Most experts define infertility as not being able to get pregnant after at least one year of trying. Women who are able to get pregnant but then have repeat miscarriages are also said to be infertile.
- A woman must release an egg from one of her ovaries (ovulation).
- The egg must go through a fallopian tube toward the uterus (womb).
- A man’s sperm must join with (fertilize) the egg along the way.
- The fertilized egg must attach to the inside of the uterus (implantation).
Infertility can result from problems that interfere with any of these steps.
No, infertility is not always a woman’s problem. In about one-third of cases, infertility is due to the woman (female factors). In another third of cases, infertility is due to the man (male factors). The remaining cases are caused by a mixture of male and female factors or by unknown factors.
Infertility in men is most often caused by:
- Problems making sperm — producing too few sperm or none at all
- Problems with the sperm’s ability to reach the egg and fertilize it — abnormal sperm shape or structure prevent it from moving correctly
Sometimes a man is born with the problems that affect his sperm. Other times problems start later in life due to illness or injury. For example, cystic fibrosis often causes infertility in men.
The number and quality of a man’s sperm can be affected by his overall health and lifestyle. Some things that may reduce sperm number and/or quality include:
Problems with ovulation account for most cases of infertility in women. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.
Less common causes of fertility problems in women include:
More and more women are waiting until their 30s and 40s to have children. Actually, about 20% of women in the United States now have their first child after age 35. So age is an increasingly common cause of fertility problems. About one-third of couples in which the woman is over 35 have fertility problems.
Aging decreases a woman’s chances of having a baby in the following ways:
- The ability of a woman’s ovaries to release eggs ready for fertilization declines with age.
- The health of a woman’s eggs declines with age.
- As a woman ages she is more likely to have health problems that can interfere with fertility.
- As a women ages, her risk of having a miscarriage increases.
Infertility can be treated with medicine, surgery, artificial insemination, or assisted reproductive technology. Many times these treatments are combined. About two-thirds of couples who are treated for infertility are able to have a baby. In most cases infertility is treated with drugs or surgery.
Doctors recommend specific treatments for infertility based on:
- Test results
- How long the couple has been trying to get pregnant
- The age of both the man and woman
- The overall health of the partners
- Preference of the partners
Doctors often treat infertility in men in the following ways:
- Sexual problems: If the man is impotent or has problems with premature ejaculation, doctors can help him address these issues. Behavioral therapy and/or medicines can be used in these cases.
- Too few sperm: If the man produces too few sperm, sometimes surgery can correct this problem. In other cases, doctors can surgically remove sperm from the male reproductive tract. Antibiotics can also be used to clear up infections affecting sperm count.
Various fertility medicines are often used to treat women with ovulation problems. It is important to talk with your doctor about the pros and cons of these medicines. You should understand the risks, benefits, and side effects.
The medications and procedures required for IVF are rarely associated with complications. Less than 1% of women who have egg retrieval with IVF may experience ovarian hyperstimulation syndrome (OHSS), which may occur after using ovarian stimulation medications. When conceiving with the help of IVF treatment, there is a risk of multiple gestation (conceiving twins, triplets etc.).