What are some of the common causes of infertility?

A sleeping baby being held

Infertility frequently affects both women and men. There are four common causes of infertility:

  • Tubal factor infertility, which occurs when the woman’s fallopian tubes (the tubes that carry the egg from the ovary to the uterus) do not function normally. This can be caused by scarring due to surgeries, blockage or swelling due to past infection.
  • Ovarian dysfunction occurs when the woman’s ovaries are unable to produce and release an egg properly. In some cases, this is due to an imbalance in the follicle-stimulating hormone and an egg is not matured within the ovary. In some cases, there is a problem with the luteinizing hormone and the egg is never ovulated from the ovary. The most common reasons for ovarian dysfunction are age and polycystic ovary syndrome.
  • Endometriosis is also a common cause of infertility in women. This can cause inflammation and scarring of the reproductive organs as well as other pelvic organs. The inflammation can then interfere with the normal function of the organ causing discomfort, pain and infertility.
  • Male factor infertility is associated with sperm production and release. Male factor infertility is diagnosed through semen analysis determining whether the concentration of sperm numbers, motility and morphology are within normal limits. It can also be caused by a blockage of the male reproductive organs brought about by trauma, surgery or genetic abnormalities. 

How long should a woman wait before seeking the help of an infertility specialist?

A woman 35 years of age and younger should try one year of unprotected intercourse before seeking the help of an infertility physician. A woman over the age of 35 should try to get pregnant for six months before seeking the help of an infertility physician.

Will I need in Vitro Fertilization (IVF) in order to have a baby?

Not everyone needs IVF to have a baby. Patients with fallopian tube disease and male factor patients are fast-tracked to IVF as a treatment for infertility. Other patients can undergo simpler treatment options, such as timed intercourse with oral stimulation medications or intrauterine inseminations, in order to get pregnant.

What is the difference between an intrauterine insemination & IVF?

For an intrauterine insemination (IUI), a sperm specimen is washed in order to recover all motile normal sperm cells. These sperm are then placed in the uterine cavity using a small catheter at the time of ovulation. Fertilization and embryo growth occur inside the body.

For IVF, the eggs are removed from the ovaries and placed in a culture dish in the laboratory. Sperm are added to those eggs and any resulting embryos are cultured in the laboratory for 3 to 5 days. The best embryos are then transferred to the uterus using a small catheter or frozen for later use.

How do I know if my insurance will cover infertility?

Always call your insurance carrier to discuss coverage for infertility. Some insurance carriers will cover diagnostic testing only to determine if you have an infertility problem. Other insurance carriers will cover simpler treatments for infertility such as IUI, blood test and ultrasounds. Be sure to have your insurance carrier distinguish between coverage for simple infertility treatments and IVF.  Always ask if there is a limit on IVF coverage, i.e., a $10,000 life time maximum.

If I do need to see an infertility specialist, what will happen first?

You will need to have an initial consultation first. The physician will ask many questions about your and your spouse’s health history to determine what may be the cause of your infertility. The doctor may order some blood tests to determine if the woman has a hormone imbalance or do an ultrasound to look for follicle development on the ovaries. She may need to have a hysterosalpingogram (HSG) to evaluate the fallopian tubes and rule out tubal disease.  The doctor may also request a semen analysis on the man to determine if there is a male factor problem. Once the physician has determined the cause of infertility, then a treatment plan can be established.