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What is infertility?

Infertility is the inablity to achieve pregnancy after attempting for one year.

To become pregnant, a couple must have intercourse during the woman's fertile time of the month. The best time to conceive is during the ovulation period. It is difficult to know the exact day of ovulation; having intercourse every other day during this time maximizes the chances of conception.

Reasons to Seek Assistance:

  • If pregnancy has not occurred after one year of trying
  • Women over age 30 having difficulty conceiving
  • Women having irregular menstrual cycles
  • Women who have had three or more miscarriages
  • Women or men who have had infections that may affect fertility


Causes of Infertility

Impairment in any step of the intricate process of conception can cause infertility. For a woman to become pregnant, her partner's sperm must be healthy. The woman's ovaries and fallopian tubes must be healthy to release the egg and place it in the fallopian tube for fertilization. The fertilized egg, called an embryo, must make its way through an open-ended fallopian tube into the uterus and implant in the uterine lining. The uterine lining must be thick and healthy to sustain a pregnancy.

Half of infertility problems are cause from the male having no sperm or too few sperm. Lifestyle can influence the number and quality of a male sperm. Alcohol and drugs – including marijuana, nicotine, and certain medications – may temporarily reduce sperm quality. Environmental toxins, including pesticides and lead, may also lead to infertility. Sperm production problems may also exist from birth or develop later as a result of severe medical illnesses. The inability to ejaculate normally may also prevent conception.

The other half of unexplained infertility cases are due to female problems affecting ovulation. Simple lifestyle factors can create a hormonal imbalance affecting ovulation. These include stress, diet, or athletic training. Hormonal imbalance may also result from serious medical conditions such as a pituitary gland tumor. Other medical problems that can lead to female infertility include blockage of the fallopian tubes or endometriosis.

A medical evaluation may determine the cause infertility.


What Tests Are Needed

The male would have a semen analysis test, focusing on the count and quality of the sperm. If this test is abnormal he would be referred to a urology specialist. We recommend Conceptions for this testing 303-794-0045.

The female would first determine if she is ovulating each month. This can be done by charting changes in morning body temperature, or by using an ovulation test kit (which is available over the counter). Other tests performed in the office include checking cervical mucous, blood tests for hormone levels, or an ultrasound to evaluate ovarian follicles.

Following the initial evaluation if additional treatment is necessary your physician may use medications or surgical procedures to assist with the treatment. A common medication used to assist with ovulation is Clomid. If Clomid is not successful it may be necessary to perform additional tests. Outpatient tests performed in the hospital include hysterosalpingogram and laparoscopy. The hysterosalpingogram is an x-ray of the fallopian tubes and uterus. Dye is injected into the uterus to determine if the fallopian tubes are blocked and if there are any abnormalities in the uterus. Laparoscopy is a procedure used to determine if the female organs appear normal or if endometriosis is present.

Should infertility continue, it is recommended that the couple seek advice from an infertility specialist. Stronger medications for ovulation as well as assisted reproductive technologies may be offered such as artificial insemination and in-vitro fertilization.

Infertility Chart 1

Infertility Chart 2

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