What Is Infertility?
Infertility is a term used to describe the inability of a couple to get pregnant or the inability of a woman to carry a pregnancy to term. Infertility is defined clinically as not being able to achieve pregnancy after one year of having regular, unprotected intercourse, or after six months if the woman is older than 35 years of age.
Infertility is a disease or condition of the reproductive system that affects an estimated 10 to 15 percent of couples trying to conceive in the United States. It occurs in both women and men; in fact, female factors and male factors each account for approximately one-third of all infertility cases. The remaining cases arise from insufficiency in both partners, or the cause of infertility simply cannot be explained.
According to the Centers for Disease Control and Prevention (CDC), more than 7.3 million Americans, or one in eight couples of childbearing age, are infertile.
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Risk Factors for Infertility
There are several risk factors that can contribute to problems with male and female fertility, including:
- extreme weight gain or loss,
- age,
- sexually transmitted infections (STIs),
- smoking, and
- alcohol use.
Many different medical conditions and other factors can contribute to fertility problems, and an individual case may have a single cause, several causes, or—in some cases—no identifiable cause.*
What Causes Female Infertility?
To become pregnant, a woman’s uterus, cervix, fallopian tubes, and ovaries all must work correctly. Infertility can be caused by many problems:
- hormone imbalances can cause problems with ovulation;
- pelvic inflammatory disease and STIs like gonorrhea and chlamydia can damage your fallopian tubes;
- endometriosis can change your uterine lining and make it difficult for fertilized eggs to implant;
- and problems with the shape and mucus inside your cervix can prevent sperm from reaching your uterus to fertilize an egg.
For some women, doctors don’t know what causes infertility.
The following conditions can also cause fertility problems:
What Causes Male Infertility?
Male infertility is a complex condition that we are just beginning to understand. When it comes to diagnosis and treatment, male infertility can be grouped into three different areas:
- The first group is where doctors can diagnose and treat your infertility.
- The second group is where doctors can diagnose the cause of infertility but cannot treat it.
- The third group is where doctors can't diagnose what's causing infertility or treat it.
Still, it's important to keep in mind that most conditions can still be surgically treated, even though they fall into the third category where doctors can't diagnose or treat the underlying cause. This means that most of the men we treat can father their own children.
Treatable Genetic Conditions
Most cases of male infertility are caused by genetic conditions that cause low sperm count. Many times, these genetic conditions can also cause no sperm to be in the ejaculate. Although we cannot treat the underlying genetic cause of many of these conditions, we are typically able to find sperm in about 70 percent of men with genetic conditions by using a special surgical procedure.
Other Treatable Causes
These other causes of male infertility can be diagnosed and treated effectively:
What Is the Percentage of Infertile Men?
Twenty five to 30 percent of all cases of infertility are caused by male infertility. Another 30 percent of infertility cases are caused by both the man and the woman having fertility problems. Causes of male infertility include the following:
- Cryptorchidism
- Testicular torsion or trauma
- Varicocele
- Seminal tract infections
- Antisperm antibodies
- Hypogonadotropic hypogonadism
- Gonadal dysgenesis
- Obstruction of the reproductive channels
Treatment for Infertility
Many advances have been made in our ability to diagnose and treat fertility problems. It is essential that both men and women have a complete and accurate diagnosis to determine the best treatment options.
For men, the Andrology Laboratory offers several diagnostic tests, including:
For women, effective treatments can be:
- intrauterine inseminations (IUI),
- IVF with intracytoplasmic sperm injection (ICSI), or
- others.
*Courtesy: Eunice Kennedy Shriver National Institute of Child Health and Human Development.
