Infertility

Infertility can be an emotionally painful complication when you’re trying to grow your family. Although infertility is fairly common, the journey to conceiving a child can be stressful and isolating. You can put your trust in your caring Atrium Health Floyd and Harbin Clinic obstetrician to work with you to discover anything that may be hindering your fertility and suggest treatment to help you start your family.

What is infertility?

By definition, infertility means not being able to become pregnant after a year of trying. After one year of having unprotected sex, about 15 percent of couples are unable to get pregnant. If a woman can get pregnant but keeps having miscarriages or stillbirths, that’s also called infertility.

With treatment, many couples treated for infertility go on to have babies. Interventions may include medications, assisted reproductive technology and surgery – and more than half of couples with infertility become pregnant after treatment.

Causes of infertility

Many factors can cause infertility. It may be due to problems in the woman, man or both: About a third of the time, infertility can be traced to the woman. In another third of cases, it is because of the man. The rest of the time, it is because of both partners or no cause can be found.

Having had some sexually transmitted infections (STIs), such as gonorrhea and chlamydia, may also increase your risk of infertility.

Causes of female infertility

Female infertility may occur when:

• The ovaries have problems producing eggs
• The eggs cannot move from the ovaries to the womb
• A fertilized egg does not attach to the lining of the uterus
• A fertilized egg or embryo doesn’t survive once it attaches to the lining of the womb (uterus)

Causes of female infertility include:

• Autoimmune disorders, such as antiphospholipid syndrome (APS)
• Birth defects that affect the reproductive tract
• Cancer or tumors
• Clotting disorders
• Diabetes
• Drinking too much alcohol
• Eating disorders or poor nutrition
• Exercising too much
• Growths (such as fibroids or polyps) in the uterus and cervix
• Hormone imbalances
• Medicines such as chemotherapy drugs
• Ovarian cysts and polycystic ovary syndrome (PCOS)
• Older age
• Pelvic infection or pelvic inflammatory disease (PID)
• Scarring from sexually transmitted infection, abdominal surgery or endometriosis
• Smoking
• Surgery to prevent pregnancy (tubal ligation) or failure of tubal ligation reversal
• Thyroid disease

Women who are underweight or overweight may increase their chances of becoming pregnant by reaching a healthier weight.

Causes of male infertility

Male infertility may be due to:

• Blockage that prevents the sperm from being released
• Decreased number of sperm
• Defects in the sperm

Causes of male infertility include:

• Birth defects
• Cancer treatments, including chemotherapy and radiation
• Exposure to high heat for prolonged periods
• Heavy use of alcohol, marijuana or cocaine
• Hormone imbalance
• Impotence
• Infection
• Medicines such as cimetidine, spironolactone and nitrofurantoin
• Obesity
• Older age
• Retrograde ejaculation
• Scarring from sexually transmitted infections, injury or surgery
• Smoking
• Toxins in the environment
• Vasectomy or failure of vasectomy reversal

Diagnosis of infertility

Deciding when to get treated for infertility depends on your age. Health care providers often suggest that women under 30 try to get pregnant without treatment for one year before getting tested.

Many experts recommend that women over 35 attempt conception for only six months before getting tested. If a pregnancy doesn’t occur within that time, they should talk to their health care provider.

Infertility testing involves a medical history and physical exam for both partners. Blood and imaging tests are most often needed.

For women, infertility tests may include:

• Blood tests to check hormone levels, including progesterone and follicle stimulating hormone (FSH)
• Home urine ovulation detection kits
• Measurement of body temperature every morning to see if the ovaries are releasing eggs
• FSH and clomid challenge test
• Antimullerian hormone testing (AMH)
• Hysterosalpingography (HSG)
• Pelvic ultrasound
• Laparoscopy
• Thyroid function tests

Infertility tests for men may include:

• Sperm testing
• Exam of the testes and penis
• Ultrasound of the male genitals
• Blood tests to check hormone levels
• Testicular biopsy

Risk factors for infertility

Healthy couples under age 30 who have sex regularly will have a 25% to 30% chance of getting pregnant each month.

A woman is most fertile in her early 20s. The chance a woman can get pregnant drops greatly after age 35 (and especially after age 40). The age when fertility starts to decline varies from woman to woman.

Infertility problems and miscarriage rates increase significantly after 35. There are now options for early egg retrieval and storage for women in their 20’s. This will help ensure a successful pregnancy if childbearing is delayed until after age 35. This is an expensive option, but for women who know they will need to delay childbearing, it may be worth considering.

Infertility treatment

If you suspect you may be infertile, talk with your Atrium Health Floyd and Harbin Clinic OB-GYN to determine the steps you can take to get pregnant. If treatment is recommended, it depends on the cause of infertility and may involve:

• Education and counseling about the condition
• Fertility treatments such as intrauterine insemination (IUI) and in vitro fertilization (IVF)
• Medicines to treat infections and clotting disorders
• Medicines that help the growth and release of eggs from the ovaries

Related conditions

Diabetes

Obesity

Pregnancy