So many couples spend a good part of their lives trying not to get pregnant, that when it comes time to start a family, they don’t conceive of infertility as being a potential problem. For approximately 12%, or 7.3 million American women, infertility is a very real problem. Infertility is typically defined as one year of trying to get pregnant without success, or the repeated loss of pregnancies.
There are several steps in the fertility cycle that must happen in order to for a pregnancy to occur. First, a woman must ovulate, and the egg that has been released must be able to travel to the uterus via the fallopian tubes. A sperm must fertilize the egg, and the fertilized egg must implant itself into the uterus. There are many reasons why any one or many of these steps do not occur, and it is up to you and your doctor to determine the cause.
Typically, about one-third of infertility can be attributed to a problem with the woman’s fertility, one-third to the man’s, and the remaining one-third to a combination of both, or unknown factors. It is important for a couple to remain open minded and to be compassionate with their partner if it is determined that they are the “problem.”
For women, the problem is most often a snag in their ovulation cycle. This may be affected by age, diet, stress, physical activity, smoking, drinking, sexually transmitted disease, hormonal problems and overall health. Since so many women — approximately one in five — are waiting to have children after 35, there has been a marked increase in infertility problems. In reality, fertility is affected by age, and a woman’s fertility decreases each year after 30. Age can affect a woman’s ovulation, the quality of her eggs and increase the risk of miscarriage.
Other factors that may contribute to a woman’s infertility include blocked and/or damaged fallopian tubes either due to illness or disease, a physical problem with her uterus, or uterine fibroids.
A man’s contribution to conception, his sperm, is the obvious factor when facing infertility. Either sperm production — too few or none at all — or sperm quality affects fertility. If his sperm count is fine, but the sperm has motility issues (it can’t travel to the egg to fertilize it), this may also contribute to the couple’s infertility. Sperm can be affected by congenital problems, illness, injury, lifestyle choices such as alcohol, drug and cigarette consumption, environmental hazards such as exposure to toxins, medications, age, and cancer treatments.
If you are under 30, and you have been trying to get pregnant for less than a year unsuccessfully, there’s no harm in talking to your doctor about options. She may advise you to keep trying for a year before undertaking a comprehensive fertility assessment. If you are over 30, don’t wait for more than six months before consulting your doctor. Of course, at any time, your doctor should be willing to discuss any fears or concerns you may have about getting pregnant, and should offer advice on optimizing your chance of getting pregnant. She may give you advice on how to track your cycle, when you are most likely to conceive and how to get your body in the best shape for conception and pregnancy.
If you feel that it is time to explore other options, your doctor will do a full assessment on both you and your partner. This will include a full medical history, a battery of tests, and an examination of your partner’s sperm. These provide the doctor with a picture of your overall health, and will allow her to rule out potential problems. While many couples will receive a simple answer to their infertility problem which may result in a simple solution, others will be diagnosed with more serious problems, and some may not receive a definitive diagnosis at all. There are many treatments and options available for the array of infertility issues couples face, so it is important to not give up, and explore your options carefully.