Source: University of Alabama at Birmingham Medicine
There are several complex processes that must occur in order for you to become pregnant and carry a baby to term. Disruption of any of these processes can lead to infertility. The physicians in UAB’s infertility program are specially-equipped to diagnose the cause of infertility and begin treatment to help you and your partner get pregnant.
Some common causes of infertility include:
Infertility in couples is not always confined to the woman. In fact, research data suggests that nearly half of all infertile couples have a male component. When facing infertility, a male semen analysis is one of the most important tests that a couple can have, and should be completed early in the infertility evaluation.
There are numerous conditions that can lead to irregular or absent ovulation. Treatments for ovulatory disorders seek to correct the underlying cause and/or stimulate ovulation. This is usually accomplished by correcting any behaviors associated with the disorder and by prescription drugs.
Polycystic Ovarian Disease (PCOS)
PCOS, also known as polycystic ovarian disease (PCOD), is a common cause of infertility in women. PCOS is characterized by a cluster of symptoms that are seen in most women who have the syndrome.
Endometriosis occurs when cells that line the uterus (endometrium) attach to organs such as the ovaries and intestine. Endometriosis is a common cause of infertility and is often accompanied by severe menstrual cramps, painful bowel movements or urination, pain during intercourse, and pelvic pain. Endometriosis may cause no pain yet still cause infertility.
Approximately 15 percent of pregnancies end between week four and week 20 in miscarriage, also known as spontaneous abortion. Spontaneous abortion means the pregnancy ends due to natural causes, versus surgical or medical. Recurrent miscarriage is defined as three or more consecutive spontaneous abortions. Recurrent miscarriage in fertility patients is especially tragic because they have often undergone months of fertility treatment to achieve pregnancy.
Cervical factor infertility
Cervical factor infertility can occur when the mucus lining the cervix is too thick, therefore impeding the man’s sperm from progressing past the cervix. It can also occur when a woman produces antibodies that attack and kill the sperm before it can enter the cervix. Intrauterine insemination (IUI) is often the first line treatment for cervical factor infertility.
Tubal factor infertility
Tubal disease occurs when conditions, such as endometriosis, cause damage to the tubes. Scarring from endometriosis can constrict and damage the tubes. Pelvic inflammatory disease can create scarring of the tubes and other internal organs. In rare cases, some women are born with only one, or no, fallopian tubes. Some women also want to have previous tubal sterilization reversed because of changes in their life situations.
Advancing age, which is ultimately accompanied by reduced ovarian reserve, is a common cause of infertility. As eggs age they lose their capacity to fertilize and develop, which results in low estrogen levels and irregular or no ovulation.
If you are in your thirties, are having regular intercourse and are not pregnant after six to 12 months, you are strongly urged to seek care from a reproductive endocrinologist. Our specialists conduct a thorough diagnostic evaluation and rapidly implement the treatments most likely to result in pregnancy.
First level treatment of unexplained infertility may involve stimulated IUI. If this is not successful, many patients become candidates for in vitro fertilization. In many cases, intracytoplasmic sperm injection or assisted hatching will also be employed.
Uterine factor infertility
Several disorders of the uterus may cause infertility. Large polyps, fibroids or scar tissue may obstruct the uterus. In most instances, times these conditions can be corrected by hysteroscopic surgery. Some women are born with congenital abnormalities of the uterus including conditions such as the unicornuate uterus (half uterus) and uterine septum (vertical barrier inside uterus). Uterine abnormalities can be diagnosed by hysterosalpingogram, ultrasound, sonohystogram, MRI, or hysteroscopy with laparoscopy.
(A Wellness Update is a magazine devoted to up-to-the minute information on health issues from physicians, major hospitals and clinics, universities and health care agencies across the U.S. Online at www.awellnessupdate.com.)