Fertility FAQs

Infertility is commonly defined as “not being able to get pregnant after one year of trying.” Experts often recommend that women who are older than 35 years and have not conceived during a six-month period of unprotected sex should make an appointment with an infertility specialist. Women who do not have a regular monthly period should also consider seeing a reproductive endocrinologist because ovulation problems are the most common infertility factor in women.

About 40% of infertility cases are attributed to male factors, and about 40% to factors that affect women. In 10% of infertile couples, the inability to conceive is caused by a combination of issues in both partners. In the remaining 10%, diagnostic tests do not provide the answer.

Causes of Female Infertility

Ovulation disorders are the leading cause of infertility in women. Anovulation (no ovulation) is a disorder in which eggs do not develop properly or are not released from the follicles of the ovaries. Women who have this disorder may not menstruate for several months, while others have periods even though they are not ovulating. Oligo-ovulation is a disorder in which ovulation doesn’t occur on a regular basis. With oligo-ovulation, menstrual cycles may be longer than the normal 24 to 35 days. Other causes may include blocked fallopian tubes and other abnormalities.

Causes of Male Infertility

Problems with sperm quality (concentration, motility and shape) are the most common infertility factors in men. These include azoospermia (no sperm cells are produced) and oligospermia (few sperm cells are produced). Another cause of male infertility is attributed to sperm cells that are malformed or die before reaching the egg. Sometimes, infertility in men is the result of medical issues, such as low testosterone and varicoceles.

Most doctors advise women to try conceiving for at least one year. However, women aged 35 years or older should see an infertility specialist after six months of trying unsuccessfully because a woman’s chances of having a baby decrease rapidly every year after the age of 30.

Other reasons for seeking a fertility evaluation may include:

• Irregular or painful menstrual cycles (less than every 25 days or more than 35 days), which may suggest that a woman is not ovulating
• Conditions such as endometriosis or pelvic inflammatory disease
• Previous pelvic surgery or infection(s), which may suggest fallopian tube disease
• Recurrent Pregnancy Loss
• If you or your partner have a known reason that may complicate the ability to conceive

A reproductive endocrinologist will conduct a physical examination of both partners to determine their general health and to evaluate any physical disorders that may be causing infertility. If no cause can be identified at this point, more specific tests may be recommended. For women, these tests include X-rays of the fallopian tubes and uterus, and laparoscopy. For men, initial tests will focus on semen analysis.

Infertility can be treated with either medicine, surgery or assisted reproductive techniques—or a combination of treatments. Experts recommend specific treatments for infertility based on the factors contributing to infertility as well as the age of the woman. A reproductive endocrinologist may recommend intrauterine insemination (IUI) or in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) to help overcome male factor infertility.