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Infertility

Although infertility is a painful and sensitive issue, it is important to realize that you are not alone. Infertility affects millions of couples in the United States, as many as 12% of the reproductive-age population. With modern advanced reproductive techniques, even severe cases of infertility can often be treated successfully.

Infertility is often defined as not being able to conceive after 6 months to 1 year of unprotected sex.  There are various reason that may cause infertility. Lot of times the reason for infertility is unknown. Couples over the age of 32 should seek assistance from an expert fertility doctor if they're unable to get pregnant after 6 months of well-timed, unprotected sex. By working with a knowledgeable reproductive endocrinologist, you can often find the right treatment for better chances of conception.

Causes of Infertility

In general, in order for one to get pregnant, there are three basic needs.

  1. The woman needs to produce eggs and ovulate.
  2. The man has to produce sperm of normal count and quality.
  3. The woman's uterus and tubes have to be normal and accommodating to pregnancy.
Thus, the causes of infertility can be divided into three categories.
  • The first category is anovulation, or lack of ovulation, which means that the woman may not be getting pregnant because she simply does not produce eggs and does not ovulate. There are many different causes for a woman not to ovulate, including polycystic ovarian syndrome, hypothalamic dysfunction, obesity, ovarian failure, and menopause, among other causes. Further, multiple factors may contribute to a lack of ovulation, including poor nutrition, extreme weight (either low or high), smoking, drinking, and stress.

  • The second category of infertility is a low sperm count, abnormal sperm or absent sperm from the semen. Causes of low sperm quality are multiple, including varicocele, vasectomy, sperm antibodies, history of trauma or infection in the testicles, chemical exposure, genetic causes, and environmental causes.

  • The third category of infertility is uterine or tubal factor. Causes of blocked tubes can be prior infection with chlamydia, history of endometriosis, ectopic pregnancy, and pelvic surgery that may have damaged the tube. Causes of problems with the uterus include fibroids; polyps; congenital problems such as septet or bicornuate uterus; and history of uterine surgery, including myomectomy or hysteroscopy, which may cause adhesions in the uterus.

Infertile patients may often suffer from a combination of these factors, for example a couple with low sperm count in the male partner and ovulation or tubal problems with the female partner.

In some cases (about 15%), the cause of infertility cannot be determined even after a thorough fertility evaluation. This is known as unexplained infertility.

*** Recently new studies have proved the impact of stress on sex and fertility. Stress can affect the quality and quantity of sperm among male and egg for female.

    ***Infertility question? of the day

    From Natalie (Santa Monica, CA)
    Dr. Saadat, I am 41 year old women with a low AMH ( MY AMH was 0.58) what can I do to improve my chances of pregnancy with in vitro fertilization (IVF). I have been to three other fertility centers and have done 4 prior IVF. I have made 4 eggs once, 3 eggs twice and 2 last time I did IVF. Please advise me . Is there any supplement or dietary advise that you can suggest that may make me have a better outcome next time. Thank You Natalie.

    "Dear Natalie,
    I can tell you from many patients that we have treated in your age group with similar conditions. There are some fertility supplements that may be of beneficial to you. These may include DHEA and Co Q10.

    We have used this supplements in our fertility clinic for years, recently there are some scientific data to explain the scientific background on how these co enzymes may work in favor of improving not only your egg quality but perhaps then number of follicles you may produce. In addition, there are other parameters to look at such as the type of protocols you used, if you have any deficiency is your body such as thyroid and vitamin D, and if you have been given adequate prenatal vitamins with omega three.

    I would be happy to review your records and make detail suggestions based on your records".

    Thanks

    Peyman Saadat, MD