Part I - Infertility: Introduction, Definition, and Causes
In this three-part article series, the physicians at All About Women discuss the complexity of infertility, from its diagnosis to its treatment.
Infertility is not a common discussion among women, and yet it's more prevalent than you might think: the Centers for Disease Control and Prevention (CDC) reports that one in every ten women experience infertility.
Infertility can be surprising and overwhelming for couples, and its personal nature keeps it from being an often-shared topic of conversation. So where do you turn if you think you might be facing infertility?
In this three-part article series, we'll examine pressing questions about fertility, including:
• When am I considered infertile?
• What causes infertility?
• How is infertility diagnosed?
• How is infertility treated?
Learning more about infertility is the first step for you to make empowered and informed decisions about what to do next.
When am I considered infertile?
Infertility is defined as being unable to conceive after a year of actively trying to become pregnant. "Actively trying" assumes that you've had sex regularly during the time of your cycle that you should be ovulating. To learn more about ovulation, read our article "Menstruation and Ovulation: A Guide".
The definition of infertility also includes women who repeatedly conceive but are unable to keep a pregnancy to term. If you've miscarried two or more times or have tried to conceive for a year, it's time to talk to your gynecologist about infertility.
The American College of Obstetricians and Gynecologists recommends that, in special circumstances, a woman seek a medical opinion on her inability to conceive after just six months of trying. These instances include if you are:
• 35 years or older
• Have irregular or abnormal periods
• Have a gynecological condition such as endometriosis or pelvic inflammatory disorder
What causes infertility?
Reproduction is a lot more intricate than we sometimes give it credit for. For a couple to conceive, there are four parts of reproduction that must work together:
1) Functioning Ovaries: A woman's ovaries have to be making and releasing quality eggs on a regular basis.
2) Healthy Sperm: A man must be delivering healthy sperm in high numbers during intercourse
3) Open Reproductive Passageways: The pathway for the sperm, which includes the cervix and the fallopian tubes, must be clear enough for the man's sperm to meet with a woman's egg. The egg must then be able to travel back through the fallopian tubes to the uterus for implantation.
4) Strong Uterine Lining: The uterus must have thick enough lining to support a pregnancy.
A fertility problem will affect one or more step in the process of conception, and that's all it takes to cause infertility. These problems for women can include:
• Hormone imbalances such as polycystic ovary syndrome (PCOS), thyroid, adrenal, pituitary
• Pelvic Inflammatory Disease
• Physical conditions such as scarring in the fallopian tubes or uterine lining
• Decreased ovulation caused by aging
And while you may think you're the cause for your fertility struggles, it could as easily be your male counterpart. According to the CDC, one-third of infertility cases are caused by problems with a man's sperm, while one-third are caused by a problem in the woman's reproductive tract, and one-third of cases are caused by unknown factors.
Infertility can be treated in many cases, even if the cause of infertility is unknown.
What do I do if I think I'm infertile?
The first step in facing infertility is to make an appointment with your gynecologist or pregnancy physician. They will be able to perform an initial infertility evaluation that involves both you and your male partner.
Continue reading about the infertility evaluation in part two of this article series, "Infertility: How it's Identified"
Part of the stress of infertility can be finding a doctor you feel comfortable with and trust to treat your infertility. The newness of the situation can make it difficult to remember to ask the right questions and to process what your doctor's telling you.
The compassionate and skilled infertility physicians at All About Women are able to provide many of the standard infertility diagnostics and treatment options. Contact our Gainesville or Lake City office to set up an appointment today.‹ All About Women OB/GYN Knowledge Center