Condition 101 About Infertility

What is the definition of Infertility?

Infertility means you cannot get pregnant (conceive).

There are 2 types of infertility:

  • Primary infertility refers to couples who have not become pregnant after at least 1 year having sex without using birth control methods.
  • Secondary infertility refers to couples who have been able to get pregnant at least once, but now are unable.

What are the alternative names for Infertility?

Inability to conceive; Unable to get pregnant

What are the causes for Infertility?

Many physical and emotional factors can cause infertility. It 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 attaches 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)
  • Birth defects that affect the reproductive tract
  • Cancer or tumor
  • Clotting disorders
  • Diabetes
  • Drinking too much alcohol
  • Exercising too much
  • Eating disorders or poor nutrition
  • Growths (such as fibroids or polyps) in the uterus and cervix
  • Medicines such as chemotherapy drugs
  • Hormone imbalances
  • Being overweight or underweight
  • Older age
  • Ovarian cysts and polycystic ovary syndrome (PCOS)
  • Pelvic infection resulting in scarring or swelling of fallopian tubes (hydrosalpinx) 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 (reanastomosis)
  • Thyroid disease

MALE INFERTILITY

Male infertility may be due to:

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

Male infertility can be caused by:

  • 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 (STIs), injury, or surgery
  • Smoking
  • Toxins in the environment
  • Vasectomy or failure of vasectomy reversal
  • History of testicular infection from mumps

Healthy couples under age 30 who have sex regularly will have about a 20% per month 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 years of age. 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. However, women who know they will need to delay childbearing may consider it.

What are the current treatments for Infertility?

Treatment depends on the cause of infertility. It 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

Couples can increase the chances of becoming pregnant each month by having sex at least every 2 days before and during ovulation.

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

Having sex before ovulation occurs is especially helpful.

  • Sperm can live inside a woman's body for at least 2 days.
  • However, a woman's egg can only be fertilized by the sperm within 12 to 24 hours after it is released.

Women who are under or overweight may increase their chances of becoming pregnant by getting to a healthier weight.

What are the support groups for Infertility?

Many people find it helpful to take part in support groups for people with similar concerns. You can ask your provider to recommend local groups.

What is the outlook (prognosis) for Infertility?

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

Most couples with infertility become pregnant after treatment.

When should I contact a medical professional for Infertility?

Call your provider if you are not able to get pregnant.

How do I prevent Infertility?

Preventing STIs, such as gonorrhea and chlamydia, may reduce your risk of infertility.

Maintaining a healthy diet, weight, and lifestyle may increase your chance of getting pregnant and having a healthy pregnancy.

Avoiding the use of lubricants during sex may help improve sperm function.

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REFERENCES

Barak S, Gordon Baker HW. Clinical management of male infertility. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 141.

Broekmans FJ, Fauser BCJM. Female infertility: evaluation and management. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 132.

Catherino WH. Reproductive endocrinology and infertility.In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 223.

Lobo RA. Infertility: etiology, diagnostic evaluation, management, prognosis. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 42.

Practice Committee of the American Society for Reproductive Medicine. Diagnostic evaluation of the infertile female: a committee opinion. Fertil Steril. 2015;103(6):e44-e50. PMID: 25936238 www.ncbi.nlm.nih.gov/pubmed/25936238.

Practice Committee of the American Society for Reproductive Medicine. Diagnostic evaluation of the infertile male: a committee opinion. Fertil Steril. 2015;103(3):e18-e25. PMID: 25597249 www.ncbi.nlm.nih.gov/pubmed/25597249.

Latest Advances On Infertility

  • Condition: Male Infertility caused by Impaired Semen Liquefaction
  • Journal: BioMed research international
  • Treatment Used: Prodom-Assisted Urokinase
  • Number of Patients: 261
  • Published —
This study tested the safety and efficacy of using a prodom-assisted urokinase to treat patients with male infertility that was caused by impaired semen liquefaction.
  • Condition: Uterine Fibroids
  • Journal: International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group
  • Treatment Used: High Intensity Focused Ultrasound Ablation and Laparoscopic Myomectomy
  • Number of Patients: 346
  • Published —
The study researched the outcomes of pregnancy after high intensity focused ultrasound ablation or laparoscopic myomectomy for treating uterine fibroids.

Clinical Trials For Infertility

Clinical Trial
  • Status: Not yet recruiting
  • Intervention Type: Other
  • Participants: 300
  • Start Date: November 2023
Survey of Dysmorphic Uterus Knowledge Among Gynecologists.