Common Fertility Problems

If you’ve been trying to get pregnant for a while, but aren’t yet, it can be really frustrating. It’s possible that things are just happening a little bit slowly for you, or you may be dealing with some kind of infertility. Infertility is usually defined as one year of trying to get pregnant without success if you’re younger than 35 years old or six months of trying without success if you’re 35 or older. Infertility is pretty common: about one in ten people in the United States have trouble getting pregnant. In this post, we’ll discuss the most common infertility problems so that you can be prepared when you talk to your doctor.

Infertility in Men

In about one-third of couples dealing with infertility, a cause is found in the male partner. One common infertility problem is called varicocele, which occurs when the veins on a man’s testicle or testicles are enlarged. This leads to increased blood flow to the testicles, which warms them up and makes them less hospitable to sperm, resulting in sperm that are decreased in number or have an unusual shape that means they are less able to fertilize an egg.

Another cause of infertility in men is impaired sperm movement—sperm can’t get from the testes to the penis because of a past injury to the reproductive system or an inherent anatomical difference. If sperm are in any way misshapen, this can also mean that sperm won’t move as well. If sperm can’t move well, they are less able to fertilize an egg.

Some causes of infertility in men are present at birth—there’s nothing that you can do. Other causes of infertility in men include certain medications, drug and alcohol use, cigarette smoking, exposure to toxins in the environment, past health problems (like mumps or cancer), and age. A few of these are also beyond your control, but others—particularly drug and alcohol use and cigarette smoking—might be worth addressing if you and your partner are having trouble conceiving. If that feels daunting, seek a professional who could help you quit smoking and drinking.

Infertility is pretty common: about one in ten people in the United States have trouble getting pregnant.

Infertility in Women

In about one-third of couples experiencing infertility, a cause is found in the female partner. The most common cause of infertility in women is trouble with ovulation: the release of an egg from the ovary so that it can be fertilized by a sperm. If you haven’t had regular periods, it’s possible that you are also not ovulating.

Polycystic ovary syndrome (PCOS) is a hormone imbalance that is the most common cause of ovulation problems, and therefore female infertility. While having PCOS does not mean that you will have infertility problems—about 60 percent of people with PCOS will conceive without treatment—the other 40 percent of people with PCOS may need fertility assistance. Another cause of ovulation issues is called primary ovarian insufficiency (POI), which means that the ovaries stop releasing eggs before menopause, usually before age 40.

Things like PCOS and POI usually have a genetic basis, and while there may be things you can do to help address them, many symptoms are outside your control. But just like in men, there are some things that affect fertility—smoking, drinking, stress, and diet—that you can address on your own or with the help of a medical or mental health professional.

The other one-third?

While about one-third of infertility problems have a male cause and another third have a female cause, the other third can be a combination of problems with both partners or might be chalked up to unknown causes. To figure out where the problem lies, you can ask your care provider for an infertility checkup, which may also involve a referral to a doctor that specializes in infertility.

At an infertility checkup, you and your partner will both have a physical exam and report health and sexual histories. Depending upon what the doctor finds, it’s possible that more tests will be performed. Semen analysis (men) and ovulation assessment (women) are usually the first steps, along with checking hormone levels in both partners. If you’re struggling to have a baby, take heart. There are lots of treatment options that could help, and seeking professional support is the first step.

Abby Olena
Dr. Abby Olena has a PhD in Biological Sciences from Vanderbilt University. She lives with her husband and children in North Carolina, where she writes about science and parenting, produces a conversational podcast, and teaches prenatal yoga.

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