Infertility (patient information)

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Infertility

Overview

What are the symptoms?

What are the causes?

When to seek urgent medical care?

Diagnosis

Treatment options

Where to find medical care for Infertility?

What to expect (Outlook/Prognosis)?

Possible complications

Prevention

Infertility On the Web

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Infertility in the news

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Directions to Hospitals Treating Infertility

Risk calculators and risk factors for Infertility

Editor-in-Chief: C. Michael Gibson, M.S.,M.D. [1] Phone:617-632-7753; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S.

## Contents

* 1 Overview
* 2 What are the symptoms of Infertility?
* 3 What causes Infertility?
* 4 When to seek urgent medical care?
* 5 Diagnosis
* 6 Treatment options
* 7 Where to find medical care for Infertility?
* 8 What to expect (Outlook/Prognosis)?
* 9 Possible complications
* 10 Prevention
* 11 Support groups
* 12 Source

## Overview

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* Infertility means you cannot make a baby (conceive).

* Infertility is grouped into two categories:

* Primary infertility refers to couples who have not become pregnant after at least 1 year of unprotected sex (intercourse).
* Secondary infertility refers to couples who have been pregnant at least once, but never again.

## What are the symptoms of Infertility?

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* The main symptom of infertility is the inability to become pregnant. Specific symptoms depend on what is causing the infertility.

* Infertility can cause many painful emotions in one or both partners.

## What causes Infertility?

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* A wide range of physical and emotional factors can cause infertility. Infertility may be due to problems in the woman, man, or both.

FEMALE INFERTILITY:

* Female infertility may occur when:

* A fertilized egg or embryo does not survive once it sticks to the lining of the womb (uterus)
* The fertilized egg does not attach to the lining of the uterus
* The eggs cannot move from the ovaries to the womb
* The ovaries have problems producing eggs

* Female infertility may be caused by:

* Autoimmune disorders, such as antiphospholipid syndrome (APS)
* Cancer or tumor
* Clotting disorders
* Diabetes
* Growths (such as fibroids or polyps) in the uterus and cervix
* Birth defects that affect the reproductive tract
* Excessive exercising
* Eating disorders or poor nutrition
* Use of certain medications, including chemotherapy drugs
* Drinking too much alcohol
* Obesity
* Older age
* Ovarian cysts and polycystic ovary syndrome (PCOS)
* Pelvic infection or pelvic inflammatory disease (PID)
* Scarring from sexually transmitted infection or endometriosis
* Thyroid disease
* Too little or too much hormones

MALE INFERTILITY:

* Male infertility may be due to:

* A decrease in sperm count
* Sperm being blocked from being released
* Sperm that do not work properly

* Male infertility can be caused by:

* Environmental pollutants
* Being in high heat for prolonged periods
* Birth defects
* Heavy use of alcohol, marijuana or cocaine
* Too little or too much hormones
* Impotence
* Infection
* Older age
* Cancer treatments, including chemotherapy and radiation
* Scarring from sexually transmitted diseases, injury, or surgery
* Retrograde ejaculation
* Smoking
* Use of certain drugs, such as cimetidine, spironolactone, and nitrofurantoin

* In healthy couples under age 30 who have sex regularly, the chance of getting pregnant is about 25 - 30% per month.

* A woman's peak fertility occurs in her early 20s. After age 35 (and especially 40), the chances that a woman can get pregnant drops considerably.

## When to seek urgent medical care?

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Call for an appointment with your health care provider if you are unable to get pregnant.

## Diagnosis

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* When you should seek treatment for infertility depends on your age. It is recommended that women under 30 should generally try to get pregnant on their own for 1 year before seeking testing.

* Infertility testing involves a complete medical history and physical examination of both partners.

* Blood and imaging tests will be done.

* In women, this may include:

* Blood tests to check hormone levels, including progesterone and follicle stimulating hormone
* Checking body temperature first thing in the morning to check if the ovaries are releasing eggs
* FSH and clomid challenge test
* Hysterosalpingography (HSG)
* Pelvic ultrasound
* Laparoscopy
* Luteinizing hormone urine test (ovulation prediction)
* Thyroid function tests

* Tests in men may include:

* Sperm testing
* Testicular biopsy (rarely done)

## Treatment options

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* Treatment depends on the cause of infertility.

* It may involve:

* Education and counseling
* Fertility treatments such as intrauterine insemination (IUI) and in vitro fertilization (IVF)
* Medicines to treat infections and clotting disorders
* Medicines that help the woman grow and release eggs from the ovaries

* It is important to recognize and discuss the emotional impact that infertility has on you and your partner, and to seek medical advice from your health care provider.

* You can increase your chances of becoming pregnant each month by having sex at least every 3 days before and during ovulation. It is especially important to do so 72 hours before ovulation begins.

* Ovulation occurs about 2 weeks before the next menstrual cycle (period) starts. If a woman gets her period every 28 days, the couple should have sex at least every 3 days between the 10th and 18th day after the period starts.

## Where to find medical care for Infertility?

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Directions to Hospitals Treating Infertility

## What to expect (Outlook/Prognosis)?

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* As many as 1 in 5 couples diagnosed with infertility eventually become pregnant without treatment.

* More than half of couples with infertility become pregnant after treatment, not including advanced techniques such as in vitro fertiliziation (IVF).

## Possible complications

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* Infertility can have a big emotional impact on you and your partner.
* Depression, anxiety, and marriage problems may occur.

## Prevention

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* Preventing sexually transmitted infections (STIs), such as gonorrhea and chlamydia, may reduce your risk of infertility.

* Maintaining a healthy diet, weight, and lifestyle may increase your chances for getting pregnant and having a healthy pregnancy.

* Take a prenatal or multivitamin containing folate before and during pregnancy. This lowers your risk for miscarriage and developmental problems in the baby.

## Support groups

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* Centers for Disease Control and Prevention
* March of Dimes

## Source

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http://www.nlm.nih.gov/medlineplus/ency/article/001191.htm

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