What is Infertility?
Infertility is when a couple fails to get pregnant or carry a pregnancy to full term. It is further divided into two types:
Primary infertility is diagnosed when partners have not conceived after 12 months of trying without the use of birth control, or 6 months if a woman is over 35 years of age.
Secondary infertility is diagnosed when a couple who previously had children cannot get pregnant again.
In the majority of cases, infertility is treatable. It is different from sterility, which is diagnosed when conception cannot occur because of lack of ovulation or sperm production due to genetics, disease, or injury.
Infertility rates have doubled in the last 50 years.2 As a result:
Roughly only 1 in every 6 couples are having difficulty getting pregnant.3
About 33% of infertility cases are due to female factors, another 33% due to male factors, and the remaining 33% come from a combination of both.2
Some 84% of couples succeed to conceive naturally within a year of trying. After two years of active attempts, about 92% get pregnant naturally.4
Signs and Symptoms of Infertility
Symptoms of Infertility
Besides not being able to conceive, there are rarely any other clear symptoms of infertility. As a result, many couples discover fertility problems once they try to conceive with no success.
Nevertheless, partners might experience symptoms associated with other conditions known to cause infertility.
Women may notice symptoms of irregular periods that might indicate that ovulation is not occurring properly. They include irregular, absent, heavy, or painful periods.
Men might report problems with sexual function, such as erectile or ejaculation issues; loss of libido; and testicular pain or swelling.
Signs of Infertility
Infertility signs used to pinpoint its underlying cause, which are obtained through infertility tests discussed below, include the following:
Women's signs of infertility can include abnormal levels of reproductive hormones; high or low thyroid hormone levels; positive screening for sexually transmitted diseases (STDs); and blockage or damage to the reproductive organs, such as fallopian tubes.
Men's signs of infertility might include abnormal semen analysis; testosterone imbalance; atypical testicular biopsy; or genetic abnormalities.
When reduced fertility is suspected, it calls for a comprehensive medical evaluation to achieve a proper infertility diagnosis. Since infertility can be caused by female, male, or mixed factors, both partners should undergo testing after 12 months of trying (or six months if a woman is above 35).
Each evaluation for fertility issues should start with a thorough physical exam to review the couple's medical and sexual history as well as a woman's menstrual cycle patterns. Further fertility tests might include the following:
Female Infertility Tests
- Pap smear to rule out STDs and anatomical problems
- Blood tests for hormonal levels and nutritional deficiencies
- Transvaginal ultrasound to evaluate the state of a woman's ovarian reserve
- Genetic testing for chromosomal defects
Male Infertility Tests
- Semen analysis to evaluate sperm's count, shape, motility, and more
- Blood tests for hormonal levels and nutritional deficiencies
- Testicular ultrasound or biopsy for blockage or organ damage
- Genetic testing for chromosomal abnormalities
Causes of Infertility
Although there are many possible causes of infertility in men and women that can be easily identified, about 15-30% of all cases are defined as unexplained infertility, which means that they cannot be traced to a clear root.5
Infertility Causes in Women
Abnormal Ovulation. Problems with female fertility are most commonly rooted in ovulation problems, which account for up to 40% of infertility cases. The underlying cause of abnormal ovulation is hormonal imbalance brought about by a number of health conditions, such as hypothalamic or pituitary dysfunction, polycystic ovary syndrome (PCOS), premature ovarian failure, and hyperprolactinemia.
Reproductive Organs' Damage. Other reasons for infertility can include damage or blockage to the reproductive organs, which prevents the egg from reaching or implanting in the uterus or disabling sperm from reaching the egg. These infertility causes are most commonly due to endometriosis, pelvic inflammatory diseases (PID), or STDs.
Uterine or Cervical Problems. Other causes of problems getting pregnant might consist of anatomical abnormalities within the uterus or cervix, which affect the quality of cervical mucus designed to aid sperm transport or prevent implantation of the egg, thus increasing the risk of miscarriage, among others.
Infertility Causes in Men
Sperm Abnormalities. Problems with male fertility are mainly rooted in abnormal production, transport, or function of sperm, affecting their count, shape, and motility. These sperm abnormalities can be brought up by various conditions, such as varicocele, trauma to the genitals, STDs, and diabetes, among others.
Hormonal Imbalance. Male infertility can also arise from hormonal imbalance, particularly testosterone, a hormone that governs sperm production, stimulates sex drive, and maintains an erection.
Genetic Disorders. Certain inheritable disorders, such as Klinefelter's syndrome or cystic fibrosis, lead to abnormal development of male genitals, thus potentially causing infertility.
