What are the various factors that are important for conception?
It’s amazing and a bit of a miracle any of us are here at all. Conception is a complicated process depending on many important factors from both the woman and the male partner. Some of these factors depend on healthy sperm and healthy eggs. Other factors depend on the condition of the reproductive organs such as healthy, open fallopian tubes, and a healthy uterus. The process is simple, the sperm must reach and egg and the egg must implant into the lining of the uterus. However simple the idea, the process is anything but, there are many factors that can inhibit any part of this process. If just one necessary factor is out of place or less than optimum, conception will be difficult.
What is infertility?
Fertility is the inability for normal, healthy couples to conceive after one year of unprotected sex. For some people, those with underlying health issues or previously diagnosed reproductive disorders, the length of time trying to conceive is reduced to six months. Women with painful periods, a history of irregular cycles, pelvic inflammatory disease and miscarriages, or couples who know that the male partner has a low sperm count should only try for 6 months at most, before seeking help from The Heard Clinic.
What are the causes of infertility?
The inability to conceive is commonly due to factors belonging to both the male and female parties. Statistics show that one third of infertility factors come from issues pertaining to female reproductive system, another third comes from some type of male factor, the rest are classified as undetermined or consisting of both female and male factors.
What causes infertility in men?
In most cases, infertility issues in men come from an issue with the sperm. Such issues include low sperm count, abnormally shaped sperm, poor sperm motility, or a combination there of. Most cases of infertility in men can be detected and addressed. Lifestyle changes can also be made to help correct unhealthy sperm or count. Tobacco, alcohol, and drug use can cause fertility problems in men by affecting sperm. Also, environmental toxins, such as exposure to pesticides and lead can cause some cases of male factor infertility. Stress, illness, genetic disease, and some medications can temporarily affect sperm.
What causes infertility in women?
Female infertility is divided into several categories.
- Ovulation – The most common cause of infertility is an ovulation disorder called Polycystic Ovarian Syndrome orPCOS. Additionally, ovulation problems stem from malfunction of the hypothalamus and pituitary gland, organs in the brain that regulate hormones
- Cervix – Cervical issues result in sperm being unable to access the egg inside the uterus. This can occur because of too little mucus or mucus that is hostile to sperm, infection from sexually transmitted diseases, or an immune attack on the sperm – also called a sperm allergy, though sperm allergy is very rare.
- Pelvis – Pelvis causes of infertility include any disruption of the normal pelvis anatomy by scar tissue or adhesions as in pelvic inflammatory disease, endometriosis, blocked or scarred, or distorted fallopian tubes and benign tumors or fibroids in the uterus.
- Fallopian Tubes – Blocked or abnormal fallopian tubes keep the egg from passing into the uterus or keep sperm from reaching the egg.
- Uterus – Infertility caused by issues originating from the uterus include abnormal uterine lining, anatomic uterine problems such as polyps, fibroids, or septum within the uterus.
What is unexplained infertility?
10 to 30% of couples undergoing infertility treatment are diagnosed with unexplained infertility. This means that fertility experts are unable to determine the cause of infertility using the available tests. Usually, couples with unexplained infertility are eventually able to conceive. Treatments range from medications to in vitro fertilization.
How does age affect fertility?
There is a direct association between advanced age and infertility. From age 30 to 35, a woman’s chance to become pregnant gradually declines. After 40 there is a sharp decline. The probability of having a baby decreases 3-5% per year after age 30 and more rapidly after age 40. There are numerous reasons for this decline in fertility including diminished egg quality and production, irregular ovulation, decreased hormonal function, and fertilization resistance.
Men are less likely to have age-related complications. Most men can produce healthy, viable sperm late in life. However, male factor infertility is still a contributor to about 47% of infertile couples.
The following are general statistics related to age based on actively trying for 12 months:
20 – 24 years – Chances of pregnancy: 86%
25-29 years – Chances of pregnancy: 78%
30-34 years – Chances of pregnancy: 63%
35 -39 years – Chances of pregnancy: 52%
How is infertility diagnosed?
The first step in identifying infertility is to conduct a medical evaluation. This process begins with physical examination, medical, and sexual histories of both parties involved. Sometimes, underlying problems can be determined early on; these common issues are usually related to poorly timed intercourse, irregular periods or lack of ovulation. If no problems can be determined through exam and questioning, more specific tests can be performed. For the male partner, these tests generally include semen analysis and hormone tests. For a woman, the first issue to address is ovulation. A woman can keep track of body temperature and cervical mucus or purchase a home ovulation test kit.
In office tests include blood analysis, ultrasound, x-ray, or laproscopy performed as an out-patient procedure. All of these tests and results can usually be obtained within one to two months.
How is infertility treated?
While all of this information can be overwhelming and frightening, don’t lose hope. There is reason to celebrate and that is because 85-90% of couples within the reproductive age can be treated with conventional medical therapies such as medications or surgery. Fertility drugs can be used on women with ovulation problems. Surgery can be performed to repair any damage. And when these treatments fail, advanced reproductive technologies such as Intrauterine Insemination or In Vitro Fertilization can be utilized, although these complex treatments are only used about 3% of the time.
When should a fertility specialist be seen?
Seek evaluation by 12 months of unsuccessful trying. However, if the female contributor is over 35 years, seek the help of a reproductive endocrinologist like Dr. Heard after 6 months – contact us. Women over the age 40 should seek evaluation immediately.
Can women choose to become pregnant after having their tubes tied?
Yes. This procedure can be reversed on an outpatient setting and usually with good results. Often couples are able to begin trying after only a short amount of time. An alternative to having a reversal would be going straight to in vitro fertilization. The egg would be harvested and fertilized outside the body, bypassing any damage done to the fallopian tubes.
What is the role of laparoscopy in infertility?
Laparoscopy is a minimally invasive surgical procedure that allows for a complete examination and evaluation of a woman’s pelvic and abdominal structures. In women with endometriosis or scarring, laparoscopic procedures can greatly improve chances of pregnancy.