Understanding infertility problems

Dealing with fertility problems can be exhausting. But if you feel discouraged or depressed, remember that you’re not alone. Keep sharing your feelings with your partner. Take advantage of help from your healthcare provider, family, or support groups. And remember that no matter what happens, you and your partner can still look forward to a rewarding life together.

What causes infertility?

Many things can cause infertility. It can be a problem in the female reproductive system. It can be a problem in the male reproductive system. Or it may be both. Below are things that can affect fertility.

Female factors

• Ovulation problems. The woman doesn’t make enough hormones to develop, mature, and release a healthy egg.
• Anatomical problems. A problem with the woman’s anatomy can prevent the egg and the sperm from meeting. The most common problem is blocked fallopian tubes. Other problems may include scar tissue in the pelvis from past surgeries or infections.
• Endometriosis.The tissue that lines the uterus implants outside the uterus in this condition. It usually implants on other reproductive organs or in the belly. Each month, this misplaced tissue reacts to the hormone changes of the menstrual cycle. This means it builds up, breaks down, and bleeds. This can cause scar tissue to form and affect fertility.
• Birth defects. Certain birth defects can affect fertility. One of the most common problems happens when a female baby is exposed to DES (diethylstilbestrol) in her mother’s womb. Pregnant women in the 1940s and 1950s took this medicine to prevent pregnancy loss. But it was found to cause problems with the development in the uterus and cervix in the baby. This would later hurt her ability to get pregnant as a woman.
• Infection. Pelvic inflammatory disease (PID) is caused by a type of bacteria such as gonorrhea and chlamydia. PID can affect the uterus, fallopian tubes, the ovaries, or all of these. It causes scar tissue to grow between organs. This leads to ongoing pelvic pain and raises the risk for an ectopic pregnancy. This is when the fertilized egg implants outside the uterus.
• Immune system problems. A problem with a woman's immune system can lead to pregnancy loss. Antibodies in a woman's system can fail to recognize a pregnancy. Or there may be an abnormal immune response to the pregnancy. Women can also develop antisperm antibodies, which attack and destroy sperm.

Male factors

• Low or no sperm production. Without enough healthy sperm, the chance of fertilization is decreased.
• Abnormal sperm function. Sperm must be able to swim and penetrate the egg.
• Varicocele. This is a condition in which varicose veins develop around the testes. It’s a very common cause of infertility in men. It’s treated with surgery.
• Hormone disorders. Hormone problems can affect sperm production and fertility.
• Chromosome defects. Some defects are linked to male infertility.
• Birth defects. Problems in a man's reproductive system can happen in the womb. Some birth defects are due to a man's exposure to DES (diethylstilbestrol) taken by his mother during pregnancy.
• Immune system problems. A man may have antisperm antibodies. These attack and destroy sperm.

These lifestyle habits can also affect sperm quality and function:

• Use of recreational drugs such as marijuana or cocaine
• Heavy alcohol use
• Smoking
• Taking certain medicines
• Too much heat to the genital area, such as using a hot tub

How is infertility diagnosed?

To diagnose infertility, both the man and the woman are tested.

Some healthcare providers can do a basic infertility evaluation. But, many causes of infertility are best treated by a reproductive endocrinologist. This is an OB/GYN who has had education and training in infertility. He or she should be certified with the American Board of Obstetrics and Gynecology.

The healthcare provider will test both partners to find the cause of infertility. The healthcare provider is looking for answers to these questions:

• Is the woman ovulating regularly?
• Is the man making healthy sperm?
• Are the woman's egg and the man's sperm able to unite and grow normally?
• Are there any problems with implantation?
• Is the woman able to maintain the pregnancy?

How is infertility treated?

Once a diagnosis is made, you can work with a fertility expert to find the best treatment. Most people with infertility are treated with medicine or surgery. Depending on the cause, there are many types of treatment.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

If you would like to make an appointment with one of our women's health experts, you can visit touro.com/findadoc or call 504-897-7777