Deciding to conceive can be a test of patience. The longer you wait, the more grueling it can be. Whether you’re just starting on this path or have been navigating it for a while, here’s a closer look at the potential causes and solutions to provide hope and direction on your journey to parenthood.
What is infertility?
When you still can’t conceive after a year of regular and unprotected intercourse, you may be infertile. This condition impacts millions worldwide and can stem from issues in either partner.
Women are born with a finite number of eggs, which decreases in both quantity and quality with age. This decline becomes more significant in the mid to late 30s and accelerates in the early 40s.
While men continue to produce sperm throughout their lives, there is a gradual decrease in semen volume and sperm motility as they age.
Common causes of infertility in women
In women, infertility may be caused by a variety of factors, each affecting a different part of the reproductive process.
Ovulation disorders
These disorders prevent the regular release of mature eggs from the ovaries. Conditions such as polycystic ovary syndrome (PCOS) and hyperprolactinemia can disrupt ovulation, making conception difficult.
PCOS is one of the most common endocrine disorders affecting women of reproductive age and is a leading cause of ovulatory infertility. While its cause isn’t known yet, the syndrome is characterized by the following:
- Irregular menstrual cycles
- Excess facial and body hair (Hirsutism)
- Severe acne
- Male-patterned baldness
- Polycystic ovaries
Meanwhile, hyperprolactinemia is a condition that affects ovulatory function and fertility. It involves the excessive production of prolactin, a hormone produced by the pituitary gland that usually stimulates breast milk production after childbirth.
Uterine abnormalities
These abnormalities can interfere with the implantation of an embryo or the development of a pregnancy.
Here are some of the common uterine abnormalities and their impact on fertility and pregnancy:
- Fibroids. These are non-cancerous growths in the muscular wall of the uterus.
- Polyps. Endometrial polyps are overgrowths of the lining of the uterus that can obstruct the uterine cavity and cause irregular bleeding.
Fallopian tube damage
Damage to your fallopian tubes can block the passage of eggs from the ovaries to the uterus. These may be caused by the following:
- Previous infections
- Previous surgeries
- Conditions that prevent the egg and sperm from meeting
Endometriosis
Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus. These can lead to the following:
- Pain
- Scarring
- Fertility issues
This abnormal tissue growth can affect the ovaries, fallopian tubes, and the implantation of the embryo.
Common causes of infertility in men
Infertility in men often stems from issues with sperm, particularly its:
- Production
- Function
- Delivery
Varicocele
Varicocele is an enlargement of the veins within the scrotum that negatively impacts sperm quality and quantity, often leading to infertility.
Low sperm production
When your sperm production is low, you’re significantly less likely to fertilize an egg. This condition is influenced by different factors, such as:
- Genetics
- Health conditions
- Lifestyle
Antibodies attacking the sperm
In some cases, a man’s immune system produces antibodies against his own sperm, attacking them as if they were harmful invaders. When this happens, the sperm motility and function are greatly reduced.
Clogged sperm ducts
Obstructions in the sperm ducts can block the path of sperm from the testicles to the urethra, which prevents the sperm from being ejaculated properly during intercourse.
Diagnosing infertility in couples
Your healthcare provider may start the diagnosis with a physical exam and a review of you and your partner’s medical history. They may also order the following tests:
- Blood tests. These measure hormone levels that influence fertility.
- Advanced imaging tests. An ultrasound or MRI can visualize the reproductive organs to detect abnormalities.
- Semen analysis. This test can evaluate sperm health, including count, motility and morphology.
With these, your healthcare provider can address the specific cause of infertility in your specific case and tailor an effective treatment plan for your situation.
Treatment options for infertility
Depending on the specific cause identified during diagnosis, there are different treatment options for infertility. Here are the most common ones:
- Medication. This is often used to improve ovulation regularity in women, which increases the chances of conceiving.
- Surgical intervention. This process addresses the physical barriers to fertility, such as blocked fallopian tubes or uterine abnormalities.
- Intrauterine insemination (IUI). With this, the sperm is strategically placed in the uterus, which increases the likelihood of fertilization.
- In vitro fertilization (IVF). IVF combines eggs and sperm outside the body in a laboratory setting. The resulting embryos are then transferred to the uterus, bypassing many common fertility issues.
Lifestyle factors affecting fertility
Lifestyle choices play a significant role in fertility for both men and women.
These choices can negatively affect your fertility, whether it’s by disrupting your hormonal balance or decreasing the quality of the egg or sperm:
- Unhealthy diet
- Being overweight
- Smoking
- Excessive drinking
- Chronic stress
- Exposure to environmental toxins
Consulting a fertility specialist
Consulting a fertility specialist is a critical step for couples facing difficulties in conceiving. Specialists recommend seeking advice after one year of trying without success for women under 35, and after six months for women over 35 due to declining fertility with age. Early consultation is especially important for those with known reproductive issues or those who have experienced multiple miscarriages.
A fertility specialist can offer a comprehensive evaluation, tailored advice, and advanced treatment options that can guide your and your partner’s journey to parenthood.
Frequently asked questions
What are the common causes of infertility in women?
Common causes of infertility in women include ovulation disorders, fallopian tube damage, endometriosis and uterine or cervical abnormalities. Age also significantly impacts fertility, with a gradual decline beginning in the late 20s.
How does age affect fertility in men and women?
In women, fertility declines sharply after the age of 35, with egg quantity and quality decreasing. For men, fertility slightly decreases after age 40. This affects sperm quality and motility.
Can lifestyle choices impact fertility?
Yes, lifestyle choices such as smoking, excessive alcohol consumption, extreme weight gain or loss, and excessive physical or emotional stress can negatively impact fertility in both men and women.
What are the signs of infertility in women?
Signs of infertility in women may include irregular menstrual cycles, painful or heavy periods, diagnosed hormonal problems, or having multiple miscarriages.
Is infertility only a woman’s issue?
No, infertility is not solely a woman’s issue. Approximately one-third of infertility cases are attributed to male factors, another third to female factors, and the remaining cases are due to both partners or unexplained.
Key takeaway
Trying for a baby can be emotionally taxing, especially when faced with repeated delays.
Infertility is a complex issue that can stem from a variety of medical, genetic and lifestyle factors affecting both men and women. Advanced diagnostic tools and treatments, ranging from medication to surgical interventions and assisted reproductive technologies like IVF, offer hope to many couples. Lifestyle modifications also play a critical role in enhancing fertility outcomes. With the right medical support and interventions, many couples find success on their path to parenthood.
