Many couples have difficulty in conceiving their first pregnancy while other couples experience problems after being able to get pregnant in the past. In either case, stress and grief are common reactions. Infertility itself is also pretty common: It affects about 10 to 15 percent of couples.
When to Get an Infertility Evaluation
Couples with no infertility problems have an average monthly pregnancy rate of 20 to 25 percent following properly timed intercourse. As a result, it often takes several months for a couple to get pregnant. Infertility, however, is defined as a lack of pregnancy following 12 months of unprotected intercourse. So if a pregnancy has not happened within a year, it’s a good idea to get an evaluation.
If any of the following conditions exist, an infertility evaluation is warranted if a pregnancy has not been achieved within six months:
- if the female is more than 35 years old,
- if the female has experienced irregular menstrual cycles, or
- if the female has a past history of pelvic inflammatory disease, extensive pelvic surgery or severe endometriosis (when tissue similar to the lining of the uterus is found outside the uterus).
An Increase in Infertility Treatment Options
It’s not known if the prevalence of infertility is increasing, but certainly the use of treatments for infertility is increasing, probably due to several societal trends. In most developed countries, there’s a trend toward people getting married later in life as well as women getting pregnant for the first time later in life. Because a female’s fertility declines with age, this naturally leads to an increasing time to conception and problems with infertility. Many couples today are more aware of infertility treatment options, in part through media coverage of infertile couples and infertility treatments.
Possible Causes Of Infertility
For pregnancy to occur, motile sperm (sperm that move spontaneously and actively) must be deposited near the cervix through intercourse. The sperm must be able to ascend through the cervix, uterus and fallopian tubes, arriving at the same time that a woman has ovulated (released an egg). Fertilization usually occurs near the end of the fallopian tube and the fertilized egg (embryo) is then transported over several days into the uterine cavity. The embryo must be able to implant into the endometrium, the tissue that lines the uterus.
Infertility can result from a disruption in any of these normal events. Male-related disruptions can include problems with sperm production and sperm transport through the male reproductive tract and delivery into the female reproductive tract. On the female side, problems with anovulation (a lack of ovulation), blocked fallopian tubes, or inability of an embryo to implant and establish a pregnancy in the uterus can all result in infertility.