Infertility

If you and your partner are struggling to have a baby, you're not alone. Infertility is defined as not being able to get pregnant despite having frequent, unprotected sex for at least a year for most couples.
Infertility may result from an issue with either you or your partner, or a combination of factors that interfere with pregnancy. Fortunately, there are many safe and effective therapies that significantly improve your chances of getting pregnant.

Symptoms

The main symptom of infertility is not getting pregnant. There may be no other obvious symptoms. Sometimes, an infertile woman may have irregular or absent menstrual periods. Rarely, an infertile man may have some signs of hormonal problems, such as changes in hair growth or sexual function.
Most couples will eventually conceive, with or without treatment.

When to see a doctor

You probably don't need to see a doctor about infertility unless you have been trying regularly to conceive for at least one year. Talk with your doctor earlier, however, if you're a woman and:

• You're age 35 to 40 and have been trying to conceive for six months or longer
• You're over age 40
• You menstruate irregularly or not at all
• Your periods are very painful
• You have known fertility problems
• You've been diagnosed with endometriosis or pelvic inflammatory disease
• You've had multiple miscarriages
• You've undergone treatment for cancer

Talk with your doctor if you're a man and:

• You have a low sperm count or other problems with sperm
• You have a history of testicular, prostate or sexual problems
• You've undergone treatment for cancer
• You have testicles that are small in size or swelling in the scrotum known as a varicocele
• You have others in your family with infertility problems

Causes of female infertility

Causes of female infertility may include:

• Ovulation disorders, which affect the release of eggs from the ovaries. These include hormonal disorders such as polycystic ovary syndrome. Hyperprolactinemia, a condition in which you have too much prolactin — the hormone that stimulates breast milk production — may also interfere with ovulation. Either too much thyroid hormone (hyperthyroidism) or too little (hypothyroidism) can affect the menstrual cycle or cause infertility. Other underlying causes may include excessive exercise, eating disorders, injury or tumors.
• Uterine or cervical abnormalities, including abnormalities with the opening of the cervix, polyps in the uterus or the shape of the uterus. Noncancerous (benign) tumors in the uterine wall (uterine fibroids) may rarely cause infertility by blocking the fallopian tubes. More often, fibroids interfere with implantation of the fertilized egg.
• Fallopian tube damage or blockageoften caused by inflammation of the fallopian tube (salpingitis). This can result from pelvic inflammatory disease, which is usually caused by a sexually transmitted infection, endometriosis or adhesions.
• Endometriosis, which occurs when endometrial tissue grows outside of the uterus, may affect the function of the ovaries, uterus and fallopian tubes.
• Primary ovarian insufficiency (early menopause), when the ovaries stop working and menstruation ends before age 40. Although the cause is often unknown, certain factors are associated with early menopause, including immune system diseases, certain genetic conditions such as Turner syndrome or carriers of Fragile X syndrome, radiation or chemotherapy treatment, and smoking.
• Pelvic adhesions, bands of scar tissue that bind organs after pelvic infection, appendicitis, or abdominal or pelvic surgery. Other causes in women include:
• Cancer and its treatment. Certain cancers — particularly female reproductive cancers — often severely impair female fertility. Both radiation and chemotherapy may affect fertility.
• Other conditions. Medical conditions associated with delayed puberty or the absence of menstruation (amenorrhea), such as celiac disease, poorly controlled diabetes and some autoimmune diseases such as lupus, can affect a woman's fertility. Genetic abnormalities also can make conception and pregnancy less likely.