Understanding Infertility

Before parents hear their baby’s first coo or cry, nature must run its course, and her path may not be as easy as you think. Within any given month, a reproductively healthy couple only has a 20 percent chance of achieving a pregnancy and carrying it to term.

One in 10 couples of childbearing age is unable to conceive a baby or carry a pregnancy to term. More than 6 million Americans age 15 to 44 are affected by infertility, and there are a variety of factors that affect both men and women equally.

You should see your health care provider if you have any concerns about your fertility. By definition you are considered infertile if you are younger than 35 and have not been able to conceive after a year of regular, unprotected intercourse (or after six months if you are older than 35).

Areas of concern
Everything must be in balance, and every process must happen at just the right time to complete the equation of a successful pregnancy.

• Are sperm healthy? The male partner must produce an adequate number of healthy sperm capable of traveling through the female reproductive tract and fertilizing an egg. A variety of conditions can cause sperm disorders, such as age, problems with the immune system, sexually transmitted diseases, prolonged exposure to high temperatures, drug use, and certain medications.

• Are hormones in balance? Another important part of the equation is the right balance of hormones, which can affect timing of ovulation cycles and release of the egg. Because the ability to produce healthy eggs declines with age, one-third of all women over the age of 35 experience fertility problems.

• Are egg and sperm able to unite? Besides being able to produce healthy eggs, the female partner must also have unblocked fallopian tubes that will allow sperm to reach the egg. Reasons for blocked fallopian tubes include past infections, abdominal surgery, and scarring caused by certain sexually transmitted infections.

• Can the embryo live in the uterus? The uterus must be receptive to an egg, and also have an environment hormonally prepared for implantation of the embryo and sustaining the developing pregnancy. Abnormalities such as polyps and fibroids can prevent an embryo from implanting or lead to a miscarriage. Other issues that can impact fertility are cervical disorders, endometriosis, polycystic ovarian syndrome, and prior cancer treatments.

Treatment options
Thankfully, there are many options available to help create a successful pregnancy. Hormone therapy and surgical treatments now allow two out of three infertile women to achieve pregnancy. A small portion of those sometimes require the use of more advanced assisted reproductive technology techniques, most commonly in vitro fertilization (IVF). Some half a million babies have been born in the U.S. as a result of such assisted reproductive technologies.

The University of Kentucky’s Division of Clinical and Reproductive Sciences in the College of Health Sciences focuses on education and research in the areas of reproduction and infertility. For more information, go to www.mc.uky.edu/CLS.