Infertility Causes and Treatments
Approximately 11-percent of couples of reproductive age will have difficulty conceiving. The number of couples seeking care for infertility related problems has increased over the last several years. No one really knows if the incidence of infertility is increasing, or if public awareness is responsible for the increased physician visits. Premier Fertility Center offers all diagnostic and treatment services for infertility including IVF and a donor egg program.
Infertility was once considered a “female problem” but we now know that sperm abnormalities (male factor infertility) are present in up to half of all couples. Certainly, this awareness has increased consults for evaluation of the male. Premier Fertility Center has a "world class" reproductive laboratory.
The American Society for Reproductive Medicine defines infertility in women less than 35 years of age as the inability to conceive after one year of unprotected intercourse. The incidence of infertility in females increases dramatically after the age of 35 and these women are often counseled to seek care after only 6 months of trying.
Significantly more women are waiting until later in life to have children. Often they want to establish their careers first, or are marrying at older ages. These societal trends have contributed to the overall increase in assisted reproductive technology cycles (IVF) especially donor egg. Unfortunately, the biological clock does not sync with these new societal morays, as women are most fertile in their teens and early twenties.
Female aging ultimately leads to reduced ovarian reserve (lower quality eggs) meaning the eggs are less likely to fertilize and develop normally. This condition is often first diagnosed by high FSH hormone levels on day 3-4 of the menstrual cycle. Oftentimes the Clomid Challenge Test will be administered to predict how a woman will respond to fertility drugs (FSH). Women aged 35 or older who suspect they may be infertile should consult a fertility specialist immediately. Many of these women can only become pregnant using donor eggs. The good news is that women in their forties and fifties can become pregnant using donor eggs as long as their overall health is good.
In order for pregnancy to occur the following processes must occur:
• Follicles, each of which contains an egg, must be recruited and develop under the influence of follicle stimulating hormone (FSH). As healthy follicles grow, they produce increasing amounts of estrogen.
• The endometrium must thicken and become more vascular under the influence of estrogen and progesterone so that an embryo can implant and develop.
• The eggs must reach maturity and be “ovulated” after a surge in luteinizing hormone (LH).
• The eggs must travel unimpeded through the fallopian tubes to the distal end where fertilization occurs. "Scarred" or blocked fallopian tubes are a major cause of infertility.
• The male must develop viable sperm that can be ejaculated into the vagina. Sperm development requires three months and sperm quality today is a reflection of conditions three months earlier. The semen analysis is one of the most important fertility tests. We have expert technicians at our fertility clinic.
• The sperm swim through the cervical mucus into the uterus and ultimately to the end of the fallopian tubes. The mucus must be the correct consistency and be free of antisperm antibodies.
• A sperm must attach to, and penetrate, an egg.
• The genetic material of the male and female must combine to result in the proper number of chromosomes with no breaks or other abnormalities. An abnormal number of chromosomes can lead to miscarriage.
• The fertilized egg must travel into the uterus and embed in the endometrium.
• The leftover follicle, known as the corpus luteum, must produce progesterone to support the embryo.
• The embryo must undergo normal cell development resulting in a healthy fetus.
• The placenta forms and must produce progesterone to support the pregnancy.
• The fetus must be carried to term and delivery.
If any of these processes fail, infertility is often the result.
To learn more about the causes of infertility, click here.