What is infertility?
Infertility is the abnormal functioning of the male or female reproductive system. The American Society for Reproductive Medicine (ASRM) and the American College of Obstetricians and Gynecologists (ACOG) and the World Health Organization (WHO) recognize infertility as a disease.
Approximately one third of infertility can be attributed to male factors, and about one third can be attributed to female factors. In about 20% of cases infertility is unexplained, and the remaining 20% of infertility is caused by a combination of problems in both partners.
Infertility affects approximately 10% of the population. Like many diseases, it crosses all socioeconomic levels, all races, and ethnicities. It is likely that a friend, relative or co-worker has struggled with infertility. Infertility is defined as the inability to conceive or carry a pregnancy to term after 12 months of trying to conceive. If you are over the age of 35, that time is reduced to 6 months. If you have had more than one miscarriage or have a history of any of the symptoms listed below, contact a fertility specialist regardless of how long you have been trying to conceive.
• painful or irregular periods
• difficulty determining your ovulation
• history of uterine or tubal surgery
• undescended testes
• testicular trauma or surgery
Infertility can make you feel isolated and create interpersonal strain. You are not alone. The Center for Disease Control and Prevention reports more than 7.3 million Americans, or 1 in 8 couples of childbearing age are infertile. This is often an uncomfortable topic to discuss because of the personal nature of the subject. By speaking with your doctor, you will be taking a step towards gaining some control over a condition that leaves many people feeling powerless.
Below is a list of the most common causes of infertility:
Diminished Ovarian Reserve (DOR)
Diminished Ovarian Reserve (DOR) or Poor Responder refers to women who produce fewer eggs than women of similar reproductive age. These women usually require larger doses of fertility medications to generate eggs.
Endometriosis is a disorder of the female reproductive system in which endometrial tissue (the normal lining of the uterus) is found outside the uterine cavity. An estimated 10 to 15% of reproductive age women have endometriosis.
Luteal Phase Defect (LPD)
Abnormalities in endometrial development, luteal phase defect (LPD) generally occurs because of insufficient secretion of progesterone by the ovary and is associated with infertility and early miscarriage.
Approximately 30% of infertility is due to a male factor including sperm production disorders, structural abnormalities, ejaculatory disturbances and immunologic disorders.
Multiple Miscarriage (Recurrent Pregnancy Loss) is generally defined as women who have experienced two or more consecutive miscarriages.
Ovulatory disorders are described as the absence of cyclical release of the egg from the ovary. Ovulation disorders account for approximately 25% of female infertility problems.
Polycystic Ovary Syndrome (PCOS)
Polycystic Ovary Syndrome (PCOS) is one of the most common hormone disorders in women with an ovulatory disorder. PCOS occurs in 6 to 8% of reproductive age women and is often under-diagnosed. This is due to its multitude of seemingly unrelated symptoms that may include irregular or absent menstrual periods, lack of ovulation, weight gain, acne, excessive facial hair and infertility. PCOS may put women at a higher risk for developing cardiovascular disease, Type 2 Diabetes, and endometrial cancer, especially if left untreated.
Premature Ovarian Failure
Premature Ovarian Failure refers to the loss of ovarian function prior to the age of 40. It occurs in 1 in 1,000 women between the ages of 15 and 29 and 1 in 100 women between the ages of 30 and 39.
Secondary infertility is generally defined as the inability to become pregnant, following the birth of one or more biological children.
Tubal factors or tubal abnormalities such as damaged or blocked fallopian tubes may impair or prevent transport of eggs, sperm or embryos.
Unexplained infertility refers to the inability to identify the cause of infertility with current diagnostic tools following a fertility evaluation. It is estimated that one in five couples completing an infertility evaluation will have unexplained infertility.
Uterine factors or uterine abnormalities can significantly impact a woman’s ability to conceive and carry a pregnancy to term. Women may have an abnormally developed uterus from birth (congenital) while others may develop a uterine problem due to infection or surgery (acquired). Uterine fibroids or endometrial polyps can also have an adverse affect on fertility.