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Infertility affects approximately 11% of couples at some time in
their reproductive lives and this percentage rises as
the female ages. Many couples delay childbearing until
they are secure in their careers and economically stable.
This is a socially responsible choice, however, most
women reach their biological peak fertility much earlier
in life. See our articles for an in depth discussion
of the effects of aging on egg quality.
Infertility
was once considered a "female" problem but
it is now known that approximately 47% of couples have
a male component. There is no test more important than
a thorough semen analysis preferably conducted by a
reproductive laboratory.
A
reproductively healthy couple having regular intercourse
has a 20% (approximate and highly dependent on several
factors) chance of conceiving each cycle. In the female
under the age of 35, infertility is defined as failure
to conceive after one year of unprotected intercourse.
The period is shortened to six months in female over
the age of 35.
Infertility
is a result of "disease" or "malfunction"
of one or more organs of the reproductive system. The
term "unexplained" is used to describe failure
to conceive when a cause cannot be identified. There is
a cause; however, science has not developed to the point
that it can be identified.
In
general, causes consist of:
- Male
Factor- Abnormalities in the number, shape, swimming
motion, viscosity, and other qualitative and quantitative
factors used to assess semen.
- Ovulatory
Dysfunction- Failure to ovulate on a regularly.
Annovulation is the failure to ovulate and oligoovulation
is irregular ovulation.
- Tubal
Disease-
Blockage or impairment of the fallopian tubes. The
fallopian tubes are responsible for transporting the
eggs from the ovaries to the uterus.
- Endometriosis-
Endometrial tissue can grow, implant, and penetrate
reproductive organs causing obstruction or blockage.
Endometriosis also sets up an "inflammatory environment"
in the pelvic cavity.
- Polycystic
Ovarian Disease- See the
complete discussion.
- Cervical
Factor-
Sperm must travel through the vagina and pass through
the cervix to reach the uterus. Abnormal cervical
mucus can impede this process and in some cases, the
female may produce antibodies to the male's sperm.
- Uterine
Factor- The embryo implants in the endometrial
lining of the uterus where it grows and develops.
A woman may be born with an absent (rare) or malformed
uterus. Other factors, such as fibroids, can interfere
with normal uterine function.
- Immunologic
Factors- There are numerous immunologic conditions
that can affect a couple's ability to conceive. The
male may produce antibodies to his sperm (relatively
rare) or the female may produce antibodies to the
male's sperm.
- Infertility
- Unexplained - There
are a significant number of couples where no cause
can be identified. IVF is often the preferred treatment
because it allows the fertilization and embryo development
processes to be observed in the laboratory and it
produces higher success rates.
The
best news is that the majority of couples who seek care
from a reproductive endocrinologist early in the course
of their diseases will conceive.
- Infertility 101- An Overview, Karen Kaplan, MD Georgia Reproductive Specialists
- Female Infertility
- Infertility-Frequent Questions, Mark Trolice, MD
- Overview by Mark Trolice, MD
- Male Factor Infertility
- Cervical Factor Infertility
- Endometriosis
- PCOS
- Ovulatory Dysfunction
- Tubal Factor Infertility
- Uterine Factor Infertility
- Unexplained Infertility
- Infertility Overview- Samuel Thatcher, MD
- PRESERVING
REPRODUCTIVE OPTIONS IN ONCOLOGY PATIENTS ,
by Bradford Kolb, M.D., F.A.C.O.G.,
Board Certified, Reproductive Endocrinology and Infertility
- THE
CONTEMPORARY FERTILITY EVALUATION, by Daniel Potter, M.D., F.A.C.O.G.,
Board Certified, Reproductive Endocrinology and Infertility,
Huntington Reproductive Center
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