One of the greatest milestones in the life of many women is becoming a mother. But, for a growing number of couples in the US, becoming pregnant is a bumpy road. According to the Center for Disease Control and Prevention (CDC), 10% of women in the US between the ages of 15-44 have difficulty getting pregnant or staying pregnant.
Infertility is defined by the inability to become pregnant after one year of trying regularly. For women 35 and over, the criteria is six months of trying with unsuccessful pregnancy.
Aging decreases a woman's chances of having a baby in the following ways:
- Her ovaries become less able to release eggs
- She has a smaller number of eggs left
- Her eggs are not as healthy
- She is more likely to have health conditions that can cause fertility problems
- She is more likely to have a miscarriage
Infertililty is not just a woman’s problem. In fact, women and men share equally in the causes of infertility. One-third of all cases can be linked to female problems, one-third to male problems and one-third to a combination of male and female problems, as well as unknown issues.
Infertility in men is most often caused by:
- Varicocele (VAIR-ih-koh-seel), which is a dilation of the veins in the testicles. The heat from the extra blood flow can affect the number or shape of the sperm.
- Factors that affect the movement of sperm, preventing it from swimming to the egg
- Factors that affect the production of sperm (e.g., low sperm count)
- Other injuries or damage to the reproductive system that block the sperm
Risk factors that have been shown to affect the health of sperm include:
- Heavy alcohol use
- Cigarette usage
- Environmental toxins, including pesticides and lead
- Health problems, such as mumps, serious conditions like kidney disease or hormone problems
- Radiation treatment and chemotherapy for cancer
Infertility in women is most often caused by problems with ovulation, the process in which the egg is released by the ovaries. Signs that a woman is not ovulating normally include irregular or absent menstrual periods.
As discussed in last month’s article, polycystic ovarian syndrome (PCOS) is the most common cause of ovulation problems and, therefore, the most common cause of female infertility.
Less common causes of fertility problems in women include:
- Blocked fallopian tubes due to scarring from pelvic inflammatory disease, endometriosis, or surgery for an ectopic pregnancy
- Physical problems with the uterus, such as uterine fibroids (non-cancerous growth of muscle on the walls of the uterus)
Other factors that can change a woman's ability to have a baby, either by altering the female’s hormonal balance or result in a blockage of the egg, include the following:
- Excess alcohol use
- Poor diet
- Athletic training
- Being overweight or underweight
- Sexually transmitted infections (STIs)
Next month, I will address the basic evaluation and touch upon the treatment for infertility.
Dr. Christine Ko is a Board Certified Family Practice physician with more than 15 years of medical experience. Her interests and focus are in women's health, integrative medicine, and sports medicine, and her approach to clinical care centers on knowledge of the disease process as well as the individual. Dr. Ko is a champion of integrated and holistic medicine, and in addition to her traditional medical training, she is trained in both medical acupuncture and mesotherapy.