More Information About Infertility

Understanding Infertility

“Infertility” is technically defined as the "failure to conceive following one year of unprotected sexual intercourse" and it is generally accepted that for healthy heterosexual couples this extends to "failure to conceive following one year of unprotected intercourse if under 35 years of age - or failure to conceive following six months of unprotected intercourse if over 35."

While this is a good baseline barometer surrounding infertility, every situation is different. Some couples have more specific infertility risk factors, such as women with a history of pelvic infection or men with a history of undescended testicles, and should be evaluated by an infertility specialist as soon as they plan on starting a family.

Individualized initial infertility evaluations should be conducted by an infertility specialist, taking into consideration the medical history of the couple and the age of the female partner. The team at Pacific NW Fertility works directly with every new patient to determine the diagnosis and best possible treatment options.


What Causes Infertility

There are many common causes of infertility such as endometriosis and Polycystic Ovarian Disease (PCOS); however there are other factors such as age (postponing childbearing), anorexia, obesity, substance abuse, environmental toxins, and sexually transmitted diseases, which can also affect reproduction.

The most common reason for infertility in women is due to an ovulation disorder that may prevent the development of a viable egg. Other common reasons include blockage of the fallopian tubes (which can be caused by endometriosis, pelvic inflammatory disease (PID), adhesions and scarring), a poor ovarian reserve or ovarian failure caused by aging or other factors, or a defect that affects the movement of the egg into the uterus or prevents implantation.

True infertility only occurs in a few specific situations, which are: Women who do not have a uterus or any egg follicles – i.e. women who experience menopause or Premature Ovarian Failure (POF) Women who have blocked fallopian tubes Men who do not have any sperm Besides the three diagnoses above, patients may have some degree of sub fertility, which means that over a period of time, there is still a chance that these couples could conceive naturally without medical intervention.


Common Fertility Disorders

Some of the more common fertility disorders and diagnoses include:

Age: The probability of having a baby decreases by 3 - 5% a year after age 30 and even faster after the age of 40. Some women are very fertile into their early 40's, while others become less fertile in their mid-to-late 30's.

Cervical Factors: Some women’s mucous does not thin around the time of ovulation as it should, and consequently this prevents the sperm from traveling through it. Infertility in this case is often caused by a cervical infection.

Diethylstilbestrol (DES): DES is a synthetic estrogen hormone that was given to women who were at risk of miscarrying, during the 1950s and 1960s. It has been found that the children or women who took DES are at a high risk for certain reproductive tract cancers and menstrual irregularities. Many “DES girls” have an abnormally shaped uterus that can lead to repeated miscarriages.

Endometriosis: Endometriosis is a painful, non-cancerous condition of the endometrium, which affects an estimated 70 percent (5.5 million) American women. Typically, women shed the endometrium during menstruation, but with endometriosis the tissue is not shed and it builds up, which causes inflammation, internal bleeding and scar tissue.

Ovulation Disorders: Any disruption of the brain that regulates ovulation can cause low levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) which affects ovulation. Some causes include injury, tumors, excessive exercise and starvation, or elevated levels of the hormone prolactin, which stimulates breast milk production.

Pelvic Adhesions: Scar tissue can hinder fertility, specifically bands of scar tissue that bind organs after pelvic infection, appendicitis, or abdominal or pelvic surgery. Recurrent Pregnancy Loss: Recurrent pregnancy loss is defined as 3 or more miscarriages; however, a woman who is 35 years old or older with 2 miscarriages should consider a consult. An evaluation would include a thorough screening with one of our specialists and may include blood tests, genetic screening of both partners, and imaging of the uterine cavity. Treatments may include medication, close monitoring, or preimplantation genetic diagnosis, but are very specific to each patient.

Polycystic Ovarian Syndrome (PCOS): This disease is characterized by a woman’s body producing too much androgen/testosterone (a male hormone) in which case the ovaries' follicles bunch up and lump together, or become cystic. These cysts don’t release mature eggs and can cause a woman to not ovulate, not have a period that month or not have any period at all. PCOS is associated with insulin resistance and obesity, and it’s estimated that one in 10 American women will be diagnosed with this disease.

STD's: Sexually transmitted diseases such as gonorrhea, chlamydia, or pelvic inflammatory disease (PID), can in some cases compromise a woman’s ability to conceive and bear a child.

Tubal Factors: It is estimated that abnormality of the fallopian tubes accounts for 20-30 percent of infertility in couples. This abnormality could be scarring, blockage or damage caused from previous surgery, infection, or a previous tubal ligation.

Benign Uterine Fibroids: Found in and around the uterus, benign uterine fibroids are non-cancerous tumors which are most common in women of childbearing age, and very prevalent in women in their 30s. Pain during your menstrual cycle, excess bleeding and bleeding between periods, can be symptomatic of uterine fibroids.

Uterine Factors: Abnormal reproductive organs may make it difficult for the fertilized egg to implant.

Unexplained Infertility: Unfortunately, there is still no obvious cause of infertility in 10-20 percent of couples.

She weighed 8lbs 7oz and is the most beautiful being I have ever laid eyes on. We were instantly in love, and I'd do it a thousand times again for her. It was painful, heartbreaking, and scary but the moment I laid eyes on my baby girl, it all melted away. I still will look at her, and can't believe she's mine. That it actually worked. She's my everything, and we're so lucky, and finally a family.

Amanda
Pacific NW Fertility Patient

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