Understanding Infertility

The absence of pregnancy after trying to conceive for one year. Each month, there is only a 20.5% chance of conceiving for health couples without infertility. It is estimated that 1 in 8 couples have trouble conceiving.  Recurrent reproductive loss can be one form of infertility. In one-third of cases, the cause is due to issues with both the man and the woman. In another third, it’s the women’s issue leaving the remaining third due to male factors. In up to 15% of cases, no cause is determined. Causes of infertility can range from blocked fallopian tubes, irregular or absent ovulation (egg release), low progesterone levels, chromosomal abnormalities, structural abnormalities of the uterus such as fibroid. In men low sperm count, poor sperm quality (shapes) and impaired motility are common reasons for low fertility.

• Blood work to evaluate for other medical conditions that can cause infertility such as thyroid disorders or polycystic ovarian syndrome (PCOS)
• Hysterosalpingogram to assess the uterine cavity and fallopian tubes to make sure they are not closed off from scarring
• Midcycle Ultrasounds are sometimes used to detect the size of the follicle that houses the egg
• Ovulation induction with medications
• Semen analysis
• Intrauterine insemination- introduces washed and concentrated sperm into the uterus to bypass the cervical mucus

Infections, ovulatory dysfunction, fibroids, endometriosis, history of pelvic inflammatory disease, Polycystic Ovarian Syndrome (PCOS), varicoceles in men, hormonal disturbances in both men and women, sperm abnormalities. Sometimes the cause is unknown.

See your doctor for an evaluation to determine the cause and management options. Ovulatory agents can be used with injections right before ovulation. Progesterone supplementation may be needed if a luteal phase defect is suspected or diagnosed. Sometimes surgery is needed to assess for endometriosis or scarring.

The best way to get pregnant fast is to have frequent  sexual intercourse starting after menstruation and continuing every day or every other day until after ovulation. Consider an ovulation kit to detect ovulation which can be used to estimate the approximate day of ovulation.