Infertility means not being able to become pregnant after a year of trying.
Infertility is fairly common. After one year of having unprotected sex, about 85 percent of couples are able to get pregnant. The remaining 15 percent of couples are considered to have infertility.
About a third of the time, infertility can be traced to the woman. In another third of cases, it is because of the man. About a third of the time there could be issues with of both partners, but sometimes no cause can be found. Female factors may involve problems with ovulation, the reproductive organs or hormones. Male factors often involve problems with the amount or health of sperm. Lifestyle factors such as being overweight or underweight, heavy alcohol consumption, smoking, marijuana use and the use of anabolic steroids can lead to infertility.
The workup for infertility includes a detailed medical history and physical exam. The medical history will include questions about your menstrual period, abnormal vaginal bleeding, pelvic pain and other disorders that can affect reproduction for both you and your partner such as medications, illnesses such as sexually transmitted diseases, past surgeries, family history of birth defects and your occupation. You will also be asked about how long you have been trying to become pregnant, methods of birth control you have used in the past, how often you have sex and whether or not you have any difficulties with intercourse.
Testing may include laboratory testing such as certain hormone levels, blood sugar and insulin levels, and thyroid studies. Imaging tests such as an ultrasound or hysterosalpingography, or procedures such as hysteroscopy or laparoscopy. The different imaging tests and procedures are used to look at your reproductive organs, and check whether your fallopian tubes are healthy and if there are problems with your uterus. The testing for a man involves a semen analysis. You may not have all of these tests and procedures as some of these tests are based on results of previous tests and procedures. Your physician will work with you and your partner to determine what testing is appropriate for your individual situation.
If a cause is found, treatment may be possible, and specifically focused on the cause. Infertility can often be successfully treated even if no specific cause is found. The treatment plan will vary based on the specific findings from the testing done on you and your partner. The treatment plan may focus on the woman, the man, or may involve both partners. Medications, surgery, and assisted reproductive technology are common treatments. The workup for infertility and some treatment plans can be done in our office, and some plans require us to refer patients to infertility clinics in Memphis or Nashville. Happily, many couples treated for infertility go on to have babies.
Article by Dr. Ryan Roy, MD.