Causes of infertility

About infertility

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There are many possible causes of infertility. For 25% of couples, a cause cannot be identified.

Infertility is a disease of the reproductive system. One third (30%) of infertility can be attributed to male factors, and about one third (30%) can be attributed to female factors. In about 20% of cases infertility is unexplained, and the remaining 10% of infertility is caused by a combination of problems in both partners.

Approximately 80% to 85% of couples who are trying to become pregnant will successfully conceive within a year. Thus, infertility is commonly defined as the inability to achieve a pregnancy within 12 months of unprotected intercourse. However, certain patients may have recognized factors that preclude normal conception. For them, the 12-month period of waiting makes little sense. Common examples of women with such problems include those who have extremely irregular periods, a history of severe endometriosis, a history of previous tubal pregnancies, or other anatomical factors that would clearly lead to diminished fertility. Since fertility declines significantly as a woman ages, couples are encouraged to seek evaluation for fertility after 6 months of no contraception if the woman is older than age 35.

The causes of infertility can be equally divided between the male and female partners in a couple.

There are endometriosis, ovulatory dysfunction, diminished ovarian reserve, tubal factor, multiple factors(female only), uterine factor, multiple factors(female+male), male factor, unexplained cause and other causes.

Half of all infertility cases, therefore, involve problems with the sperm of the male partner.

Many factors can reduce the female partner's ability to conceive. For example, a woman may have anatomical problems related to the fallopian tubes, uterus, and peritoneal structures within the pelvis such as adhesions or endometriosis. Problems with ovulation are very common in infertile patients, and woman with irregular periods may suffer from a common disorder such as polycystic ovarian syndrome (PCOS). Another major fertility factor is reproductive aging. Peak fertility occurs when a woman is in her twenties, and it declines significantly during her thirties and forties. The rate of decline increases after the age of 35 as is evident in decreased IVF pregnancy rates and decreased embryo implantation rates in this age group.

If you decide to seek medical help, the best thing to do is to get a consultation with a fertility specialist. Many infertility problems can be pinpointed and the vast majority can be treated.

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