Infertility Causes
Medically speaking, a couple is said to be having fertility difficulties when they have had regular unprotected sex for 12 months without achieving a pregnancy. Up to 15% of all couples fit this definition. The aim of investigating couples experiencing fertility difficulties is to identify potentially treatable infertility causes (diagnosis), and to identify their chances of achieving a pregnancy without further assistance (prognosis). While infertility is classified into "causes affecting women" and "causes affecting men," the reality is that there is often a bit of both that compounds the situation. Almost 20% of the time, no clear reason is found at all (which is called unexplained infertility).
The common infertility causes are:
- Ovulation (egg production) disorders, causing complete absence of or reduced production of eggs e.g.
- Polycystic Ovary Syndrome
- Premature menopause
- Tubal disorders - blockage or absence of one of both fallopian tubes e.g. pelvic infection, scarring from surgery
- Abnormal semen test - low or no sperm, inactive sperm, abnormal appearing sperm or any combination of these
- Other factors such as age, genetic disorders and endometriosis can also have an impact on the chance of pregnancy.
Making a diagnosis
- Testing for egg production - this might involve keeping a temperature chart, hormone testing and ultrasound scans, depending on the individual situation.
- Testing the Fallopian tubes for blockage - which can be done either using an X-ray called a hysterosalpingogram (or HSG) or surgery called a laparoscopy.
- A semen analysis - this needs to be repeated at Fertility Solutions to be sure of the severity of the problem.
Sometimes the cause of a couple's infertility is so obvious that no testing is needed (e.g. the man has had a vasectomy), but for most couples it isn't that clear cut. The tests that are carried out include:
Once a problem has been identified, more tests may be required to determine the precise infertility cause and whether it will respond to treatment. Sometimes no problem at all will be identified. This is called Unexplained Infertility.
Treatment Options
Disorders of egg production can be treated with a variety of medicines to bring on ovulation known as ovulation induction or OI. Insemination with partner or donor sperm can be a treatment option as long as the fallopian tubes are open (patent) and if using partner's sperm there is only a mild problem with the sperm. IVF is a further option for some and can be used as a treatment for any cause of infertility, provided we can get an egg, some sperm and there is a uterus. However, depending on the cause(s) of infertility, there can be other treatments that might also be successful. Surgery might be an option for some forms of fallopian tube problems. If you aren't clear about why fertility treatment may be the best option for you and your partner at this present point in time, we encourage you to discuss your specific situation with your fertility nurse or specialist.