Infertility Risk Factors
Besides medical causes of infertility, certain other factors, including unhealthy lifestyle habits, put men and women at a higher risk of having trouble getting pregnant. They include:
- Being over 35 in women and 40 in men
- Excess or insufficient body fat percentage
- Excessive alcohol use
- Environmental toxins
- Prolonged stress or depression
In the majority of cases, infertility treatments show effective in resolving the underlying causes. They can include lifestyle adjustments, alternative medicine, and conventional medicine.
Many couples suffering from infertility can benefit from implementing wholesome practices, which might consist of reaching a healthy body mass index (BMI), ensuring proper nutrition, quitting smoking and drinking alcohol, exercising regularly, and reducing stress through yoga or meditation. For women, learning how to estimate their ovulation day more precisely is also essential. For men, on the other hand, having frequent sex helps maintain proper sperm quality.
Hormonal imbalance behind fertility issues can also be resolved with herbal supplements. They most commonly consist of phytoestrogenic supplements, such as red clover, black cohosh, or ginseng, or hormone-balancing supplements, like Macafem. Other fertility-boosting supplements might include vitamins and minerals, such as zinc, iron, selenium, and vitamins A, B, and C.
Depending on the underlying cause, medications might be aimed at stimulating ovulation in women, treating STDs, improving sperm health and function in men, among others. In some cases, surgery might be necessary to remove blockages in the reproductive tracts and restore fertility.
Alternative Options for Infertile Couples
When troubles getting pregnant cannot be effectively treated, couples can take advantage of a number of assisted reproductive technologies (ARTs). These advanced options for infertile couples include artificial insemination, in vitro fertilization (IVF), and surrogacy.
Without a doubt, having trouble conceiving can be truly nerve wracking. To complicate conception struggles even further, infertility usually does not produce easily-distinguishable symptoms. Although it might bring just a little comfort to the partners facing the difficulties, fertility issues are quite common as they affect one in every six couples. Fortunately, the majority of couples successfully get pregnant within a year of trying with proper treatment, ranging from lifestyle adjustments, such reaching a healthy weight with a nutritious diet and exercise, to using hormone-balancing supplements, like Macafem, or conventional methods, like medications or surgery.
- American Journal of Men's Health. (2017). The Impact of Intense Exercise on Semen Quality. Retrieved from November 22, 2018 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5675222/
- American Pregnancy Association. (2018). Male Infertility. Retrieved from November 22, 2018 from http://americanpregnancy.org/infertility/male-infertility/
- Better Health Channel. (n.d.). Infertility in women. Retrieved November 29, 2018 from https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/infertility-in-women
- Eunice Kennedy Shriver National Institute of Child Health and Human Development. (2017). Fertility Treatments for Females. Retrieved November 29, 2018 from https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/treatments/treatments-women
- Eunice Kennedy Shriver National Institute of Child Health and Human Development. (2017). What are some possible causes of male infertility? Retrieved from November 22, 2018 from https://www.mayoclinic.org/diseases-conditions/male-infertility/symptoms-causes/syc-20374773
- Human Reproduction Update. (2017). Dietary patterns, foods, and nutrients in male fertility parameters and fecundability: a systemic review of observational studies. Retrieved from November 22, 2018 from https://www.ncbi.nlm.nih.gov/pubmed/28333357
- Mayo Clinic. (2018). Female Infertility. Retrieved November 29, 2018 from https://www.mayoclinic.org/diseases-conditions/female-infertility/symptoms-causes/syc-20354308
- Mayo Clinic. (2018). Male Infertility. Retrieved from November 22, 2018 from https://www.mayoclinic.org/diseases-conditions/male-infertility/diagnosis-treatment/drc-20374780
- Medline Plus. (2018). Female Infertility. Retrieved November 29, 2018 from https://medlineplus.gov/femaleinfertility.html
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- Office on Women's Health. (2018). Infertility. Retrieved November 29, 2018 from https://www.womenshealth.gov/a-z-topics/infertility
- Reproductive Biology and Endocrinology. (2015). A unique view on male infertility around the globe. Retrieved January 28, 2020 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4424520/
- CDC. (2018). Infertility FAQs. Retrieved January 28, 2020 from https://www.cdc.gov/reproductivehealth/infertility/index.htm
- Biology of Reproduction. (2019). The forgotten men: rising rates of male infertility urgently require new approaches for its prevention, diagnosis and treatment. Retrieved January 28, 2020 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6877781/
- U.S. Department of Health & Human Services. (2019). Male infertility. Retrieved January 28, 2020 from https://www.hhs.gov/opa/reproductive-health/fact-sheets/male-infertility/index.html
- Obstetrics & Gynecology. (2008). Diagnosis and Treatment of Unexplained Infertility. Retrieved January 28, 2020 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505167/