Causes of Infertility
The underlying causes of infertility are generally equally attributable to male and female issues. Evaluation of the male partner involves a thorough health history and a semen analysis. The male partner must be have a semen analysis prior to proceeding with treatment. The results will direct us to further evaluation and treatment.
Certain medications can impact sperm production. Testosterone supplementation or any “body-building” supplements should not be used under any circumstances by men who desire pregnancy. After stopping testosterone use, it may take many months for the semen analysis to return to normal.
Disorders of ovulation are one of the most common causes of infertility. Irregular menstrual cycles, abnormal hair growth, acne, and breast discharge are some of the common symptoms of problems with ovulation. A careful medical history, a physical examination, transvaginal ultrasound, and laboratory tests will guide us in determining further evaluation and treatment. Treatments include management of underlying conditions (such as hypothyroidism, hyperprolactinemia, and polycystic ovary syndrome) and medications to improve ovulation.
Tubal Factor infertility
The fallopian tubes are the site when the egg and sperm meet and fertilization occurs. Some women have damage to their fallopian tubes that results in complete or partial blockage. Others have had their tubes tied or removed. Tubal damage can result in infertility and an increased risk for ectopic (tubal) pregnancy. The most successful fertility treatment for women with tubal factor infertility is to bypass the tubes altogether with in vitro fertilization/intravaginal culture.
Abnormalities of the uterus can contribute to an inability to get pregnant. The most common abnormalities are uterine fibroids, endometrial polyps, and abnormalities of uterine development (such as uterine septum, bicornuate uterus, or duplication of the uterus). Surgical repair or correction may be recommended.
Endometriosis is the growth of cells and tissue similar to the lining of the uterus in places other than the uterus itself. Endometriosis can cause pelvic discomfort, pain, pelvic adhesions (scarring), and infertility. Options for infertility related to endometriosis include ovarian stimulation medications with intrauterine insemination and in vitro fertilization/intravaginal culture.
About 10-15% of women have unexplained infertility. That is, despite careful, comprehensive evaluation, no cause for infertility can be found. If you have unexplained infertility, we still have very successful treatment options including ovarian stimulation medications with or without inseminations and in vitro fertilization/intravaginal culture.