Infertility affects both men and women. The reasons for these conditions vary, and infertility experienced by either partner can result in the inability to get pregnant.
Infertility and Men:
Although some people still think of fertility as a “woman’s problem,” a third of all cases of infertility involve problems solely with the male partner.
Infertility in a man may be the sole reason that a couple can’t conceive, or it may simply add to the difficulties caused by infertility in his partner. So it’s crucial that men get tested for fertility as well as women. It’s also important that men do it early. Though some guys may want to put off being tested — possibly to avoid embarrassment — early testing can spare their partners a great deal of unnecessary discomfort and expense. It’s also a good way to quickly narrow down potential problems.
Reasons for Male Infertility
There are a wide number of reasons for male infertility. Some are caused by physical problems that prevent the sperm from being ejaculated normally in semen. Others affect the quality and production of the sperm itself.
Infertility is the inability to get pregnant after a year of unprotected intercourse.
About 10% of couples in the United States are affected by infertility. Both men and women can be infertile. According to the Centers for Disease Control, 1/3 of the time the diagnosis is due to female infertility, 1/3 of the time it is linked to male infertility, and the remaining cases of infertility are due to a combination of factors from both partners. For approximately 20% of couples, the cause cannot be determined.
How Does Age Affect Fertility?
Women are born with a finite number of eggs. Thus, as the reproductive years progress, the number and quality of the eggs diminish. The chances of having a baby decrease by 3% to 5% per year after the age of 30. This reduction in fertility is noted to a much greater extent after age 40.
What Causes Female Infertility?
Female infertility can also be caused by a number of factors, including the following:
- Damage to fallopian tubes. Damage to the fallopian tubes (which carry the eggs from the ovaries to the uterus) can prevent contact between the egg and sperm. Pelvic infections, endometriosis, and pelvic surgeries may lead to scar formation and fallopian tube damage.
- Hormonal causes. Some women have problems with ovulation. Synchronized hormonal changes leading to the release of an egg from the ovary and the thickening of the endometrium (lining of the uterus) in preparation for the fertilized egg do not occur. These problems may be detected using basal body temperature charts, ovulation predictor kits, and blood tests to detect hormone levels.
- Cervical causes. A small group of women may have a cervical condition in which the sperm cannot pass through the cervical canal. Whether due to abnormal mucus production or a prior cervical surgical procedure, this problem may be treated with intrauterine inseminations.
- Uterine causes. Abnormal anatomy of the uterus; the presence of polyps and fibroids.
- Unexplained infertility. The cause of infertility in approximately 20% of couples will not be determined using the currently available methods of investigation.
How Is the Cause of Infertility Determined?
If male infertility is suspected, a semen analysis is performed. This test will evaluate the number and health of his sperm. A blood test can also be performed to check his level of testosterone and other male hormones.
If female infertility is suspected, your doctor may order several tests, including:
- A blood test to check hormone levels
- An endometrial biopsy to check the lining of the uterus
- Two diagnostic tests that may be helpful in detecting scar tissue and tubal obstruction are hysterosalpingography and laparoscopy.
- Hysterosalpingography (HSG). This procedure involves either ultrasound or X-rays taken of the reproductive organs. Either dye or saline and air are injected into the cervix and travel up through the fallopian tubes. This enables the ultrasound or X-ray to reveal if the fallopian tubes are open or blocked.
- Laparoscopy. In this procedure, a laparoscope (a slender tube fitted with a fiberoptic camera) is inserted into the abdomen through a small incision near the belly button. The laparoscope enables the doctor to view the outside of the uterus, ovaries, and fallopian tubes to detect abnormal growths, as in endometriosis. The doctor can also check to see if the fallopian tubes are open at the same time.
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