National Infertility Awareness Week is the subject of today’s post. Infertility is a tough subject. It is surrounded by a swirling cloud of stigma, shame, guilt, depression, pain, loss, and fear. It used to be considered taboo to talk about fertility struggles openly.

Learn About Infertility During National Infertility Awareness Week

In simplest terms, infertility is the inability to get pregnant. The definition of infertility is the inability to get pregnant despite having regular unprotected sex for between six months to a year. The length of time depends on your age. Under age 35, it is considered infertility if you have tried to get pregnant for over a year but have not conceived. After age 35, the length of time is only six months. Fertility decreases after age 30. Your chances of becoming pregnant after age 35 are much lower.

For example, there are many additional factors that contribute to the ability to get pregnant. If one of those factors isn’t quite right, it can derail your ability to conceive. If both partners have fertility issues it can compound difficulty of getting pregnant. This occurs in around 20% of couples experiencing infertility. Medical intervention is always an option for couples who are unable to have a baby on their own.

What Causes Infertility?

Infertility can be caused by a lot of different health issues. Sometimes, there is no identifiable cause of infertility. For example, approximately 15% of couples that go through infertility testing are unable to find any source for their struggle. Further, both men and women can have issues with fertility. It tends to affect both men and women pretty equally, but the causes are very different.

What Causes Infertility in Men?

The biggest cause of infertility in men is a problem with sperm. There are a lot of things that can affect sperm count or sperm quality. A low sperm count can make conception very difficult, if not impossible. A normal sperm count ranges anywhere from 15 million to 200 million sperm per millimeter. A low sperm count is considered anything under 15 million. A low sperm count doesn’t mean you can’t get pregnant, it means it may take more tries. It’s a numbers game. The more attempts, the higher the odds.

Another issue men can experience is low sperm motility. Low sperm motility just means that they don’t move quite as well. For that reason, if the sperm aren’t strong swimmers, it makes it more difficult for them to reach the egg.

External Factors in Men – National Infertility Awareness Week

Sometimes external factors can affect a man’s sperm count or quality. Testicular injury can affect the production of sperm. Sperm count will typically return to normal as long as no permanent or long-term damage is done. Something as common as heat can also affect sperm. A recent study by Fertility and Sterility showed that the heat produced by electronics can affect sperm motility. It even found that it causes damage to the DNA in the sperm.

Another common external factor that can affect sperm is medication, drugs, and alcohol. There are lots of different kinds of medications that are known to cause infertility. This is because they affect the production of sperm. Medications used to treat anxiety and depression, supplemental testosterone, anabolic steroids, hair loss treatments like Propecia, erectile dysfunction medicine, chemotherapy, and more can affect sperm. Heavy drinking, smoking cigarettes or marijuana, and other illegal drugs can also impact fertility.

What Causes Infertility in Women?

Infertility in women gets a little trickier. There are a lot of things that can affect a woman’s ability to get pregnant. The biggest issue for women is lack of ovulation. If ovulation doesn’t occur, the egg doesn’t release from the ovary. One of the most common causes is a condition called Polycystic Ovarian Syndrome. It can also be a result of long-term birth control pill use. Ovulation will usually return to normal after a few months off of birth control.

Infertility and PCOS – National Infertility Awareness Week

Polycystic Ovarian Syndrome, or PCOS, falls under the category of problems with ovulation. PCOS is a disease that causes hormone imbalance. The hormone imbalance causes issues with ovulation. PCOS is one of the most common causes of infertility in women. PCOS is more common in obese women because of an associated insulin resistance. Other medical issues that affect ovulation are hypothalamic dysfunction, premature ovarian failure, and excess prolactin production. Most of these issues can be treated with hormones. PCOS is represented by the color teal.

Another common cause of infertility is Endometriosis. Endometriosis is a condition that causes endometrial tissue to travel and grow outside of the uterus. Endometriosis can also affect the uterine lining. This can prevent a fertilized egg from implanting in the uterus. Endometriosis can cause scarring wherever it occurs. Scarring within the uterus or fallopian tubes can make it difficult for the egg to implant. There is an increase in fertility immediately following surgery. The surgical treatment to remove endometriosis can cause scarring later on.

Uterine Problems

Uterine and cervical issues are also potential causes of infertility. The most common uterine problems are fibroids and myomas. Fibroids and myomas are benign polyps or tumors. These non-cancerous growths can prevent an egg from implanting. Sometimes, they can grow near the fallopian tube and block the opening. Other uterine and cervical issues can occur at birth or during development. The uterus can be shaped abnormally. There is a cervical malformation called cervical stenosis. Cervical stenosis means that the cervix is narrower than it should be. This can make it difficult for the sperm to reach the uterus.

Unexplained Infertility

Generally speaking, infertility is broken up into thirds. One third of infertility cases are due to female infertility. One third is due to male infertility. The remaining third is due to either a combination or unexplained infertility. There isn’t always a clear and direct cause of infertility. There may be a few minor issues that all intersect when trying to conceive.

Additional factors that can contribute to infertility are age, weight, smoking, alcohol, caffeine, past sexually transmitted infections, and stress. Most of these factors can be minimized by simple lifestyle changes.

Are There Tests to Diagnose the Cause of Infertility?

There are many diagnostic tests to figure out what is causing your infertility. For women, the first step is determining if infertility is being caused by ovulation issues. This is done with a simple blood test. The blood test measures the level of progesterone in the blood. The body produces more progesterone after ovulating. The doctor may also test for other blood levels, such as prolactin. There are also at-home ovulation prediction kits. These kits test for the increase in luteinizing hormone that is produced before ovulation.

Other tests may be done depending on what the blood tests show. If the tests show a problem with ovulation, the doctor may order other hormone tests in addition to ovarian reserve testing. Ovarian reserve testing is done to determine how many eggs there are and the quality of those eggs. Women over 35 are more likely to have these problems. If the tests show that ovulation is normal, other tests can be done to find out what else may be preventing pregnancy.

Can You Treat Infertility?

You can treat fertility issues with medications in some instances. There are a handful of medicines that can stimulate ovulation for women. There are also other medications that used to treat specific issues like PCOS or high prolactin levels. In short, once you determine the source of the struggle, there are options to treat or fix the problem. If the issue stems from a structural problem, growth, blockage, scar tissue or endometriosis, there are surgical options to improve the issue.

Reproductive Assistance – National Infertility Awareness Week

If the issue can’t be corrected or improved with any of these therapies there are other methods. These methods are called reproductive assistance. Reproductive assistance is for people who have not been able to improve the cause of their infertility. It is also for couples who have been unable to determine the cause of infertility. The most common reproductive assistance methods are intrauterine insemination and IVF.

IVF

Another method for infertility is intrauterine insemination. This is a method that works by placing sperm inside the uterus around ovulation. IVF is considered the most effective assisted reproductive method. IVF is a little more involved than intrauterine insemination. It requires egg retrieval and daily hormone injections. The eggs are combined with the sperm in a lab. Fertilized eggs are then implanted into uterus. If all else fails, there are always options such as adoption, sperm donation, egg donation, and surrogacy.

One in Eight Couples Struggle with Infertility

In summary, it is important to realize that infertility is a fairly common problem. About one in eight couples will struggle with infertility. One of the biggest issues with infertility is the stigma surrounding it. Because infertility is personal in nature, some people try to hide their struggle and put on a brave face. Infertility is not a failure or a flaw. It is simply an obstacle. It can typically be overcome with the help of a doctor. Remember to be kind to yourself, keep hoping for the best, and stay optimistic. One way or another, everything will be okay.

Sources: WebMD, Mayo Clinic