Medical Minute: Infertility

I think we all know someone who has battled infertility.  It is especially hard if you don’t understand the causes.  Even if you haven’t personally dealt with infertility, your friends who have will appreciate you having some background knowledge.

Infertility means a couple has not been able to get pregnant after one year of trying.  It also may refer to situations when a woman is 35 or older and has not been able to get pregnant after six months or if she has not been able to carry a pregnancy to term. According to the Centers for Disease Control and Prevention, approximately 10 percent, or 6.1 million women, in the United States between the ages of 15 and 44 have problems getting or staying pregnant. But infertility is not just a problem for women. Men can be infertile too. About one-third of infertility problems can be traced to the woman, about one-third to the man, and the rest of the time it is because of either both partners or for no known reason.

There are many reasons why a couple may be infertile. In women, the most common causes include damage or blockage to the fallopian tube (which transports the egg from the ovary to the uterus), endometriosis (when cells lining the uterus grow in other areas of the body), ovulation disorders, elevated prolactin, polycystic ovary syndrome, early menopause, benign uterine fibroids and pelvic adhesions.

Causes of male infertility are commonly associated with problems with the sperm, including impaired shape and movement of sperm, low concentrations of sperm, varicocele (varicose vein in the scrotum), undescended testicle, testosterone deficiency, infections, or genetic defects. Men also may experience problems with the delivery of sperm, such as retrograde ejaculation (semen goes into the bladder), not having any semen, blockage of the ejaculatory ducts, misplaced urinary opening or anti-sperm antibodies.

Both men and women have many of the same risk factors that can contribute to infertility, including age, stress, tobacco smoking, alcohol or drug use, certain medications, environmental toxins, and genetic conditions. Physicians first will check a man’s sperm while a woman is tested to see if her ovaries are working properly. Both partners will undergo a general physical examination and review of their medical histories, including illnesses, medications and sexual habits. Treatment will depend on the cause, time infertile, age of the couple and their personal preferences.

While some causes of infertility cannot be corrected, a woman may still be able to become pregnant by taking fertility drugs to regulate or induce ovulation. Surgery also may be an option if there are blockages or other problems in the fallopian tubes. For men, surgery, hormones, or sometimes assisted reproductive technology (ART) could correct a lack of sperm. The most common form of ART is in vitro fertilization (IVF). IVF involves retrieving mature eggs from the woman, fertilizing them with sperm in a dish in a laboratory, and then implanting the embryos in the uterus.

Dealing with infertility can be stressful and time-consuming. Fortunately, there are many safe and effective ways to overcome infertility and approximately two-thirds of couples go on have babies. For more information about infertility, talk with your doctor or visit the American Society for Reproductive Medicine website at

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