What You Need to Know First About Infertility

Starting a family is one of life’s milestones, and for most men and women, the journey to parenthood is trouble-free. But for others, not being able to conceive is a tough reality. Suddenly having to learn a strange new vocabulary—with terms like IVF, sperm count, and basal body temperature—can be intimidating and discouraging. The good news is that, for many couples, infertility (the inability to conceive children) is a challenge that can be overcome with proper diagnosis, medical treatments and procedures, and even lifestyle changes. If you think you may be facing infertility, here are some basics you need to know first.

Quick Infertility Stats

According to statistics from the CDC (Center for Disease Control):

  • 12.1% of all women aged 15-44 have difficulty conceiving or carrying a baby to term
  • 6.7% of married women aged 15-44 are infertile

From the American Urological Association (AUA):

  • 15% of couples are unable to conceive after one (1) year of unprotected intercourse
  • 30-40% of infertility in couples is caused by a combination of male and female factors

From the Journal of Human Reproductive Sciences:

  • 40-50% of infertility in couples is due to male factor only
  • 2% of all men produce sperm that are not optimal for conception during their reproductive years

According to a pair of 2018 studies, male sperm count and testosterone levels have dropped significantly in the last 40 years. It’s essential to understand that infertility is not just a woman’s problem: If you’re having difficulty conceiving, it could be male-caused.

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How Do I Know if I’m Infertile?

The only way to confirm that you and/or a partner are infertile is to have a complete assessment by a gynecologist (for women) and a urologist (for men).

If you’re under 35: Individuals or couples under the age of 35 should seek medical help for infertility if they are unable to achieve pregnancy or help their partner achieve pregnancy after one (1) year of unprotected intercourse.
If you’re over 35: Individuals or couples over the age of 35 should seek medical help for infertility if they are unable to achieve pregnancy or help their partner achieve pregnancy after six (6) months of unprotected intercourse.

Possible Causes of Female Infertility

In order to become pregnant, all key parts of a woman’s reproductive system must function properly: uterus, ovaries, and fallopian tubes.

Possible uterine issues
• Fibroid cysts: benign tumors made of muscle cells and tissue that grow in or around the uterus
• Lack of a uterus or uterus-shape abnormalities

Possible ovarian issues:
• Endometriosis: a condition when the lining of the uterus (endometrium) grows where it shouldn’t, most commonly around ovaries and the fallopian tubes, impeding their proper functions
• Irregular periods: when periods aren’t predictable “like clockwork,” a woman is most likely not ovulating, a condition which can be caused by a number of factors such as
Polycystic ovary syndrome (PCOS): a hormone irregularity
Amenorrhea: no periods at all, brought on by extreme exercise or very low body weight
Hypothalamus and pituitary glands not functioning correctly
Low egg reserve in the ovaries
Premature menopause or menopause

Possible fallopian issues
• Fallopian-tube obstruction caused by sexually-transmitted diseases, a history of pelvic infection or abdominal surgery
• Endometriosis: a condition when the lining of the uterus (endometrium) grows where it shouldn’t, most commonly around ovaries and the fallopian tubes, impeding their proper functions

Possible Causes of Male Infertility

Because conception requires that a sperm successfully meets an egg, a man’s semen is generally the focus of analysis when male infertility is suspected. Factors that are evaluated include the number of sperm (sperm count), how they move (sperm motility), and their shape (sperm morphology).

Lifestyle choices that may affect sperm
• Too much heat: wearing tight underwear or frequent use of saunas and hot tubs
• Heavy alcohol use
• Smoking
• Steroid use
• Illicit drug use
• Overeating
• Some supplements and medications

Physical and medical causes of male infertility
• Trauma to the testes
• Cancer treatments
• Diabetes
• Cystic Fibrosis
• Improper function of the hypothalamus and pituitary glands
• Genetic disorders

Any of the possible causes for male infertility listed above can affect sperm count, motility, and morphology. Men who aren’t yet ready for a visit to the urologist can check their sperm-count level quickly, easily, and privately at home with SpermCheck Fertility. This FDA-cleared kit is available at your local retailer and is a product of DNA Diagnostics Center (DDC), a corporate sponsor of the American Pregnancy Association. SpermCheck works much like a home pregnancy test and results are ready in minutes.

What’s my Next Step?

If you’re under 35 and have been actively trying to get pregnant for a year or if you’re over 35 and have been trying for about six months, your next step is to make an appointment with a gynecologist to assess possible female infertility and with a urologist to assess male infertility. It’s important that you both be tested. Once those assessments have been made, your medical providers can make recommendations for treatment.

Infertility is a scary word, but modern medical treatments along with optimizing chances of conception by making targeted lifestyle changes have helped thousands of couples on their journey to parenthood.

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Sources

“Endometriosis.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 23 Mar. 2019, www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656.
“FastStats – Infertility.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 15 July 2016, www.cdc.gov/nchs/fastats/infertility.htm.
Fetters, Ashley. “Sperm Counts Continue to Fall.” The Atlantic, Atlantic Media Company, 12 Oct. 2018, www.theatlantic.com/family/archive/2018/10/sperm-counts-continue-to-fall/572794/.
“Infertility | Reproductive Health | CDC.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 16 Jan. 2019, www.cdc.gov/reproductivehealth/infertility/index.htm.
Jarow, Jonathan, et al. “Optimal Evaluation of the Infertile Male.” Optimal Evaluation of the Infertile Male – American Urological Association, American Urological Association, 2011, www.auanet.org/guidelines/male-infertility-optimal-evaluation-best-practice-statement.
Kumar, Naina, and Amit Kant Singh. “Trends of Male Factor Infertility, an Important Cause of Infertility: A Review of Literature.” Journal of Human Reproductive Sciences, Medknow Publications & Media Pvt Ltd, 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4691969/.
“Uterine Fibroids | Fibroids.” MedlinePlus, U.S. National Library of Medicine, 18 Mar. 2019, medlineplus.gov/uterinefibroids.html.