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InfertilityDefinitionInfertility is the inability to become pregnant after 12 months of unprotected sex (intercourse). Alternative NamesBarren; Inability to conceive; Unable to get pregnantCausesPrimary infertility is the term used to describe a couple that has never been able to achieve a pregnancy after at least 1 year of unprotected sex. Secondary infertility describes couples who have been pregnant at least once, but have not been able to achieve a pregnancy again. Causes of infertility include a wide range of physical and emotional factors. About 30 - 40% of all infertility is due to a "male" factor such as:
Some factors that affect sperm count are:
"Female" factor causes include:
The other 10 -30% of infertility cases may be caused by factors from both partners, or no cause that can be identified. About 10 - 20% of couples will be unable to conceive after 1 year of trying to become pregnant. It is important that you try to get pregnant for at least 1 year. The chances for a pregnancy in healthy couples who are both under the age of 30 and having sex regularly is only 25 - 30% per month. A woman's peak fertility occurs in her early 20s. As a woman ages beyond 35 (and especially after age 40), the likelihood of getting pregnant drops to less than 10% per month. In addition to age-related factors, other infertility risks include:
Symptoms
Exams and TestsA complete history and physical examination of both partners is essential. Tests may include:
TreatmentTreatment depends on the cause of infertility. It may involve:
It is important to recognize and discuss the emotional impact that infertility has on you and your partner, and to seek medical advice from your health care provider. Support GroupsMany organizations provide informal support and referrals for professional counseling. See infertility - support group. Outlook (Prognosis)A cause can be determined for about 85- 90% of infertile couples. Getting the right therapy (not including advanced techniques such as in vitro fertilization) allows pregnancy to occur in 50 - 60% of couples who were infertile. Without any treatment, 15 - 20% of couples diagnosed as infertile will eventually become pregnant. Possible ComplicationsAlthough infertility itself does not cause physical illness, it can have a major emotional impact on the couples and individuals it affects. Couples may have problems with their marriage. Individuals may experience depression and anxiety. When to Contact a Medical ProfessionalCall for an appointment with your health care provider if you are unable to get pregnant. PreventionBecause sexually transmitted diseases (STDs) often cause infertility, practicing safer sex behaviors may minimize the risk. Gonorrhea and chlamydia are the two most common causes of STD-related infertility. STDs often don't have symptoms at first, until PID or salpingitis develops. These conditions scar the fallopian tubes and lead to decreased fertility, infertility, or an increased risk of ectopic pregnancy. Getting a mumps vaccine in men has been shown to prevent mumps and its complication, orchitis. The vaccine prevents mumps-related sterility. Some forms of birth control, such as the intrauterine device (IUD), carry a higher risk for future infertility. IUDs are not recommended for women who have not already had a child. If you are considering getting an IUD, carefully weigh the increased risk of infertility and the potential benefits with your partner and health care provider. Getting diagnosed and treated early for endometriosis may decrease the risk of infertility. ReferencesSperoff L, Fitz M. Clinical Gynecologic Endocrinology and Infertility. 7th ed. Lippincott Williams & Wilkins; 2004. Stenchever A. Comprehensive Gynecology. 4th ed. St. Louis, Mo: Mosby; 2001:1204-1206.
Review Date:
2/5/2008 Reviewed By: Peter Chen, MD, Department of Obstetrics & Gynecology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-
A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.  |
