  • Surrogate Gestational Carrier - patient's egg is fertilized by partner's sperm and placed into another woman's uterus. This is an option for a couple if the patient's eggs are okay but her uterus is unable to carry a baby to term.
  • In Vitro Fertilization - after sperm fertilizes egg, incubation takes place in a petri dish for 1-3 days and is then placed into the womb.
  • Gamete Intrafallopian Transfer - after sperm and egg are blended and then inserted into a fallopian tube.
  • Zygote Intrafallopian Transfer - after sperm fertilizes egg, it is then placed into a fallopian tube.
  • Oocyte (egg) Donation - Women can receive healthy eggs if they themselves do not have healthy eggs but do have a healthy uterus.

Infertility Facts

  • It is estimated that 10% to 20% of couples will be unable to conceive after 1 year of attempting to become pregnant.
  • It is important that pregnancy be attempted for an extended period (at least 1 year).
  • The chances for pregnancy occurring in healthy couples who are both under the age of 30, having intercourse regularly, is only 25% to 30% per month.
  • A woman’s peak fertility is in her early 20s.
  • As a woman ages beyond 35 (and particularly after age 40), the likelihood of conceiving is less than 10% per month.

Possible Causes of Infertility

  • Multiple sexual partners (therefore increasing the risk for STDs)
  • A sexually transmitted disease
  • A past history of PID (pelvic inflammatory disease) (after a single episode, 10% to 15% of women may become infertile)
  • A past history of orchitis or epididymitis ( men)
  • Mumps (men)
  • A varicocele (men)
  • A past medical history that includes DES exposure (men or women)
  • Eating disorders (women)
  • Anovulatory menstrual cycles
  • Endometriosis
  • Abnormalities of the uterus (myomas) or cervical obstruction
  • A chronic disease (such as diabetes)