Frequently Asked Questions
When Should a Couple See a Specialist?
- If the woman has ever had a pelvic infection, and attempts to conceive have failed for six months. Pelvic infections can cause problems with the fallopian tubes that contribute to infertility.
- If the woman has irregular menstrual cycles, which indicate that ovulation (release of eggs) does not occur every month, and attempts to conceive have failed for six months.
- If attempts to conceive have failed for one year.
Facts about Infertility
- 15-20% of couples who want to conceive have infertility problems.
- Infertility problems can result from either the man or woman. In 15-20% of infertile couples, both the man and woman have problems.
What is Infertility?
Infertility is a disease of the reproductive system that impairs one of the body's most basic functions: the conception of children. Conception is a complicated process that depends upon many factors: on the production of healthy sperm by the man and healthy eggs by the woman; unblocked fallopian tubes that allow the sperm to reach the egg; the sperm's ability to fertilize the egg when they meet; the ability of the fertilized egg (embryo) to become implanted in the woman's uterus; and sufficient embryo quality.
Finally, for the pregnancy to continue to full term, the embryo must be healthy and the woman's hormonal environment adequate for its development. When just one of these factors is impaired, infertility can result.
What Causes Infertility?
Approximately one-third of infertility cases can be attributed to male factors, and about one-third to factors that affect women. For the remaining one-third of infertile couples, infertility is caused by a combination of problems in both partners or, in about 20 percent of cases, is unexplained.
The most common male infertility factors include azoospermia (no sperm cells are produced) and oligospermia (few sperm cells are produced). Sometimes, sperm cells are malformed or they die before they can reach the egg. In rare cases, infertility in men is caused by a genetic disease such as cystic fibrosis or a chromosomal abnormality.
The most common female infertility factor is an ovulation disorder. Polycystic ovary syndrome is the most common reason for anovulatory infertility. Other causes of female infertility include blocked fallopian tubes, which can occur when a woman has had pelvic inflammatory disease or endometriosis (a sometimes painful condition causing adhesions and cysts). Congenital anomalies (birth defects) involving the structure of the uterus and uterine fibroids are associated with repeated miscarriages.
How is Infertility Diagnosed?
The doctor will conduct a physical examination of both partners to determine their general state of health and to evaluate physical disorders that may be causing infertility. Usually both partners are interviewed at the initial visit in order to determine whether intercourse is taking place properly for conception.
If no cause can be determined at this point, more specific tests may be recommended. For women, these include an analysis of body temperature and ovulation and x-ray of the fallopian tubes and uterus. For men, initial tests focus on semen analysis.