is defined as trying to get pregnant (with frequent
intercourse) for at least a year with no success. Female
infertility, male infertility or a combination of the two
affects millions of couples in the United States. An estimated
10 to 18 percent of couples have trouble getting pregnant or
having a successful delivery.
results from female factors about one-third of the time and
male factors about one-third of the time. The cause is either
unknown or a combination of male and female factors in the
infertility causes can be difficult to diagnose. There are
many available treatments, which will depend on the cause of
infertility. Many infertile couples will go on to conceive a
child without treatment. After trying to get pregnant for two
years, about 95 percent of couples successfully conceive.
symptom of infertility is the inability to get pregnant. A
menstrual cycle that’s too long (35 days or more), too short
(less than 21 days), irregular or absent can mean that you’re
not ovulating. There may be no other outward signs or
see a doctor sometimes depends on your age:
to age 35, most doctors recommend trying to get pregnant for
at least a year before testing or treatment.
you’re between 35 and 40, discuss your concerns with your
doctor after six months of trying.
you’re older than 40, your doctor may want to begin testing
or treatment right away.
doctor may also want to begin testing or treatment right away
if you or your partner has known fertility problems, or if you
have a history of irregular or painful periods, pelvic
inflammatory disease, repeated miscarriages, prior cancer
treatment, or endometriosis.
these factors is essential to become pregnant:
need to ovulate. To get pregnant, your ovaries must produce
and release an egg, a process known as ovulation. Your doctor
can help evaluate your menstrual cycles and confirm ovulation.
partner needs sperm. For most couples, this isn’t a problem
unless your partner has a history of illness or surgery. Your
doctor can run some simple tests to evaluate the health of
your partner’s sperm.
need to have regular intercourse. You need to have regular
sexual intercourse during your fertile time. Your doctor can
help you better understand when you’re most fertile.
need to have open fallopian tubes and a normal uterus. The egg
and sperm meet in the fallopian tubes, and the embryo needs a
healthy uterus in which to grow.
pregnancy to occur, every step of the human reproduction
process has to happen correctly. The steps in this process
of the two ovaries releases a mature egg.
egg is picked up by the fallopian tube.
Sperm swim up the cervix, through the uterus and into the
fallopian tube to reach the egg for fertilization.
fertilized egg travels down the fallopian tube to the uterus.
fertilized egg implants and grows in the uterus.
women, a number of factors can disrupt this process at any
step. Female infertility is caused by one or more of the
disorders, meaning you ovulate infrequently or not at all,
account for infertility in about 1 in 4 infertile couples.
Problems with the regulation of reproductive hormones by the
hypothalamus or the pituitary gland, or problems in the ovary,
can cause ovulation disorders.
Polycystic ovary syndrome (PCOS). PCOS causes a hormone
imbalance, which affects ovulation. PCOS is associated with
insulin resistance and obesity, abnormal hair growth on the
face or body, and acne. It’s the most common cause of female
Hypothalamic dysfunction. Two hormones produced by the
pituitary gland are responsible for stimulating ovulation each
month — (FSH) and luteinizing hormone (LH). Excess physical
or emotional stress, a very high or very low body weight, or a
recent substantial weight gain or loss can disrupt production
of these hormones and affect ovulation. Irregular or absent
periods are the most common signs.
Premature ovarian failure. Also called primary ovarian
insufficiency, this disorder is usually caused by an
autoimmune response or by premature loss of eggs from your
ovary (possibly from genetics or chemotherapy). The ovary no
longer produces eggs, and it lowers estrogen production in
women under the age of 40.
much prolactin. The pituitary gland may cause excess
production of prolactin (hyperprolactinemia), which reduces
estrogen production and may cause infertility. Usually related
to a pituitary gland problem, this can also be caused by
medications you’re taking for another disease.
TO FALLOPIAN TUBES (tubal infertility)
or blocked fallopian tubes keep sperm from getting to the egg
or block the passage of the fertilized egg into the uterus.
Causes of fallopian tube damage or blockage can include:
Pelvic inflammatory disease, an infection of the uterus and
fallopian tubes due to chlamydia, gonorrhea or other sexually
Previous surgery in the abdomen or pelvis, including surgery
for ectopic pregnancy, in which a fertilized egg implants and
develops in a fallopian tube instead of the uterus
Pelvic tuberculosis, a major cause of tubal infertility
worldwide, although uncommon in the United States
occurs when tissue that normally grows in the uterus implants
and grows in other locations. This extra tissue growth — and
the surgical removal of it — can cause scarring, which may
block fallopian tubes and keep an egg and sperm from uniting.
can also affect the lining of the uterus, disrupting
implantation of the fertilized egg. The condition also seems
to affect fertility in less-direct ways, such as damage to the
sperm or egg.
OR CERVICAL CAUSES
uterine or cervical causes can impact fertility by interfering
with implantation or increasing the likelihood of a
Benign polyps or tumors (fibroids or myomas) are common in the
uterus. Some can block fallopian tubes or interfere with
implantation, affecting fertility. However, many women who
have fibroids or polyps do become pregnant.
Endometriosis scarring or inflammation within the uterus can
Uterine abnormalities present from birth, such as an
abnormally shaped uterus, can cause problems becoming or
Cervical stenosis, a narrowing of the cervix, can be caused by
an inherited malformation or damage to the cervix.
Sometimes the cervix can’t produce the best type of mucus to
allow the sperm to travel through the cervix into the uterus.
the cause of infertility is never found. A combination of
several minor factors in both partners could cause unexplained
fertility problems. Although it’s frustrating to get no
specific answer, this problem may correct itself with time.
But, you shouldn’t delay treatment for infertility.
factors may put you at higher risk of infertility, including:
The quality and quantity of a woman’s eggs begin to decline
with increasing age. In the mid-30s, the rate of follicle loss
speeds, resulting in fewer and poorer quality eggs. This makes
conception more difficult, and increases the risk of
Smoking. Besides damaging your cervix and fallopian tubes,
smoking increases your risk of miscarriage and ectopic
pregnancy. It’s also thought to age your ovaries and deplete
your eggs prematurely. Stop smoking before beginning fertility
Weight. Being overweight or significantly underweight may
affect normal ovulation. Getting to a healthy body mass index
(BMI) may increase the frequency of ovulation and likelihood
Sexual history. Sexually transmitted infections such as
chlamydia and gonorrhea can damage the fallopian tubes. Having
unprotected intercourse with multiple partners increases your
risk of a sexually transmitted infection that may cause
fertility problems later.
Alcohol. Stick to moderate alcohol consumption of no more than
one alcoholic drink per day.
a woman thinking about getting pregnant soon or in the future,
you may improve your chances of having normal fertility if
Maintain a normal weight. Overweight and underweight women are
at increased risk of ovulation disorders. If you need to lose
weight, exercise moderately. Strenuous, intense exercise of
more than five hours a week has been associated with decreased
smoking. Tobacco has multiple negative effects on fertility,
not to mention your general health and the health of a fetus.
If you smoke and are considering pregnancy, quit now.
Avoid alcohol. Heavy alcohol use may lead to decreased
fertility. And any alcohol use can affect the health of a
developing fetus. If you’re planning to become pregnant,
avoid alcohol, and don’t drink alcohol while you’re
Reduce stress. Some studies have shown that couples
experiencing psychological stress had poorer results with
infertility treatment. If you can, find a way to reduce stress
in your life before trying to become pregnant.
Limit caffeine. Research suggests that limiting caffeine
intake to less than 200 milligrams a day shouldn’t affect
your ability to get pregnant. That’s about one to two cups
of 6 to 8 ounces of coffee per day.