What is infertility?

Infertility is a disease of the reproductive system. One third (30 percent) of infertility can be attributed to male factors, and about one third (30 percent) can be attributed to female factors. In about 20 percent of cases infertility is unexplained, and the remaining 10 percent of infertility is caused by a combination of problems in both partners.

Infertility is the inability to conceive children. There are many causes of infertility, and they are generally grouped into primary infertility, in which a couple isn't able to conceive after one year of trying, and secondary infertility, in which the couple had previously conceived but is now unable to. Infertility can be caused by either male or female health problems.

There are many causes of infertility, which can have specific symptoms related to them. The emotional problems stemming from infertility can be very serious including anxiety, depression and marital problems.

Your physician can talk to you more about infertility if you are worried about not being able to conceive.

Debra Fulghum Bruce PhD
Healthcare Specialist

The traditional definition of infertility is twelve months of unprotected sexual intercourse without establishing a successful pregnancy. This definition was derived in studies showing that 90 percent of couples will conceive during that timeframe.

Approximately 50 percent of otherwise healthy reproductive age women should be pregnant in the first three or four months of trying to make a baby. About 70 percent of women should be pregnant by six months and of the remaining 10 percent not pregnant after twelve months, still about one third will become pregnant in the following two years.

You may wonder if the incidence of infertility is increasing today. Obviously, there are two trends that may increase the chance of infertility:

  1. Women are delaying childbearing. The age factor alone is of paramount importance. Yet also with aging, there’s a greater risk of developing endometriosis or progression of other GYN disorders; and
  2. In general, there are an increased number of sexual partners, which increases the risk of scarred tubes.

Many women are postponing childbearing until the late 20s to late 30s while they seek higher education, career choices or other life objectives. Just so you know: the maximum female fertility occurs in mid-twenties at a time when menstrual cycles are most regular and ovulatory. Also, fertility is slightly decreased before age 20 and after age 30. Women over age 37 are much less fertile. Presently, age forms the largest barrier to successful fertility therapy. (From Making a Baby by Debra Fulghum Bruce, PhDRandom House, 2010.)

Dr. Alice Domar
Psychology Specialist

The official definition of infertility is a year of unprotected sexual intercourse, which does not result in the birth of a baby. But more current recommendations are that if the woman is 35 or less, she can try for a year before seeing a fertility specialist but if she is aged 35-40, she should only try on her own for six months, and if 40 or over, see a doctor after only three months. If there are other medical considerations, such as a history of irregular or absent menstrual periods, a history of endometriosis or a pelvic infection, she should consider seeing a fertility doctor earlier as well, no matter her age. For the male partner, if he has a history of undescended testicles, groin injury or mumps as an adult, he should also be seen sooner rather than later.

Dr. Mark Perloe, MD
Fertility Specialist

Infertility is diagnosed after a couple is not able to concieve after one year of trying. The process of diagnosis begins with a thorough medical history on both partners. A physical examination to assess your overhall health along with a transvaginal ultrasound to check for uterine abnormatlities will be among the first steps. Ovulation may be documented by history, basal body temperature charts, ultrasound or progesterone levels. The male history is carefully reviewed for medications and lifestyle factors taht may interfere with fertility. A semen analysis is obatined prior to initiating invasive testing on the female and certainly prior to any treatment.

The fallopian tubes are evaluated with an Xray called an HSG or hysterosalpingogram which is performed in the radiology department. Laboratory testing may include testing for PCOS, a prenatal panel, testing for age related fertility with an AMH level or day three FSH and Estradiol test. Your may be asked to provide a copy of your most recent pap smear and both you and your partners screening for Hepatitis B & C, as well as HIV and syphillis. Some physicians recommend screening for various genetic conditions such as sickle disease, cystic fibrosis or others prior to treatment so as to allow you to consider IVF with genetic screening if you are risk for these or other severe genetic disorders.

Dr. John K. Jain, MD
OBGYN (Obstetrician & Gynecologist)

Infertility is usually defined as the inability to conceive after one year of regular, properly-timed intercourse. Some people may be perfectly healthy, experiencing no other major symptoms of illness, but find themselves simply unable to get pregnant. After one year of trying, 90 percent of couples should conceive. The remaining 10 percent have infertility and should seek evaluation. For women over 40, seeking a fertility evaluation before one year of trying (usually 6 months) may be warranted given the limited number of reproductive years remaining.

Early evaluation should also be sought by women with a history of menstrual irregularity, STDs, pelvic surgery, endometriosis, autoimmune conditions and cancer therapy as the risk of infertility is potentially greater.

When trying to identify causes of infertility, it is important that both the male and female partner receive infertility testing. Current statistics indicate that male infertility is as common as female infertility.

Infertility is a condition in which a couple is not able to become pregnant, even though they're trying. Most of the time, a couple must be "trying" to get pregnant (that is, having regular, unprotected sex) for at least one year before it's considered infertility. Infertility can affect both men and women, and it can be caused by a number of factors. Fortunately, there are many ways of treating infertility, so many couples who face this problem end up overcoming it eventually.

The process for diagnosing infertility in both men and women may be quite complex. At that point of not being able to conceive over a 12-month period, for both men and women, diagnosis usually begins with a physical exam and a review of your medical history. Blood tests may also be done for both sexes to analyze levels of certain hormones. Imaging tests, usually ultrasounds, may be done to analyze internal problems in men's testes or scrotum or women's fallopian tubes or uterus.

The major symptom of infertility is being unable to get pregnant after trying for a substantial period of time. Usually, no other symptoms will be too noticeable, but in some cases women may have irregular menstruation, and men may have problems with sexual function.

To manage your infertility on a daily basis, it's important to address your physical and emotional health. Taking care of your general physical health by maintaining a healthy weight, exercising moderately and avoiding alcohol and drugs may improve your fertility. However, your emotional health may be more affected than your physical health during this time. Make sure you and your partner talk openly about your feelings and expectations for treatments. It's also important to talk about other options you may consider, such as adoption or surrogacy.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.