Infertility: An Overview
Donald Aulds, M.D.
Infertility is commonly defined as the inability to get pregnant after one year of unprotected intercourse. If a couple has been trying to conceive for one year or more, a physician should be consulted to attempt to find the reason for the infertility. When you consider the events that must take place for a pregnancy to result, one realizes that the process is very complex and problems can occur at any stage of the process. The process includes: the woman must release an egg from the ovary, the egg must pass through the fallopian tube toward the uterus, the sperm must join the egg, and the fertilized egg must attach to the lining of the uterus. At any stage of the process, problems can occur which can either prevent the pregnancy or decrease the chance of carrying the pregnancy. The topic of infertility to too extensive to cover in this article, so an overview will be introduced to attempt to help you understand some of the causes and available therapies.
How often does infertility occur?
In studies in 2002, the National Institute of Health reported that approximately 12% of all women age 15-44 can have difficulty getting pregnant or carrying a baby. In couples over age 30, the frequency of infertility increases with another increase occurring over age 40.
Do infertility problems occur in men?
Yes, infertility can occur in men as well as women. Some studies have shown that male infertility occurs in 30-40% of reported cases of couples have difficulty conceiving. The problem in most cases is caused by problems producing sperm or problems with the sperm.s ability to reach the egg and fertilize it. What can affect the sperm? The following list includes some of the factors:
- Some men are born with problems with sperm production
- Illness or injury can occur to reduce production or quality of the sperm
- Alcohol
- Drugs
- Smoking
- Medicines
- Environmental toxins, such as pesticides and lead
- Age
- Radiation and chemotherapy for cancer
Semen analysis (sperm count) can be performed to see if there is a problem present with the number of sperm produced, abnormal shapes, or problems with movement of the sperm. If the test is abnormal, the man should see an urologist or a specialist in male infertility. Some of the therapies may include antibiotics if an infection is found, surgery if obstruction of the vas deferens (the tube carrying sperm from the testes to the penis) or other problems are present, or medications to improve sperm production.
What are causes of infertility in women?
Causes of infertility in women may include problems with ovulation (the most common cause), blocked fallopian tubes, uterine fibroids, or other problems with the uterus. There are several factors that can affect a woman.s ability to conceive including:
- Age - about 20% of women in this country delay having their first child until after age 35. It has been shown in studies that after age 35 the ability of the ovary to release eggs declines with age, the health of the eggs decrease, risk of miscarriage is increased, and health of the woman may be changing.
- Stress
- Overweight or underweight
- Smoking
- Alcohol
- Poor diet - diet poor in fat can alter the production of hormones. So a no or extremely low fat diet can alter the hormones of the body and possible increase the risk of infertility
- Health problems
- Athletic training - a woman with very low level of body fat may not have the balance of hormones, may not ovulate regularly and may not have periods at all.
A gynecologist or infertility specialist should be seen if a couple feels that they are having problems. Evaluation can be done to see if a factor can be identified and therapy offered. Therapies may include hormones or medications to help stimulate ovulation, surgery to open the fallopian tubes or even in-vitro fertilization. Testing for a woman may include blood testing, hysterosalpingogram (a study done with X-ray to see if the tubes and uterus are normal), or a surgery called laparoscopy to evaluate the woman's organs for problems.
Only a physician can help you determine what is best to help you. If you consider that there may be a problem, talk to your gynecologist. Your gynecologist may be comfortable with doing testing and therapy, but he or she may refer you to a specialist. Even if you are not sure whether you desire to proceed with testing and therapy, you should talk to your gynecologist for answers to your questions.
More about Dr. Aulds
Donald G. Aulds, MD is an Obstetrician and Gynecologist and currently serves as the Medical Director for both the Women's Center and the Best Start Program of North Alabama. He is a Diplomat of the American Board of Obstetrics and Gynecology and Fellow of the American College of Obstetricians and Gynecologists.
Dr. Aulds completed his medical education at Louisiana State University School of Medicine, New Orleans, LA and his Internship and Residency in Obstetrics and Gynecology at Ochsner Medical Foundation, New Orleans, LA.
Dr. Aulds has been an active member of the Huntsville Hospital Medical Staff since 1980.
