Infertility (patient information)

For the WikiDoc page for this topic, click here

Editor-in-Chief: C. Michael Gibson, M.S.,M.D. [mailto:mgibson@perfuse.org] Phone:617-632-7753; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S.

Overview

 * Infertility means you cannot make a baby (conceive).


 * Infertility is grouped into two categories:
 * Primary infertility refers to couples who have not become pregnant after at least 1 year of unprotected sex (intercourse).
 * Secondary infertility refers to couples who have been pregnant at least once, but never again.

What are the symptoms of Infertility?

 * The main symptom of infertility is the inability to become pregnant. Specific symptoms depend on what is causing the infertility.


 * Infertility can cause many painful emotions in one or both partners.

What causes Infertility?

 * A wide range of physical and emotional factors can cause infertility. Infertility may be due to problems in the woman, man, or both.

FEMALE INFERTILITY:


 * Female infertility may occur when:
 * A fertilized egg or embryo does not survive once it sticks to the lining of the womb (uterus)
 * The fertilized egg does not attach to the lining of the uterus
 * The eggs cannot move from the ovaries to the womb
 * The ovaries have problems producing eggs


 * Female infertility may be caused by:
 * Autoimmune disorders, such as antiphospholipid syndrome (APS)
 * Cancer or tumor
 * Clotting disorders
 * Diabetes
 * Growths (such as fibroids or polyps) in the uterus and cervix
 * Birth defects that affect the reproductive tract
 * Excessive exercising
 * Eating disorders or poor nutrition
 * Use of certain medications, including chemotherapy drugs
 * Drinking too much alcohol
 * Obesity
 * Older age
 * Ovarian cysts and polycystic ovary syndrome (PCOS)
 * Pelvic infection or pelvic inflammatory disease (PID)
 * Scarring from sexually transmitted infection or endometriosis
 * Thyroid disease
 * Too little or too much hormones

MALE INFERTILITY:


 * Male infertility may be due to:
 * A decrease in sperm count
 * Sperm being blocked from being released
 * Sperm that do not work properly


 * Male infertility can be caused by:
 * Environmental pollutants
 * Being in high heat for prolonged periods
 * Birth defects
 * Heavy use of alcohol, marijuana or cocaine
 * Too little or too much hormones
 * Impotence
 * Infection
 * Older age
 * Cancer treatments, including chemotherapy and radiation
 * Scarring from sexually transmitted diseases, injury, or surgery
 * Retrograde ejaculation
 * Smoking
 * Use of certain drugs, such as cimetidine, spironolactone, and nitrofurantoin


 * In healthy couples under age 30 who have sex regularly, the chance of getting pregnant is about 25 - 30% per month.


 * A woman's peak fertility occurs in her early 20s. After age 35 (and especially 40), the chances that a woman can get pregnant drops considerably.

When to seek urgent medical care?
Call for an appointment with your health care provider if you are unable to get pregnant.

Diagnosis

 * When you should seek treatment for infertility depends on your age. It is recommended that women under 30 should generally try to get pregnant on their own for 1 year before seeking testing.


 * Infertility testing involves a complete medical history and physical examination of both partners.


 * Blood and imaging tests will be done.


 * In women, this may include:
 * Blood tests to check hormone levels, including progesterone and follicle stimulating hormone
 * Checking body temperature first thing in the morning to check if the ovaries are releasing eggs
 * FSH and clomid challenge test
 * Hysterosalpingography (HSG)
 * Pelvic ultrasound
 * Laparoscopy
 * Luteinizing hormone urine test (ovulation prediction)
 * Thyroid function tests


 * Tests in men may include:
 * Sperm testing
 * Testicular biopsy (rarely done)

Treatment options

 * Treatment depends on the cause of infertility.


 * It may involve:
 * Education and counseling
 * Fertility treatments such as intrauterine insemination (IUI) and in vitro fertilization (IVF)
 * Medicines to treat infections and clotting disorders
 * Medicines that help the woman grow and release eggs from the ovaries


 * It is important to recognize and discuss the emotional impact that infertility has on you and your partner, and to seek medical advice from your health care provider.


 * You can increase your chances of becoming pregnant each month by having sex at least every 3 days before and during ovulation. It is especially important to do so 72 hours before ovulation begins.


 * Ovulation occurs about 2 weeks before the next menstrual cycle (period) starts. If a woman gets her period every 28 days, the couple should have sex at least every 3 days between the 10th and 18th day after the period starts.

Where to find medical care for Infertility?
Directions to Hospitals Treating Infertility

What to expect (Outlook/Prognosis)?

 * As many as 1 in 5 couples diagnosed with infertility eventually become pregnant without treatment.


 * More than half of couples with infertility become pregnant after treatment, not including advanced techniques such as in vitro fertiliziation (IVF).

Possible complications

 * Infertility can have a big emotional impact on you and your partner.
 * Depression, anxiety, and marriage problems may occur.

Prevention

 * Preventing sexually transmitted infections (STIs), such as gonorrhea and chlamydia, may reduce your risk of infertility.


 * Maintaining a healthy diet, weight, and lifestyle may increase your chances for getting pregnant and having a healthy pregnancy.


 * Take a prenatal or multivitamin containing folate before and during pregnancy. This lowers your risk for miscarriage and developmental problems in the baby.

Support groups

 * Centers for Disease Control and Prevention
 * March of Dimes

Source
http://www.nlm.nih.gov/medlineplus/ency/article/001191.htm