If you’ve been trying to conceive and those two little pink lines still elude you, know that you are not alone. While it takes most couples an average up to one year to become pregnant, one in six couples experiences infertility issues.
For women under 35, infertility is defined as trying to conceive for one year without a pregnancy. For women over 35, infertility is defined as trying for six months without a pregnancy.
While the causes of infertility can vary greatly, there are five common diagnoses to be aware of:
1. Ovulatory Disorders:
Ovulatory disorders are a leading cause of female infertility. Ovulation occurs when an egg is released from the ovary. This is a condition which occurs when a woman does not ovulate regularly or has ceased ovulation. For most women with ovulatory disorders, periods are irregular or absent. The causes of ovulatory dysfunction can be broad and thus important to be evaluated. At least 75 percent of women that receive treatment for an ovulatory disorder will become pregnant.
Solutions will vary patient to patient, but it is important to maintain a healthy weight, decrease stress, and eat healthy. Exercise and proper nutrition can help normalize ovulation. For patients with hormone, thyroid, insulin or other endocrine imbalances, medication can aid in restoring ovulation.
2. Male Infertility:
Women and men experience infertility equally, making this another common diagnosis. When sperm are low in number, misshapen, or immobile, this can make conception difficult. Male infertility can be caused by a number of reasons, such as injury, illness, health problems and lifestyle choices.
Exercise, proper nutrition, and abstaining from drugs, cigarettes and excessive alcohol consumption can transform male fertility. For some cases of male factor infertility, semen can undergo a semen wash, where the most viable semen are collected. Sperm can then be injected directly into the uterus in an intrauterine insemination (IUI). An additional option is in vitro fertilization (IVF), where the highest quality sperm can be selected and injected into eggs.
3. Poor Ovarian Reserve:
Women are born with six to seven million eggs, which is reduced to 300,000-400,000 at the onset of puberty. Over the next 40 years, approximately, 400-500 eggs will ovulate. Ovarian reserve declines as a woman ages, with egg supply taking a rapid decline in the late 20s and again in a women’s 30s. A low ovarian reserve or poor quality eggs can make conception and a healthy pregnancy difficult to achieve.
Treatment protocol for poor ovarian reserve can vary greatly based upon age and quality of egg supply. Options can include intrauterine insemination, in vitro fertilization, and donor egg. Couples and individuals now are able to use both fresh and frozen donor eggs as a treatment option.
Endometriosis is a painful, chronic disease that affects at least 6.3 million women in the U.S. and millions across the globe. Approximately 35 to 50 percent of women with infertility also have endometriosis. Each month when women menstruate, they shed the endometrial lining found in their uterus. When the endometrial tissue normally found in the uterus grows outside the uterus and in other places of the body, it is known as endometriosis.
Scar tissue can form as a result of endometriosis, making surgical treatment to remove excess scar tissue a viable treatment solution. Should more extensive treatment be required, patients can also pursue in vitro fertilization.
5. Tubal Factor:
When fallopian tubes are blocked or damaged, eggs cannot travel down the tubes to meet sperm and become fertilized. Tubal damage can be caused by scar tissue, which can occur as a result of endometriosis, prior surgery, or numerous other factors. Blockage can also occur as a result of tubal ligation or from infection, such as a sexually transmitted disease.
Surgical treatment can remove scar tissue or repair damaged tubes, allowing eggs to travel properly down the fallopian tubes. Tubal ligation can also be reversed through surgery. When surgical treatment is not an option, patients have experienced great success with in vitro fertilization.
Keep in mind that each person, diagnosis and situation is different, and only after a medical evaluation can a tailored treatment plan can be prescribed. If you are having difficulty getting pregnant, please consult your doctor.
Dr. Jennifer Hirshfeld-Cytron is a reproductive endocrinologist with Fertility Centers of Illinois. Dr. Hirshfeld-Cytron is well published in the areas of fertility preservation and cost analysis of fertility therapies. Her professional interests include fertility preservation for cancer patients and social reasons.