Causes of Infertility
Infertility is defined as the inability to conceive after one year of regular, unprotected intercourse, for women under the age of 35. As a woman ages, the chances of conception decrease. Thus, for women over the age of 35, and for those who have irregular periods, who have been unable to conceive after six months of regular, unprotected intercourse we recommend an evaluation.
The 1 Year Myth
A common misconception is one should wait until a year or six months have passed before talking with a fertility specialist. There are many advantages to speaking with a fertility specialist before the six-month or year mark. Your fertility specialist may order blood testing or recommend a prenatal vitamin regimen that can improve fertility and ensure the health of your baby. Learn more by scheduling a consultation with one of our fertility specialists. Ohio Reproductive Medicine is widely regarded as the leading fertility clinic in Central Ohio.
One in six couples ages 15-44 has difficulty conceiving without assistance, so you’re not alone. About 12% of women in that age group have difficulty carrying to term.
Infertility is a shared problem between a man and a woman. At least 1/3 or more of infertile couples have a female factor that accounts for infertility, and 1/3 or more of infertile couples have a male factor that accounts for infertility. In the remaining one-third, there are issues with both the man and woman, or no cause is discovered. For this reason, we recommend that both partners and individuals be evaluated.
To achieve pregnancy, four things are necessary:
- Regular intercourse during a woman’s fertile periods
- Sperm capable of fertilizing the egg
- A fertilized egg that can travel through the fallopian tubes to implant in the uterine wall
The Most Common Causes of Infertility in Women
1. Ovulation Disorders
It is the cause of infertility in about 40% of women. Ovarian disorders affect the release of the egg and can be caused by one or more of the following:
- Premature menopause, when the ovaries stop working before the age of 40
- An autoimmune disorder, genetic abnormalities, or damage due to chemotherapy and radiation
- Hormone disorders including thyroid disorders, and Polycystic Ovary Syndrome (PCOS). PCOS is a common cause of infertility. Studies report that 5-10% of American women have PCOS.
- Eating disorders, alcohol and drug use, stress, and intense exercise.
2. Fallopian Tube Damage or Blockage
Fallopian Tube damage or blockage may be a result of infection, Pelvic Inflammatory Disease (PID), abdominal disease, previous surgeries, or ectopic pregnancy. Scarring of the tubes impacts the release of the egg after ovulation or interferes with the movement of the egg through the fallopian tubes. About 25% of infertility is due to tubal disease. We usually do a test called a hysterosalpingogram to examine the health of the fallopian tubes.
3. Uterine and Cervical Disorders
- Studies report that 30-40% of women who have endometriosis are infertile.
- Uterine fibroids contribute to infertility in 5-10% of infertile women.
- Uterine polyps on the inside lining of the uterus can interfere with the ability to retain a pregnancy after conception. Surgical removal of the polyps can improve the chance of retaining a pregnancy.
- Uterine scarring due to previous injury or surgery can increase the risk of miscarriage and infertility.
- Congenital defects in the shape of the uterus can impact the ability to retain a pregnancy.
- Cancer of the reproductive organs, treatment chemotherapy, and radiation.
- Chronic cervical infections can reduce the amount or quality of cervical mucus necessary to retain a pregnancy.
4. Age Contributes to Infertility
When trying to conceive, the quality of a woman’s eggs is vital. Egg quality and quantity (on average) begin to steadily decline after the age of 35 and this regression occurs more rapidly after age 40. As the quality of female eggs declines, it becomes more difficult to conceive.
The Most Common Causes of Infertility in Men
Male infertility is caused by any health issue that reduces the chance of conception because of sperm abnormalities including low sperm count, low sperm mobility, the inability to fertilize the egg or for sperm to reach the egg. It can be caused by:
1. Structural Abnormalities
Scarring of the Vas Deferens that blocks sperm ducts. This can be due to infection, previous vasectomy, and hormonal factors.
2. Sperm Abnormalities
90% of male infertility is due to sperm abnormalities. It may be abnormal shape or size of sperm, low sperm count, or low motility. Causes include:
- Certain medical conditions like Benign Prostatic Hyperplastic (BPH), prostate cancer, diabetes, HIV, urinary tract and genital infections, and thyroid disease affect male fertility.
- Testosterone therapy shuts down the production of hormones that are needed for sperm production.
- Chemotherapy and radiation and some medications interfere with fertility.
- Smoking is a major factor in reduced sperm quality. It affects semen volume, sperm count, motility, and morphology (sperm shape).
- Reduced sperm count and quality due to aging, or genetic disorders.
- Varicoceles or varicose veins of the testicles increase temperature and affect sperm development.
- Many common drugs like blood pressure medications can impair sperm production or function.
3. Ejaculatory Disturbances
Ejaculatory disturbances account for about 5% of infertility. The inability to obtain or maintain an erection, premature ejaculation, retrograde ejaculation, or psychological issues that result in impotence.
At Ohio Reproductive Medicine in Columbus, Ohio we have many available treatments to help you achieve conception and carry to term. Even when we cannot determine a clear reason for infertility, we can design a treatment plan that will give you better chances of getting pregnant than continuing to try on your own.
In addition to your physical health, we understand emotional issues related to infertility that provoke feelings of anger, guilt, anxiety, shame, and sadness. The treatments can be a source of financial, emotional, and physical distress, and can strain a couple’s relationship. For that reason, we have an in-house licensed counselor to help you through these challenges. We are dedicated to successfully resolving your fertility issues.