Infertility Management

Symptoms

The main symptom of infertility is not being able to get pregnant. There may be no other clear signs. However, women with infertility may have irregular or no periods. Men might have signs like changes in hair growth or sexual function. Many couples will eventually conceive, whether they get treatment or not.

When to see a doctor

You probably don't need to see a doctor about infertility unless you've been trying to get pregnant regularly for at least a year. However, women should see a doctor earlier if they:

1) Are 35 or older and have been trying for 6 months or longer
2) Are over 40
3) Have irregular or absent periods
4) Have very painful periods
5) Have known fertility problems
6) Have been diagnosed with endometriosis or pelvic inflammatory disease
7) Have had multiple miscarriages
8) Have undergone cancer treatment

Causes

Getting pregnant requires all steps in ovulation and fertilization to happen correctly. Some infertility issues are present from birth, while others develop later in life.

Infertility can be caused by problems in either partner, or both. In general:
1) In about one-third of cases, the issue is with the man
2) In about one-third of cases, the issue is with the woman
3) In the rest of the cases, the problem is with both partners or the cause is unknown.

Causes of Male Infertility

1) Abnormal sperm production or function caused by issues like undescended testicles, genetic problems, diabetes, or infections (like chlamydia, gonorrhea, mumps, or HIV). Enlarged veins in the testes (varicocele) can also affect sperm quality.

2) Problems delivering sperm due to issues like premature ejaculation, certain genetic conditions (e.g., cystic fibrosis), blockages in the testicles, or injury to the reproductive organs.

3) Overexposure to harmful environmental factors like pesticides, chemicals, radiation, and substances such as cigarette smoke, alcohol, marijuana, and anabolic steroids. Heat from saunas or hot tubs can also affect sperm production.

4) Damage from cancer treatments like radiation or chemotherapy, which can severely affect sperm production.

Causes of Female Infertility

1) Ovulation disorders, where the ovaries don’t release eggs properly. This can be caused by hormonal disorders like polycystic ovary syndrome (PCOS), or other issues such as thyroid problems, eating disorders, or tumors.

2) Uterine or cervical issues, like problems with the cervix or abnormal growths in the uterus, such as polyps or fibroids, which can block the fallopian tubes or prevent implantation.

3) Fallopian tube damage or blockage, usually caused by pelvic inflammatory disease, endometriosis, or scar tissue.

4) Endometriosis, when tissue similar to the uterine lining grows outside the uterus, affecting the ovaries, uterus, and fallopian tubes.

5) Early menopause, when the ovaries stop working and periods end before age 40. This can happen due to certain diseases, genetic conditions, or treatments like radiation or chemotherapy.

6) Pelvic adhesions, scar tissue from past infections, surgeries, or conditions like endometriosis can hamper implantation.

7) Cancer treatments like radiation, chemotherapy destroys oocytes in the ovaries making the person infertile.