Infertility can be a daunting subject, and it’s often associated with women. However, infertility can affect both women and men. A woman may be considered to have primary infertility if she has never been able to become pregnant. Also, a woman who’s had at least one successful pregnancy in the past but struggles to conceive or carry may be considered to have secondary infertility.

Men are considered infertile if they produce too little sperm. They are also infertile if their sperm is considered unhealthy to combine with a woman’s egg. It’s not too common for couples to struggle to get pregnant. However, there are factors involved that can make it difficult for others. Let’s go over what is infertility, the causes, and the treatments that your doctor may recommend for you and your partner.

What Is Infertility?

Infertility is defined as the inability to get pregnant after one year of unprotected sexual intercourse. For women over 35, an evaluation is recommended after six months of trying. If a woman is over 40, it’s advised to consult with her OB/GYN about pregnancy options.

Causes of Infertility

What causes infertility? Normally the most common cause of female infertility is an issue with ovulation. With males, the most common cause is sperm cells and how they’re functioning. Other factors could be:

• Age
• Lifestyle
• Health conditions

In some cases, there is no sign of any causes found. This is called unexplained infertility.

For younger couples in their early 20s to early 30s, the chances of pregnancy are about 25 to 30% during any menstrual cycle. However, starting in the early 30s, this number starts to decrease. By age 40, the chances of pregnancy drop to about 10% per menstrual cycle. Men’s fertility cannot be entirely predicted, however it does decline with age.

Common factors that affect fertility are factors such as weight. Women who are overweight, underweight, or engage in excessive exercise may find it more difficult to conceive. Other factors like smoking and drinking alcohol regularly or at heavy levels may also reduce fertility. For men, heavy drinking, smoking, and marijuana may reduce sperm count and sperm movement.

In women, health problems can affect overall fertility such as:

• Problems with their reproductive organs or hormones
• Scarring or blockages of the fallopian tubes (from past sexually transmitted infections [STIs] or endometriosis)
• Problems with the thyroid gland or pituitary gland
• In men, infertility can be caused when the tubes that carry sperm from the testicles are blocked.

Can Infertility Be Prevented or Avoided?

While some factors leading to infertility are beyond control, some steps may help prevent infertility. Maintaining a healthy lifestyle including a balanced diet and regular exercise, can improve fertility. Additionally, avoiding excessive alcohol, smoking, and recreational drug use is important. Regular check-ups with a professional OB/GYN and early intervention can also reduce the risk of infertility-related complications.

What Is the Treatment for Infertility?

Infertility treatment depends on the underlying cause. This may involve lifestyle changes, medications, surgery, or a combination of these. Below are some common treatment options available for both men and women:

• Lifestyle Changes: Adjusting diet, exercise, and reducing stress can enhance fertility.
• Medications: These are used to regulate hormones or stimulate ovulation.
• Surgery: Surgical procedures might correct issues such as blockages or damage to reproductive organs.
• Assisted Reproductive Technology (ART): This includes procedures like in vitro fertilization (IVF), where eggs are fertilized outside the body and then implanted into the uterus.

What Are the Different Types of Fertility Treatments?

Several fertility treatments are available depending on the specific issue causing infertility. The treatments range from simple medication to more complex procedures like IVF. Common treatments include:

• Ovulation Stimulation: Medications like clomiphene citrate or gonadotropins stimulate the ovaries to release eggs.
• Intrauterine Insemination (IUI): Healthy sperm is placed directly into the uterus to increase the chances of fertilization.
• IVF (In Vitro Fertilization): Eggs and sperm are combined outside the body and the resulting embryos are placed in the uterus.
• ICSI (Intracytoplasmic Sperm Injection): A single sperm is injected into an egg for fertilization, often used in cases of male infertility.

Doctors For Infertility

You should seek counsel from your OB/GYN first. They may refer you to an OB/GYN who specializes in infertility, known as a reproductive endocrinologist. Men may be referred to a urologist for evaluation.

Surgery For Infertility

In women, surgery may be used to:

• Repair blocked or damaged fallopian tubes
• Treat endometriosis, which is commonly associated with infertility
• Remove polyps or fibroids in the uterus

In men, surgery may be used to address common issues like swollen veins in the scrotum. This is a condition that can contribute to infertility. In some cases, this can be successfully treated through surgery.

