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Problems Conceiving
Getting pregnant may seem simple, but the act of conceiving a child can often be very difficult. It involves many bodily functions and systems being in good condition in both the male and the female, all of which must happen in the right sequence and at the right time.
Consider that the average woman of reproductive age only has a 20% chance of getting pregnant in any month of trying. If conditions are hampering male and/or female reproductive systems, the chances are much lower. Infertility – defined as not conceiving after 12 months of having regular, unprotected intercourse – affects as many as 1 in 8 couples.
Causes of infertility can range from not timing intercourse properly to lifestyle factors to structural problems with the reproductive organs. At the Reproductive Science Center of New Jersey (RSCNJ), our goal is to find out what factors are causing infertility in an individual or couple and develop a personalized treatment plan to help them achieve pregnancy.
The primary causes of failure to achieve pregnancy fall into three categories: medical issues, lifestyle factors and genetics. Patients can change certain lifestyle habits and our reproductive endocrinologists can address most medical conditions. Genetic issues have no direct solution as far as correcting the genetic problem, but that doesn’t mean we can’t work around them.
Psychological Impact
By Susan Scott MSW, LCSW – Most couples will face some degree of emotional distress when they are diagnosed and being treated for infertility. Contact RSCNJ for more information on the mental health professionals who deal with infertility.
Genetic Disorders and Infertility
Genetic disorders are a major cause of infertility. Our testing can help diagnose and address these problems.
Sexual Dysfunction and Infertility
Sexual dysfunction may be a cause of a couple’s infertility. RSCNJ can help evaluate an individual’s or couple’s sexual health and improve it.
Diabetes and Infertility
Diabetes and infertility are linked in men and women, but hope lies in management and assisted reproductive technology. Learn about signs and treatment options.
Lifestyle issues affecting conception
Lifestyle factors that can affect fertility are often within our control through choices and behaviors. Therefore, we encourage individuals who are experiencing difficulties in becoming pregnant to consider making these changes, if applicable. Most lifestyle issues impact both men and women.
Weight: This is one of the primary lifestyle issues that can cause infertility in both men and women. Women who are obese or overweight may experience problems with ovulation, which reduces the effectiveness of in vitro fertilization (IVF). In men, obesity can harm sperm production. While consistent exercise is important for weight management, women who are trying to get pregnant should avoid excessively strenuous workouts.
Diet: Without proper nutrients, the body doesn’t perform tasks efficiently, including reproduction. In particular, women should limit caffeine intake. Poor nutrition can also limit sperm production in men.
STDs: Sexually transmitted diseases (STDs) can cause infertility in women, and some STDs can block delivery of sperm in men. Safe sex with a limited number of partners is the best way to prevent infection.
Stress: This can disrupt hormone activity that regulates ovulation in women and cause similar hormonal issues in men that affects healthy sperm.
Alcohol: Men should limit alcohol consumption, and women trying to get pregnant should avoid drinking altogether.
Illicit drug use: This can cause varied reproductive related problems in both sexes.
Exposure to toxins: Whether through work, outdoor activities, or unhealthy indoor environments, chemicals, pesticides, and other toxins can alter the hormonal balance in men and women, affecting fertility.
Temperature: Men should avoid activities that increase the temperature of their scrotum, such as placing a laptop computer on it.
Age: While not an adjustable factor, age is also a major influence in infertility, affecting females more dramatically than males. Men generally experience infertility issues later in life due to injury or illness.
Medical conditions that cause problems conceiving
Males and females have different medical issues and conditions, some present at birth, that can cause problems conceiving. One medical condition may also lead to another illness or disorder that inhibits infertility.
Male medical issues
- Sperm problems are the primary medical cause of male infertility
- Infections, tumors, medications, surgeries
- Hormonal problems
- Erectile dysfunction and ejaculation issues
- Structural problems, including undescended testicles and varicocele
Female medical issues
- Ovulation disorders are the most common medical cause of infertility in women
- Structural defects
- Fallopian tube issues (hydrosalpinx)
- Uterine fibroids
- Ovarian cysts
- Anatomical uterine abnormalities
- Diseases and conditions that can result in some of the causes above
- Endometriosis
- Polycystic ovary syndrome (PCOS)
- Factors that make a woman prone to miscarriage
Genetic issues affecting conception
Genetic issues typically involve chromosomal abnormalities or single-gene disorders. These problems can lead to failed embryo implantation and pregnancy loss. Additionally, if a child is born with a chromosomal or single-gene defect, it may result in birth defects.
Chromosomal disorders can relate to one or more of an embryo’s chromosome pairs containing either one too many or one too few chromosomes. When the chromosome is not paired correctly, it is called aneuploidy. A chromosome may also have an abnormal structure. Both kinds of chromosome problems can be present in the female egg and the male sperm.
Single-gene defects result from the embryo inheriting a genetic flaw from one or both parents. The gene could be one that results in cystic fibrosis or muscular dystrophy in birth. These single-gene defects can also cause embryo implantation failure or pregnancy loss.
Genetic issues often can be identified through preimplantation genetic screening, two types of embryo evaluation during IVF that can identify either form of genetic issues.
Unexplained infertility
Unexplained infertility is the diagnosis that fertility specialists give an individual or couple when fertility tests can not confirm a definitive cause for infertility. Unexplained infertility does not mean that there is not a cause for infertility; it simply means that the tests and examinations are not able to detect the reason an individual or couple is struggling to conceive. Unexplained infertility is the diagnosis in about 10 to 15% of infertility cases.
When is unexplained infertility the diagnosis?
Individuals and couples will receive an unexplained infertility diagnosis when the following conditions exist:
- The woman is ovulating regularly and has an appropriate ovarian reserve (antral follicle count)
- The female or female partner has at least one open fallopian tube (evaluated using a hysterosalpingogram)
- The male or male partner’s semen analysis is normal (including sperm count, shape and movement)
- Exams of the individual or of both partners did not result in the diagnosis of conditions or structural abnormalities that can cause infertility, such as uterine fibroids in women or varicoceles in men
Unexplained infertility treatment
The inability to pin down a diagnosis with current fertility testing technology does not mean that a couple cannot get pregnant. In some cases, simple lifestyle changes can improve the chances of pregnancy.
Fertility treatments such as fertility medications combined with IUI (intrauterine insemination) or in vitro fertilization (IVF) can dramatically improve the chances of pregnancy for those struggling with unexplained infertility.