Advocate Good Shepherd Hospital
a patient or visitor a physician or healthcare professional an employer
PrintEmail
Decrease (-) Restore Default Increase (+) font size

medical services home
search by doctor name 
Doctor Name Contains (Smart Search)
OR
search by specialty

search by city/zip code
Find a doctor near your location by entering a city name OR ZIP code.
Near:


Within miles:
0 1 5 10 15 30 30+

search by insurance
Insurance Name Contains (Smart Search)
 (what's this)
 

a-z health information - Disease

 

Infertility

Definition

Infertility means you cannot get pregnant (conceive).

There are two types of infertility:

  • Primary infertility refers to couples who have not become pregnant after at least 1 year having sex without using birth control methods.
  • Secondary infertility refers to couples who have been able to get pregnant at least once, but now are unable.

Alternative Names

Inability to conceive; Unable to get pregnant

Causes

Many physical and emotional factors can cause infertility. It 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 attaches 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)
  • Birth defects that affect the reproductive tract
  • Cancer or tumor
  • Clotting disorders
  • Diabetes
  • Drinking too much alcohol
  • Exercising too much
  • Eating disorders or poor nutrition
  • Growths (such as fibroids or polyps) in the uterus and cervix
  • Medicines such as chemotherapy drugs
  • Hormone imbalances
  • Obesity
  • Older age
  • Ovarian cysts and polycystic ovary syndrome (PCOS)
  • Pelvic infection or pelvic inflammatory disease (PID)
  • Scarring from sexually transmitted infection, abdominal surgery or endometriosis
  • Smoking
  • Surgery to prevent pregnancy (tubal ligation) or failure of tubal ligation reversal (reanastomisis)
  • Thyroid disease

MALE INFERTILITY

Male infertility may be due to:

  • Decreased number of sperm
  • Blockage that prevents the sperm from being released
  • Defects in the sperm

Male infertility can be caused by:

  • Birth defects
  • Cancer treatments, including chemotherapy and radiation
  • Exposure to high heat for prolonged periods
  • Heavy use of alcohol, marijuana, or cocaine
  • Hormone imbalance
  • Impotence
  • Infection
  • Medicines such as cimetidine, spironolactone, and nitrofurantoin
  • Obesity
  • Older age
  • Retrograde ejaculation
  • Scarring from sexually transmitted infections, injury, or surgery
  • Smoking
  • Toxins in the environment
  • Vasectomy or failure of vasectomy reversal

Healthy couples under age 30 who have sex regularly will have a 25-30% per month chance of getting pregnant each month.

A woman is most fertile in her early 20s. After age 35, the chance a woman can get pregnant drops greatly after age 35 (and especially after age 40). The age when fertility starts to decline varies from woman to woman.

Exams and Tests

Deciding when to get treated for infertility depends on your age. Doctors often suggest that women under 30 try to get pregnant on their own for 1 year before getting tested.

Infertility testing involves a medical history and physical exam for both partners.

Blood and imaging tests are most often needed. In women, these may include:

  • Blood tests to check hormone levels, including progesterone and follicle stimulating hormone (FSH)
  • Measurement of body temperature every morning to see if the ovaries are releasing eggs
  • FSH and clomid challenge test
  • Antimullerian hormone testing (AMH)
  • Hysterosalpingography (HSG)
  • Pelvic ultrasound
  • Laparoscopy
  • Luteinizing hormone urine test (ovulation prediction)
  • Thyroid function tests

Tests in men may include:

  • Sperm testing
  • Exam of the testes and penis
  • Ultrasound of the male genitals (sometimes done)
  • Blood tests to check hormone levels
  • Testicular biopsy (rarely done)

Treatment

Treatment depends on the cause of infertility. It may involve:

  • Education and counseling about the condition
  • Fertility treatments such as intrauterine insemination (IUI) and in vitro fertilization (IVF)
  • Medicines to treat infections and clotting disorders
  • Medicines that help the growth and release of eggs from the ovaries

Couples can increase the chances of becoming pregnant each month by having sex at least every 3 days before and during ovulation.

Ovulation occurs about 2 weeks before the next menstrual cycle (period) starts. Therefore, 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 her period starts.

Having sex before ovulation occurs is especially helpful.

  • Sperm can live inside a woman's body for at least 3 days.
  • However, a woman's egg can only be fertilized by the sperm for a few hours after it is released.

Women who are under or overweight, may increase their chances of becoming pregnant by getting to a healthier weight.

Support Groups

Many people find it helpful to take part in support groups for people with similar concerns. You can ask your health care provider to recommend local groups.

Outlook (Prognosis)

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. This figure does not include advanced techniques such as in vitro fertilization (IVF).

When to Contact a Medical Professional

Call your health care provider if you are unable to get pregnant.

Prevention

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 chance of getting pregnant and having a healthy pregnancy.

References

American Society for Reproductive Medicine. Diagnostic evaluation of the infertile female: a committee opinion. Fertil Steril. 2012;98:302-307.

American Society for Reproductive Medicine. Diagnostic evaluation of the infertile male: a committee opinion. Fertil Steril. 2012;98:294-301.

Bulun SE. Physiology and pathology of the female reproductive axis. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 17.

Lobo RA. Infertility: etiology, diagnostic evaluation,management, prognosis. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, Pa: Elsevier Mosby; 2012: chap 41.


Review Date: 2/24/2014
Reviewed By: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com
 

quick links patient information health care professional information employer information connect with Advocate

About Advocate | Contact Us | Jobs | SiteMap | Terms of Use | Notice of privacy practices ®Advocate Health Care, Downers Grove, Illinois, USA | 1.800.3.ADVOCATE | TDD 312.528.5030