A common question we hear in our office is “What Causes Infertility?”
Did you know that 10-15% of all couples experience infertility? Infertility is typically defined as the absence of conception after 12 months of regular, unprotected intercourse. For women under 35, this is the time you should consider having a fertility evaluation. In women over 35 years of age, infertility may be evaluated after 6 months of trying to conceive. Sometimes, women are able to conceive, but then experience recurrent pregnancy loss (RPL). Couples experiencing RPL should be evaluated as soon as possible.
Statistically speaking, approximately one third of infertility results from female factors, one third results from male factors, and the final third results from a combination of male and female factors. Of that final third, up to 20% of infertility cases are deemed “unexplained”, meaning the cause cannot be pinpointed.
Generally speaking, things such as advanced age (especially in women), being overweight, being underweight, excessive exercise, smoking, and living a sedentary lifestyle can affect fertility. Also, things like pesticides, artificial sweeteners, caffeine and processed foods may impact fertility.
Female causes of infertility
Possible causes of female infertility include ovulation disorders, low egg reserve, blocked tubes, other anatomical issues, or unexplained causes.
Ovulation disorders can be cause by Polycystic Ovarian Syndrome (PCOS), or by diabetes, thyroid or pituitary disorders. All these issues may result in absent, infrequent, or disrupted ovulation. Irregular ovulation can lead to infertility.
The number of eggs a woman has is set at birth. Each month a woman ovulates, her egg supply is diminished. There is variation in the original supply, as well as how many eggs are used each month. A blood test call AMH (anti-mullerian hormone) can evaluate a woman’s egg supply. Diminished egg supply is a cause of female infertility.
If the fallopian tubes are blocked, eggs cannot reach the uterus for fertilization by the male’s sperm. Blocked tubes may be cause by pelvic inflammatory disease (PID), endometriosis, or voluntary reasons (tubal ligation). This type of female infertility is often treated successfully by in vitro fertilization (IVF).
Less frequently, female infertility can be caused by uterine structural issues that may be genetic (bicornuate uterus) or from uterine fibroids. These issues must be evaluated for their severity. In some cases, surgery can improve fertility.
Unexplained female infertility happens when there are minor abnormalities that are not severe enough on their own to result in infertility, but coupled with other issues, result in diminished fertility. Often, they cannot be tested for. Examples might be poor egg quality or quantity, tubal factors, or hormonal disorders.
Male causes of infertility
Sperm quality and quantity can affect fertility. Male partners of patients at Park Avenue Fertility undergo a semen analysis (SA) to evaluate sperm quality and quantity. Under a microscope, sperm is evaluated for amount, shape, and motility (ability to move into the uterus for fertilization). If it is determined that there is a significant male factor, IVF with ICSI (intracytoplasmic sperm injection) is often successful in achieving conception.
A complete absence of sperm in semen is called azoospermia. This may have a genetic or an obstructive cause. A vasectomy is a voluntary cause of azoospermia. In these cases, a sperm donor may need to be considered.
As the name implies, this type of infertility results from more than one factor. Both partners may have issues that diminish their fertility. If it is determined that multiple factors are contributing to infertility, Dr. Levi and the team at Park Avenue Fertility work together to develop a plan of action to address both issues.
For more information on infertility and what you can do to grow your family, please contact Dr. Levi at Park Avenue Fertility to schedule a consult.