Infertility is a condition where couples are unable to conceive after six months or one year of unprotected and regular intercourse. Infertility affects about 6% of married women 15-44 years of age. Contrary to popular belief, infertility affects both men and women. Studies found that 7.5% of sexually active men reported seeing a fertility doctor during their lifetime, this equals 3.3-4.7million men.
Infertility in men can be caused by multiple factors and can be evaluated using a semen analysis. The semen from the individual is evaluated for the concentration (amount), motility (movement), and morphology (shape). If the semen analysis is slightly abnormal, it does not always mean that the patient is infertile. Conditions that may contribute to an abnormal semen analysis includes:
- Varicoceles: the veins in the testicle is enlarged causing it to overheat which affects the number or shape of the sperm.
- Other medical conditions: Diabetes, trauma, infection or previous history of chemotherapy or radiation may affect the sperm.
- Habits: use of alcohol, smoking, steroid use or drug use can also affect the sperm
- Environmental toxins and exposure
For women, Infertility can be caused by any interruption to the process below:
- Ovulation: the process where the woman releases an egg from one of the ovaries. Some women do not ovulate due to:
- Polycystic ovarian syndrome (PCOS): a hormone imbalance interfering with ovulation
- Functional hypothalamic amenorrhea (FHA): absent period due to no physical or emotional stress
- Diminished ovarian reserve (DOR): ovary is unable to produce eggs due to surgical, medical or unexplained reasons. Number of eggs also decrease with age.
- Menopause: ovarian function declines due to age and eventually stops producing eggs.
2. Fertilization: A man’s sperm must meet the egg along the way. If the woman’s tube is blocked, fertilization cannot happen.
4. Implantation: after travelling to the womb, the fertilized egg must be able to attach to the inside of the uterus.
For women, age is one of the factors that contribute to infertility. In today’s world, many women are waiting until they are successful and stable enough in life to have a baby. This usually occurs in their 30s or 40s. 20% of women in the United States have their first child after the age of 35 years old.
Aging not only decreases fertility but also increases the chance of miscarriage and having a child with a genetic anomaly. With age, a woman’s ovaries are less able to release eggs. They also have less eggs (decreased reserve), less healthy eggs, more health conditions that may cause fertility problems and more likely to have a miscarriage. Coupled with today’s lifestyle, many women smoke, drink alcohol excessively, are either obese or underweight, and have stress that can contribute to infertility.
It is recommended that women below the age of 35 can try to conceive for 1 year and women above the age of 35 years old should see a doctor after 6 months of trying to conceive unsuccessfully. A woman’s chance of conceiving declines after the age of 30.
- Reproductive health: Infertility FAQs. Centers for Disease Control and Prevention. https://www.cdc.gov/reproductivehealth/infertility/. Accessed 2/3/2017.
- Understanding Infertility. WebMD. http://www.webmd.com/infertility-and-reproduction/guide/understanding-infertility-symptoms#1. Accessed 2/3/2017.