Technically, “infertility” is the inability to conceive after a year of unprotected intercourse in women under 35, after six months in women over 35, or the inability to carry a pregnancy to term. In a more modern interpretation, any patient who is not easily able to conceive is welcome to come in for a “fertility evaluation.”
Infertility affects nearly seven million American couples, which is approximately 15% of those of childbearing age.
There are a number of reasons infertility can occur. About one-third of cases can be attributed to male factors, one-third of cases are attributed to female factors, and for the remaining one-third, infertility can be caused by a combination of problems in both partners or, in about 20 percent of cases, it is completely unexplained.
Testing is the only proven method of finding out why you are having challenges conceiving. Basic tests for egg quality (blood tests), Fallopian tube function (HSG), and sperm quality (semen analysis) are usually the first steps in the reproductive evaluation.
OB/GYNs have expertise in both obstetrics and gynecology, but not necessarily in reproductive endocrinology and infertility. Board Certified Reproductive Endocrinologists complete a four-year residency in Obstetrics and Gynecology and then an additional three-year fellowship in Reproductive Endocrinology and Infertility, thus have acquired extensive sub-specialty knowledge.
A man's sperm function can be impacted by his overall health and lifestyle. Some things that may reduce the health or number of sperm include:
- Heavy alcohol use
- Environmental toxins, including pesticides and lead
- Health problems such as mumps, serious conditions like kidney disease, or hormone problems
- Radiation treatment and chemotherapy for cancer
Many things can change a woman's ability to have a baby. These include:
- Excess alcohol use
- Poor diet
- Intense athletic training
- Being overweight or underweight
- Sexually transmitted infections (STIs)
- Health problems that cause hormonal changes, such as polycystic ovarian syndrome and primary ovarian insufficiency