WHAT IS INFERTILITY?
Infertility is “the inability to conceive after 12 months of unprotected intercourse.” This means that a couple is not able to become pregnant after a year of trying. However, for women aged 35 and older, inability to conceive after 6 months is generally considered infertility.
HOW COMMON IS IT?
Infertility affects 10-15% of couples (~1 out of 7 couples has trouble in conceiving) This makes it one of the most common diseases for people between that ages of 20 and 45. Most couples with normal fertility will conceive within a year of trying.
WHAT CAN CAUSE INFERTILITY?
A woman’s age can have a big effect on her ability to have a baby, especially as she enters her 30s and 40s. for a healthy woman in her 20s or early 30s, the chance of conceiving each month is 25-30%. But by the time woman is 40 years old, the chances are 10% or less.
If a woman doesn’t ovulate (release an egg) about once a month, she may have trouble getting pregnant. Problems like Polycystic Ovary Syndrome (PCOS), thyroid disease and other hormonal disorders can affect ovulation and lead to infertility. Women who don’t have regular menstrual periods often don’t ovulate. Women who are overweight or underweight are more likely to have problems with ovulation than women of normal body weight.
Fallopian tubes are the tubes attached to the Uterus where the sperm and egg usually meet. Blocked or damaged tubes can cause infertility or ectopic pregnancy (pregnancy outside the uterus). The chances of having blocked tubes are higher in women who have had endometriosis, surgery in the pelvis or sexually transmitted infections.
Conditions within the cervix, which is the lower part of the uterus, may impact fertility, but they are rarely the sole cause of infertility. Problems within the uterus may interfere with the implantation of the embryo or may increase the incidence of miscarriage. Possible uterine abnormalities that may be identified include scar tissue, polyps, fibroids or an abnormally-shaped uterine cavity.
Peritoneal Abnormalities refer to abnormalities involving the peritoneum (lining of the surfaces of the internal organs) such as scar tissue (adhesions) or endometriosis.
Endometriosis is a condition where tissue that normally lines the uterus begins to grow outside the uterus. The tissue may grow on any structure within the pelvis including the ovaries and is found in about 35% of infertile women who have no other diagnosable infertility problem.
A third of all cases of infertility are because of a problem in the male partner. In another third cases, infertility is due to a combination of male and female problems. In the male partner, infertility can be caused by not being able to make or ejaculate (release) Sperm. Sperm quality is also important and is measured by the amount, the movement and the shape of sperm. Sometimes other medical problems can affect a man’s ability to make normal amounts or normal quality sperm. Men with diabetes, for instance, might have trouble ejaculating. Men with cystic fibrosis might have blockage that prevents the sperm from being ejaculated.
In some (10% or more) cases there may not be an obvious reason why a couple can’t conceive. This is known as unexplained infertility. Fertility treatments can often help these couples.
WHEN SHOULD I SEE A SPECIALIST?
Generally, a couple should see a specialist if they have not been able to conceive with 12months of trying. If a woman is 35 or older, she should see a fertility specialist if she hasn’t gotten pregnant after 6 months of trying. If a woman is younger than 35 but has a family history of early menopause, other health problems that can cause early menopause or has had certain cancer treatments, she might consider seeking fertility advice sooner.
A couple might also seek fertility consultation sooner if there is a risk for infertility such as irregular menstrual cycles or potential risk for fallopian tube damage. For men who have any prior health problems that can increase the chance of infertility, such as childhood problems with the testicles or prior cancer treatment, the couple can seek evaluation sooner.