Infertility (patient information)

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Editor-in-Chief: C. Michael Gibson, M.S.,M.D. [1] Phone:617-632-7753; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S.

• Infertility means you cannot make a baby (conceive).

• Infertility is grouped into two categories:

• Primary infertility refers to couples who have not become pregnant after at least 1 year of unprotected sex (intercourse).
• Secondary infertility refers to couples who have been pregnant at least once, but never again.

• The main symptom of infertility is the inability to become pregnant. Specific symptoms depend on what is causing the infertility.

• Infertility can cause many painful emotions in one or both partners.

• A wide range of physical and emotional factors can cause infertility. Infertility may be due to problems in the woman, man, or both.

FEMALE INFERTILITY:

• Female infertility may occur when:

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

• Female infertility may be caused by:

• Autoimmune disorders, such as antiphospholipid syndrome (APS)
• Cancer or tumor
• Clotting disorders
• Diabetes
• Growths (such as fibroids or polyps) in the uterus and cervix
• Birth defects that affect the reproductive tract
• Excessive exercising
• Eating disorders or poor nutrition
• Use of certain medications, including chemotherapy drugs
• Drinking too much alcohol
• Obesity
• Older age
• Ovarian cysts and polycystic ovary syndrome (PCOS)
• Pelvic infection or pelvic inflammatory disease (PID)
• Scarring from sexually transmitted infection or endometriosis
• Thyroid disease
• Too little or too much hormones

MALE INFERTILITY:

• Male infertility may be due to:

• A decrease in sperm count
• Sperm being blocked from being released
• Sperm that do not work properly

• Male infertility can be caused by:

• Environmental pollutants
• Being in high heat for prolonged periods
• Birth defects
• Heavy use of alcohol, marijuana or cocaine
• Too little or too much hormones
• Impotence
• Infection
• Older age
• Cancer treatments, including chemotherapy and radiation
• Scarring from sexually transmitted diseases, injury, or surgery
• Retrograde ejaculation
• Smoking
• Use of certain drugs, such as cimetidine, spironolactone, and nitrofurantoin

• In healthy couples under age 30 who have sex regularly, the chance of getting pregnant is about 25 – 30% per month.

• A woman’s peak fertility occurs in her early 20s. After age 35 (and especially 40), the chances that a woman can get pregnant drops considerably.

Call for an appointment with your health care provider if you are unable to get pregnant.

• When you should seek treatment for infertility depends on your age. It is recommended that women under 30 should generally try to get pregnant on their own for 1 year before seeking testing.

• Infertility testing involves a complete medical history and physical examination of both partners.

• Blood and imaging tests will be done.

• In women, this may include:

• Blood tests to check hormone levels, including progesterone and follicle stimulating hormone
• Checking body temperature first thing in the morning to check if the ovaries are releasing eggs
• FSH and clomid challenge test
• Hysterosalpingography (HSG)
• Pelvic ultrasound
• Laparoscopy
• Luteinizing hormone urine test (ovulation prediction)
• Thyroid function tests

• Tests in men may include:

• Sperm testing
• Testicular biopsy (rarely done)

• Treatment depends on the cause of infertility.

• It may involve:

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

• It is important to recognize and discuss the emotional impact that infertility has on you and your partner, and to seek medical advice from your health care provider.

• You can increase your chances of becoming pregnant each month by having sex at least every 3 days before and during ovulation. It is especially important to do so 72 hours before ovulation begins.

• Ovulation occurs about 2 weeks before the next menstrual cycle (period) starts. If a woman gets her period every 28 days, the couple should have sex at least every 3 days between the 10th and 18th day after the period starts.

Directions to Hospitals Treating Infertility

• As many as 1 in 5 couples diagnosed with infertility eventually become pregnant without treatment.

• More than half of couples with infertility become pregnant after treatment, not including advanced techniques such as in vitro fertiliziation (IVF).

• Infertility can have a big emotional impact on you and your partner.
• Depression, anxiety, and marriage problems may occur.

• Preventing sexually transmitted infections (STIs), such as gonorrhea and chlamydia, may reduce your risk of infertility.

• Maintaining a healthy diet, weight, and lifestyle may increase your chances for getting pregnant and having a healthy pregnancy.

• Take a prenatal or multivitamin containing folate before and during pregnancy. This lowers your risk for miscarriage and developmental problems in the baby.

• Centers for Disease Control and Prevention
• March of Dimes

http://www.nlm.nih.gov/medlineplus/ency/article/001191.htm

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