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.
Overview
- Infertility means you cannot make a baby (conceive).
- Infertility is grouped into two categories:
What are the symptoms of Infertility?
- 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.
What causes Infertility?
- 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:
- 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.
When to seek urgent medical care?
Call for an appointment with your health care provider if you are unable to get pregnant.
Diagnosis
- 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 options
- 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.
Where to find medical care for Infertility?
Directions to Hospitals Treating Infertility
What to expect (Outlook/Prognosis)?
- 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).
Possible complications
- Infertility can have a big emotional impact on you and your partner.
- Depression, anxiety, and marriage problems may occur.
Prevention
- 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.