One-third of infertility is caused by female factors.
One-third of infertility is caused by male factors.
Around 20 percent of infertility is unexplained.
Around 10 to 15 percent of infertility is caused by a combination of male and female factors.
Among women, the main causes of infertility are
Ovulatory disorders: No ovulation or irregular ovulation
Tubal disorders: Blocked or infected tubes
Uterine issues: Fibroids, polyps, or adhesions
For men the most common causes of infertility are
Low sperm count
Decreased sperm motility
Abnormally shaped sperm
No sperm at all in the ejaculate
Each of these categories of infertility can be caused by a number of things; for example, a decreased sperm count can be caused by a disease such as diabetes, by a birth defect, or by trauma. A woman can have blocked tubes from endometriosis, pelvic inflammatory disease, or from a congenital malformation. Anovulation can be caused by polycystic ovarian syndrome, premature ovarian failure, or by overexercising. While it may be fairly obvious what the problem is, finding the reason for the problem may be more difficult.
Diagnosing Infertility
You may think this is a no-brainer: If you’re not getting pregnant, it seems like you’ve already diagnosed yourself with infertility! However, diagnosing a lack of pregnancy is the easy part; figuring out why you’re not getting pregnant is the hard part.
After reading through Chapter 6, which discusses simple techniques for increasing your pregnancy odds, or Chapters 11 and 12, which explain some of the tests used to diagnose infertility, of this book, you may be able to diagnose the reason for your difficulty in getting pregnant without any help from your doctor. For example, you may be having sex at the wrong time of the month — your “infertility issue” may be solved with a calendar, a thermometer, and an ovulation predictor kit! Or you may not have realized how irregular your periods were — 35 days apart one month, 40 the next, 60 the next — maybe you’re not ovulating on a regular basis.
Your gynecologist can run a few simple blood tests to help determine whether or not you’re ovulating. Ovulation is, after all, the first step in getting pregnant, and usually blood tests or observation of your own cervical mucus and temperature (see Chapter 6 for ways to figure this out) can help you figure out when you’re ovulating so you can time sex accordingly.
If you’re still not pregnant after six months of “hitting the mark,” it’s time for more testing; your doctor may suggest a test to see if your tubes are open and testing on your partner to see if “his boys can swim.”
This process of looking for the problem and then seeing if it’s fixed can take a few months. Only 20 percent of infertile couples never have a definite answer to why they can’t get pregnant, so the odds are in your favor.
Recognizing Why Getting Pregnant Seems Harder Today
Sometimes things seemed easier in Grandma’s day. Large families were common, and it appeared that everyone had children. In fact, getting pregnant for some groups of people is more frequent while it seems to have decreased for others. But for the general population, statistics gathered by the government have shown a rather steady percentage of the population meeting the definition of infertile. This has been near 15 percent since 1965. Some factors that may make it harder to conceive are as follows:
People are having children later in life. Over age 25, there is a slight but definite decrease in fertility in women. Men are also less fertile at older ages but not for the same reasons as women.
Due to better medical management, people are living longer and getting pregnant (or trying to) despite the presence of serious chronic disease, such as diabetes or lupus. In the past, just the presence of these conditions would have precluded the possibility of pregnancy.
Male infertility, related to decreased sperm counts, has increased. Many theories circulate as to why this is occurring, with environmental factors being carefully studied. However, caution is needed here since it is not the semen parameters that matter but whether or not a man fathered a child. Lower semen numbers or characteristics do no always translate into lower pregnancy rates.
The incidence of sexually transmitted diseases has increased. Some of these diseases, such as chlamydia, cause serious damage to the reproductive organs.
More men and women have had either a vasectomy or a tubal ligation at a young age and then decided to have another child. Needless to say, they immediately face fertility issues due to their previous choices.
It may seem as if everyone had children years ago, but start asking questions and you’ll get a different story. You may find out that Uncle Charlie wasn’t really Aunt Jo’s son; he was her sister’s child, whom she raised after his mother died young, and on and on. Everyone may have been raising children, but many of those children may have been extended family members.
People today talk more. Just because you never heard about your grandmother’s stillborns or your mother’s miscarriages doesn’t mean they didn’t happen. Pregnancy talk today is big business, and everyone in the world seems to be in the news talking about their babies, lack of babies, adopted babies, and how they got pregnant. This focus puts a constant in-your-face emphasis on pregnancy. It also makes you feel, when you’re trying to get pregnant, like everyone else is doing it — and doing it better than you are!
Calculating the Cost of Infertility
Infertility costs a lot. We’re not just talking money here; the emotional toll is usually much higher and longer lasting than any hit to your pocketbook. In the next sections, we look at the costs of infertility on your self-esteem, your marriage, and last of all on your wallet. While it may be uncomfortable to talk about the cost of infertility treatments, lack of funds is one of the main reasons people do not pursue fertility treatment.
Preparing for the emotional toll
Infertility is not for the faint of heart. Will it test your mental, physical, and spiritual strength? Um, possibly. Will you come out a better person than before? No guarantee, but as with all of life’s challenges, the better prepared you are going in, the more likely your psyche is to survive and thrive.
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