According to The American Society for Reproductive Medicine, infertility is defined as the inability of a sexually active couple who are not using birth control to get pregnant after one year of trying, and for women who are 35 or older, that window shortens to 6 months. Causes of infertility can be due to the woman, the man, by both the woman and man, or due to unknown problems.
Out of the 15% of couples that have trouble getting pregnant, female infertility affects about 10% of women of reproductive age and approximately 7% of all men.
Common Causes of Infertility in Women
The most common cause of infertility in women is due to ovulation disorders, accounting for about 1 in 4 infertile couples. Every month during the female menstrual cycle, an egg is released from the ovaries into the fallopian tubes in a process called ovulation. Prior to being released, follicles – each containing an immature egg – in the ovaries must grow and develop into mature eggs. While a woman’s body has many immature follicles, each month only one becomes the dominant follicle that matures and is released during ovulation. For conception to be achieved, ovulation must occur.
If you have an ovulation disorder, you may have irregular or absent menstrual periods, meaning there is no egg (or an immature egg) available to be fertilized.
Polycystic ovary syndrome (PCOS) is the most common cause of infertility in women and is responsible for 70% of infertility issues in women who have difficulty ovulating. The condition is caused by problems with the regulation of reproductive hormones that results in a series of small cysts on the ovaries. PCOS is defined by an erratic menstrual cycle, meaning your periods can be irregular or even no period at all for a few months at a time. According to the PCOS Foundation, 10 percent of women of childbearing age are affected, but less than half are diagnosed.
The ovulation-inducing oral medications clomiphene citrate (also known as clomid) and letrozole are the principal treatments used to promote ovulation. For women not responsive to these medications, even with diet and lifestyle modification, there are additional treatment options available such as stimulating the ovaries to produce eggs with follicle-stimulating hormone (FSH) injections followed by an intrauterine insemination (IUI) or in vitro fertilization (IVF).
Problems in the ovary can also cause ovulation disorders, such as with primary ovarian insufficiency (POI), in which a woman’s ovaries stop functioning normally before she is 40. It’s less common than PCOS, affecting 1 in 100 women younger than 40, and the main cause is from hormonal imbalances. The first sign of POI is usually menstrual irregularities or missed periods. Additionally, some women with POI have symptoms like those experienced by women who are going through natural menopause.
For patients diagnosed with POI, the most common fertility treatment includes donor eggs. For young patients who are beginning to experience the symptoms of POI, fertility preservation may be an option.
Endometriosis is a disorder where uterine lining tissue develops outside of the uterus on the pelvic organs. The uterine lining continues to function like it would in the uterus by thickening and breaking down with each menstrual cycle. However, this displaced tissue has no way to exit your body which leads to pain, adhesions, and scarring. Endometriosis can affect the fallopian tubes, ovaries and other pelvic tissue which can affect your chances of conceiving. This can also disrupt the implantation of a fertilized egg in the uterus.
For women with endometriosis, there are different treatment options based on the severity of their disorder. It is also important to note that endometriosis may worsen with time and a consultation with a fertility specialist at a younger age can help guide the patient on their chances of success as they age.
Common Causes of Infertility in Men
Causes of infertility in men is usually due to deficiencies in the semen, such as low sperm production, abnormal sperm function or blockages that prevent the delivery of sperm. The following are some common male fertility conditions:
- Varicocele – The most common (and reversible!) cause of male infertility is varicocele – a condition of swollen testicle veins that is present in about 15% of all men and in about 40% of infertile men.
- Klinefelter Syndrome – a chromosomal defect that occurs in males early in the womb that results in smaller testes which reduces the levels of testosterone and sperm production that naturally occurs.
- Immune infertility related to antisperm antibodies – when the immune system mistakes sperm for a harmful intruder cell and tries to destroy them is considered the cause of infertility in roughly about 20% of infertile couples.
There are several ways in which a male’s sperm production can be considered abnormal, the most common being:
- Oligospermia – when there is a low concentration of sperm in the semen. Often, exhibiting a higher percentage of abnormal sperm cells.
- Azoospermia – when there is no measurable level of sperm in the semen.
- Necrospermia – when the sperm is either immobile or dead.
While published statistics tend to focus on the woman, it is important to note that male infertility diagnoses are just as common. In most cases, there is no obvious sign that a man is infertile without testing.
Approximately 1 in 4 fertility challenged couples will be told there is no explanation for why they can’t conceive. It may be important to note, however, that in many cases, the odds of conceiving on your own may be higher than it is for most infertility diagnoses.
At Vios Fertility, Conception is Our Life
At Vios, we are here to make your dreams of parenthood come true. Not being able to conceive a child can be stressful and frustrating, but a number of infertility diagnostic tests and treatments are available. We work with you to show you your chances of success utilizing different treatment plans based on your specific medical situation. During your consultation, we will discuss your goals for family building, your medical history, and review needed fertility testing to determine the best treatment path for you.
To understand your specific options concerning fertility diagnosis and treatment paths, schedule a consultation today.