Infertility

What is infertility?

Infertility is generally defined as the inability of a couple to achieve conception, or to bring a pregnancy to term, after a year or more of regular, unprotected intercourse. The average chance to conceive for a normally fertile couple having regular unprotected intercourse is approximately 25 percent during each menstrual cycle. It is estimated that 10 percent of normally fertile couples fail to conceive within their first year of attempt and 5 percent after two years.

What causes infertility?

A cause for infertility can be diagnosed in about 80 percent of cases, and the source of infertility is almost equal in men and women.

The most common causes of female infertility are ovulatory disorders and anatomical abnormalities such as damaged fallopian tubes, and less frequently, endometriosis and hyperprolactinemia.

The most common causes of male infertility include sperm production disorders, anatomical obstructions, and other factors such as immunological disorders.

If you suspect that you are experiencing infertility, seek medical consultation early. The age of the woman and the duration of the couple's infertility may influence the success of treatment.

How may infertility be treated?

Specific treatment for infertility will be determined by your physician(s) based on:

• your overall health and medical history
• extent of the disorder
• your tolerance for specific medications, procedures, or therapies
• expectations for the course of the disorder
• your opinion or preference

Generally, the obstetrician or reproductive endocrinologist will evaluate specific situations and perform tests in both the male and female partners to determine the cause of infertility. The physician is looking for answers to these questions:

1. Is the female ovulating regularly?
2. Is the male producing healthy, viable sperm?
3. Are the female's egg and the male's sperm able to unite and grow normally?
4. Are there any obstacles to proper implantation and maintenance of the pregnancy?

Once a diagnosis is made, the specialist can work with you to determine the course of treatment. Depending on the type of infertility, there are many options to offer an infertile couple.

Female patients may be treated with medication, or have surgery to repair damage to the reproductive organs, such as those caused by endometriosis or infectious diseases.

Treatment options for male-factor infertility also include medication and surgery.

Many assisted reproductive technologies (ART) are being used with success. These include:

• in vitro fertilization (IVF)
• intracytoplasmic sperm injection (ICSI)
• gamete intrafallopian transfer (GIFT)
• zygote intrafallopian transfer (ZIFT)
• donor-egg in vitro fertilization
• frozen embryo transfer