Infertility
Although infertility is a painful and sensitive issue, it is important to realize that you are not alone. Infertility affects millions of couples in the United States, as many as 12% of the reproductive-age population. With modern advanced reproductive techniques, even severe cases of infertility can often be treated successfully.
Causes of Infertility
In general, in order for one to get pregnant, there are three basic needs.
- The woman needs to produce eggs and ovulate.
- The man has to produce sperm of normal count and quality.
- The woman's uterus and tubes have to be normal and accommodating to pregnancy.
Thus, the causes of infertility can be divided into three categories.
- The first category is anovulation, or lack of ovulation, which means that the woman may not be getting pregnant because she simply does not produce eggs and does not ovulate. There are many different causes for a woman not to ovulate, including polycystic ovarian syndrome, hypothalamic dysfunction, obesity, ovarian failure, and menopause, among other causes. Further, multiple factors may contribute to a lack of ovulation, including poor nutrition, extreme weight (either low or high), smoking, drinking, and stress.
- The second category of infertility is a low sperm count, abnormal sperm or absent sperm from the semen. Causes of low sperm quality are multiple, including varicocele, vasectomy, sperm antibodies, history of trauma or infection in the testicles, chemical exposure, genetic causes, and environmental causes.
- The third category of infertility is uterine or tubal factor. Causes of blocked tubes can be prior infection with chlamydia, history of endometriosis, ectopic pregnancy, and pelvic surgery that may have damaged the tube. Causes of problems with the uterus include fibroids; polyps; congenital problems such as septate or bicornuate uterus; and history of uterine surgery, including myomectomy or hysteroscopy, which may cause adhesions in the uterus.
Infertile patients may often suffer from a combination of these factors, for example a couple with low sperm count in the male partner and ovulation or tubal problems with the female partner.
In some cases (about 15%), the cause of infertility cannot be determined even after a thorough fertility evaluation. This is known as unexplained infertility.
