Infertility

Piedmont Preferred Women's Healthcare

OB-GYNs located in Ridgeway, VA & Eden, NC

What is infertility? In general, infertility is defined as not being able to get pregnant (conceive) after one year (or longer) of unprotected sex. Because fertility in women is known to decline steadily with age, some providers evaluate and treat women aged 35 years or older after 6 months of unprotected sex.

How common is infertility?

An estimated 1 in 10 women between the ages of 15 and 44 have trouble conceiving.

Women who have pregnancy problems may lose the baby:

Before the 20th week of pregnancy (miscarriage).
After the 20th week of pregnancy (stillbirth).

What are the types of infertility?

Types of infertility include:

Primary: A woman who was never pregnant and who can’t conceive after one year of not using birth control.
Secondary: Secondary infertility occurs when a woman can’t get pregnant again after having at least one successful pregnancy.

What are risk factors for infertility in all genders?

These factors increase the risk of infertility in all genders:

Age (over age 35 for women or over 40 for men).
Diabetes.
Eating disorders, including anorexia nervosa and bulimia
Excessive alcohol use
Exposure to environmental toxins, such as lead and pesticides
Over exercising
Radiation therapy or other cancer treat

How is female infertility diagnosed?

Your healthcare provider may ask you to record signs of ovulation, such as basal body temperature and cervical mucus. You may also use a home ovulation kit.

These tests can also help diagnose or rule out a female fertility problem:

Pelvic exam: Your provider will perform a pelvic exam, including a Pap smear to check for structural problems or signs of disease.
Blood test: A blood test can check hormone levels, including thyroid hormones.
Transvaginal ultrasound: Your doctor inserts an ultrasound wand into the vagina to look for problems with the reproductive system.
Hysteroscopy: Your provider inserts a thin, lighted tube (hysteroscope) into the vagina to examine the uterus.
Saline sonohysterogram (SIS): Your provider fills the uterus with saline (sterilized salt water) and conducts a transvaginal ultrasound. A full uterus makes it easier to see inside the uterus.
Hysterosalpingogram (HSG): X-rays capture an injectable dye as it travels through the fallopian tubes. This test looks for blockages.
Laparoscopy: Your provider inserts a laparoscope (thin tube with a camera) into a small abdominal incision. Female pelvic laparoscopy helps identify problems like endometriosis, uterine fibroids and scar tissue.

How is male infertility diagnosed?

These tests can help diagnose or rule out a male fertility problem:

Semen analysis: This test checks for problems with sperm, such as low sperm count and poor mobility. Some men need a needle biopsy to remove sperm from the testicles and test it. For most men, this is the only test that will be needed in the workup of infertility.
Blood test: A blood test can check testosterone, thyroid and other hormone levels. Genetic blood tests look for chromosomal abnormalities.
Scrotal ultrasound: An ultrasound of the scrotum identifies varicoceles or other testicular problems.

When should you seek help for infertility?

Women under the age of 35 who aren’t pregnant after one year of trying should see a healthcare provider. You should seek help sooner (after six months of trying) if you’re older than 35. A woman’s chances of getting pregnant decrease with age. A 30-year-old woman is half as fertile as a 20-year-old woman.

Regardless of gender, you should seek help early if you have a risk factor that affects fertility.

How is female infertility treated?

Treatments for infertility include:

Medications: Fertility drugs change hormone levels to stimulate ovulation.
Surgery: Surgery can open blocked fallopian tubes and remove uterine fibroids and polyps. Surgical treatment of endometriosis doubles a woman’s chances of pregnancy.

How is male infertility treated?

Treatments for male infertility include:

Medications: Medications can raise testosterone or other hormone levels. There are also drugs for erectile dysfunction.
Surgery: Some men need surgery to open blockages in the tubes that store and carry sperm. Varicocele surgery can make sperm healthier and can improve the odds of conception.

What are fertility treatment options for all genders?

Some couples need more help conceiving. To increase pregnancy odds, a woman may first take medications to stimulate ovulation before trying one of these options:

Intrauterine insemination (IUI): A healthcare provider uses a long, thin tube to place sperm directly into the uterus.
In vitro fertilization (IVF): IVF is a type of assisted reproductive technology (ART). It involves harvesting the eggs at the end of the stimulation and placing sperm and eggs together in a lab dish. The sperm fertilize the eggs. A provider transfers one of the fertilized eggs (embryo) into the uterus.
Intracytoplasmic sperm injection (ICSI): This procedure is similar to IVF. An embryologist (highly specialized lab technician) directly injects a single sperm into each of the harvested eggs and then a provider transfers an embryo into the uterus.
Third-party ART: Couples may use donor eggs, donor sperm or donor embryos. Some couples need a gestational carrier or surrogate. This person agrees to carry and give birth to your baby.

Credit to: Cleveland Clinic

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