Infertility and being sterile are different. Infertility—or, more accurately, subfertility—is diagnosed if a couple is unable to conceive a child after having well-timed, unprotected intercourse over the course of a 12-month time period. It does not mean you may never get pregnant. Sterility is diagnosed after a thorough medical examination indicates the patient has no uterus, no ovaries, no egg production or no sperm production.
Infertility affects approximately one in eight couples in the United States, or about 15% of the population.
Infertility is found in both men and women and it affects nearly an equal number of men and women. Approximately one-third of infertility is attributed to the female partner, one-third is attributed to the male partner and one-third is caused by a combination of problems in both partners. However, about 20 percent of infertility cases remain “unexplained” even after a full diagnostic work-up.
If the woman is under the age of 35 and has been trying to conceive for more than one year, we recommend that the couple consult a fertility specialist.
If the woman is over the age of 35 and has been trying to conceive for more than six months, we recommend that the couple consult a fertility specialist.
Symptoms for women can include:
- Abnormal, irregular or painful periods
- No periods
- Skin changes, including more acne
- Changes in sex drive and desire
- Dark hair growth on the lips, chest and chin
- Loss of hair or thinning hair
- Unexplained weight gain
- Hot flashes
- Painful intercourse or inability to have intercourse
- Milky breast discharge
Symptoms for men can include:
- Pain, lump or swelling in the testicles
- Problems with erections and ejaculations
- Small, firm testicles
- Changes in hair growth
- Changes in sexual desire
Yes. Age is the single most important factor that influences a woman’s fertility. A woman is born with all the eggs she will ever have. As a woman ages, her eggs also age, and they diminish in quantity and quality. Currently, there are no methods or treatments available to stop or reverse that process. At age 30, a woman’s chance of conceiving each month is about 20 percent. At 40, it’s about 5 percent.
Yes. The quality of a man’s sperm decreases with age starting at age 40. Declining fertility, however, occurs much more slowly in men than in women.
A fertility evaluation should begin with a medical history of both the female and male partners. Both partners will then be asked to undergo a physical exam, including a gynecological exam and pelvic ultrasound for the woman.
A semen analysis will be performed on the man, and a hormone screening will be performed on the woman.
A woman may also undergo an evaluation of tubal patency (whether the fallopian tubes are open or blocked) and the uterine cavity.
The most common treatments for infertility are intrauterine insemination (IUI) and in vitro fertilization (IVF). The fertility specialist will evaluate each couple individually and discuss a personalized treatment plan with each couple based on their specific circumstances. In some cases, reassurance may be all that’s needed.