Hormone Treatments For Infertility

In women, hormone treatment can be:

• Abnormal levels of hormones can cause problems with ovulation. Your specialist may check your hormone levels. If a hormone problem is found, treatment often can correct it. This treatment also may improve your chances of getting pregnant.
• Ovulation stimulation is the use of drugs to help your ovaries release an egg. This treatment is used when ovulation is irregular or absent, and other potential causes have been ruled out. Ovulation stimulation may be used with other infertility treatments.

Ovulation Stimulation

Ovulation stimulation uses oral drugs to help stimulate ovulation. These drugs include clomiphene citrate and aromatase inhibitors. During these drug treatments, the doctor will monitor if and when ovulation occurs. This is typically done by tracking your menstrual cycle or using an ovulation prediction kit, such as an at-home urine test. Blood tests or ultrasounds may also be used to give further insight.

Another drug used to help trigger ovulation is called Gonadotropins. These are used if other drugs are not successful and if many eggs are needed for infertility treatments. Gonadotropins are administered as a series of shots during the early part of the menstrual cycle. To track this progress, blood tests and ultrasound exams are used to monitor the development of the follicles.

Once the test results show that the follicles have reached a certain size, another drug may be administered to signal a follicle to release its matured egg.

Are There Any Risks?

• Multiple pregnancy is a risk when women are treated with clomiphene citrate, aromatase inhibitors, and gonadotropins. The risk is higher with gonadotropins. If too many eggs are developing, your specialist may postpone the cycle to reduce the chance of a multiple pregnancy.
• Ovulation stimulation, especially with gonadotropins, can lead to ovarian hyperstimulation syndrome. Most cases of this condition are mild. In severe cases, a hospital stay may be needed. Women taking medication to stimulate ovulation are monitored for this condition.

Intrauterine Insemination

Intrauterine insemination or IUI, is when the healthy sperm is placed inside the uterus. Combined with ovulation stimulation, the sperm is timed to be placed as close to ovulation as possible.

Are There Any Risks?

If IUI is combined with ovulation drugs like Gonadotropins, the risk of multiple pregnancies can occur. This means too many eggs developed at the same time around insemination. If this is the case, insemination may be postponed.

Assisted Reproductive Technology (ART)

This means all fertility treatments are used and both the sperm and the eggs are handled. The art of ART normally also involves IVF or in vitro fertilization. IVF is when the sperm is combined with the egg in a lab and then the entire embryo is transferred into the uterus. IVF may be used when the causes of infertility include:

• Damaged or blocked fallopian tubes that cannot be treated with surgery
• Severe endometriosis
• Primary ovarian insufficiency
• Some male infertility factors
• Unexplained infertility

In Vitro Fertilization

This treatment happens in cycles. These cycles don’t always work the first time and may take more than one to have a successful conception and pregnancy. The steps for in vitro fertilization are:

• Obtaining an Egg: Ovulation usually is triggered with gonadotropins so that multiple eggs are produced. When your eggs are ready, a needle is used to remove mature eggs from the ovaries.
• Fertilization of Eggs by the Sperm: This can be done in two ways: 1) the sperm can be added to the eggs in a laboratory, or 2) a single sperm can be injected into each egg. The eggs are checked the next day to see if they have been fertilized.
• Embryo Transfer: A few days after fertilization, one or more embryos are placed in the uterus through the vagina. Healthy embryos that are not transferred may be frozen and stored.

Are There Any Risks?

There’s an even higher risk for multiple pregnancies with IVF. Doctors will run tests that help suggest if too many eggs are developing at once. If this happens, the shot to trigger ovulation may be delayed or postponed. Your healthcare provider might also reduce the number of embryos transferred to your uterus for added caution.

There are so many treatment options and combinations to help with infertility. Keep in mind that these options require time, and commitment, and can sometimes be costly.

The doctors at Rosh Maternal & Fetal Medicine specialize in high-risk obstetrics. Simply put, they’re trusted experts in high-risk pregnancies. So, you’ll receive the highest quality care. They provide holistic prenatal care and all the advanced medical procedures you may need!

Struggling with Infertility? Our Doctors Are Here to Help!

The doctors at Rosh Maternal & Fetal Medicine are experts at determining the precise cause of your issues and can help in initiating a customized treatment plan to correct the underlying cause. Don’t wait to get medical help!

Any underlying health problems should be treated to prevent more serious problems from developing. You can count on the extensive experience of the doctors at Rosh Maternal & Fetal Medicine to identify the cause. We will effectively treat and guide you through your infertility concerns. If you have any questions about your fertility and the treatments we offer, call our office in the Midtown East area of New York City, or schedule an appointment online.