Infertility: symptoms, treatment, and more

Infertility is a medical condition characterized by the inability of a person or a couple to conceive a child despite regular and unprotected sexual intercourse for an extended period, typically one year for most couples. This condition can affect both men and women and may result from a variety of factors.

What are infertility symptoms?

• Irregular menstrual cycles

• Painful periods

• Absence of menstruation

• Abnormal bleeding

• Painful intercourse

• Changes in libido

• Pelvic pain

• Hormonal imbalances

• Repeated miscarriages

• Unsuccessful conception

If you suspect you have an infertility issue or are experiencing any of these symptoms, consult with a St. Joseph Health provider for a proper diagnosis and to discuss treatment options.

Infertility causes

• Ovulatory disorders: In women, irregular or absent ovulation can be a significant cause of infertility. Conditions such as polycystic ovary syndrome (PCOS) and hypothalamic dysfunction can disrupt the normal ovulation process.

• Age-related factors: As women age, their fertility naturally declines. This is primarily due to a decrease in the quantity and quality of eggs in the ovaries. Advanced maternal age can make conception more challenging.

• Tubal issues: Blocked or damaged fallopian tubes can prevent the sperm from reaching the egg and the fertilized egg from moving to the uterus. This can result from infections, scar tissue, or other factors.

• Uterine problems: Abnormalities in the uterus, such as fibroids or structural issues, can hinder the implantation of a fertilized egg.

• Endometriosis: Endometriosis is a condition where tissue similar to the lining of the uterus grows outside the uterus. It can lead to fertility problems by affecting the function of the ovaries, fallopian tubes, and the uterus.

• Male factor infertility: In men, factors such as low sperm count, poor sperm motility, and abnormal sperm shape can contribute to infertility. These issues can be caused by hormonal imbalances, genetic factors, infections, or lifestyle choices.

Diagnosing infertility

Some common diagnostic tests used to assess and understand female infertility:

• A thorough review of the individual's medical history and a physical examination can provide valuable initial insights into potential factors contributing to infertility, such as irregular menstrual cycles, hormonal imbalances, or anatomical issues.

• Ovulation assessment:

  • Basal Body Temperature (BBT) charting: Charting BBT over several menstrual cycles can help identify patterns of ovulation.

  • Ovulation predictor kits: These kits can help predict the timing of ovulation by detecting hormonal changes in urine.

• Blood tests:

  • Hormone testing: Blood tests can assess hormone levels, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, and thyroid hormones.

  • Anti-Müllerian Hormone (AMH) test: This test evaluates ovarian reserve, helping to determine the quantity of a woman's remaining eggs.

  • Prolactin test: Elevated levels of prolactin can affect ovulation.

• Pelvic ultrasound can detect structural issues like ovarian cysts, fibroids, or polyps that may interfere with fertility.

• Hysterosalpingography (HSG) involves injecting a contrast dye into the uterus to check for blockages or abnormalities in the fallopian tubes.

• Hysteroscopy is used to visually examine the inside of the uterus for polyps, fibroids, or other abnormalities.

• In cases where endometriosis or pelvic adhesions are suspected, a laparoscope is inserted through a small incision to examine the pelvic area.

• In some cases, genetic testing may be recommended to identify potential chromosomal abnormalities that could lead to recurrent pregnancy loss or infertility.

Infertility treatment options

Treating infertility involves a range of medical and lifestyle interventions aimed at addressing the underlying causes and improving the chances of successful conception. The specific treatment approach will depend on the cause of infertility and the individual or couple's unique circumstances. Here are some common methods and approaches used to treat infertility:

• Fertility medications:

  • In women, medications like clomiphene citrate or letrozole may be prescribed to stimulate ovulation.

  • Hormonal treatments may be used to correct imbalances that affect ovulation.

• Intrauterine insemination (IUI): This involves placing washed and concentrated sperm directly into the uterus, bypassing the cervix. It's often used in cases of unexplained infertility or mild male factor infertility.

• In Vitro Fertilization (IVF):

  • IVF is a highly effective assisted reproductive technology. It involves the fertilization of an egg and sperm outside the body and transferring the resulting embryo(s) into the uterus.

  • IVF is often used in cases of severe male factor infertility, blocked fallopian tubes, and unexplained infertility.

• Surgery: Surgical procedures can correct issues like blocked fallopian tubes, uterine abnormalities, or ovarian cysts that may be causing infertility.

• Lifestyle modifications:

  • Maintaining a healthy weight, quitting smoking, and reducing alcohol or caffeine consumption can positively impact fertility.

  • A balanced diet and regular exercise can also improve fertility.

• Stress management: Reducing stress through techniques like relaxation, meditation, or counseling can help regulate hormones and enhance fertility.

• Donor sperm or eggs: In cases of severe male or female infertility, donor sperm or eggs may be used in IVF procedures.

• Surrogacy: Surrogacy involves another woman carrying and delivering the baby for a couple. It is an option when a woman cannot carry a pregnancy to term.

Each person's situation is unique, and consulting with a St. Joseph Health provider specializing in infertility can provide valuable insights and options tailored to your specific needs and circumstances.