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Fertility/Infertility

Infertility is defined as the inability to conceive, or carry a pregnancy to term, after 12 months of trying to conceive. If a woman is over the age of 35, the time of trying to conceive is reduced to six months.

A common assumption is that infertility is primarily related to women. However, only one-third of infertility cases are related to the woman alone. About one-third of infertility problems can be attributed to male factors, while the remaining one-third is caused by a combination of problems in both partners, or unknown causes.

Causes

Infertility generally occurs as a result of a disease or disorder of the reproductive system. Infertility can affect both men and women. There are many different causes for infertility, which is why it’s important to see your physician if you are experiencing difficulty in becoming pregnant.

The most common cause of female infertility is ovulation disorders due to polycystic ovary syndrome, premature ovarian failure and thyroid imbalances. Other causes include problems in the uterus or fallopian tubes due to fibroids, pelvic inflammatory disease or endometriosis; congenital anomalies; and aging, since ovulation declines with age, especially after age 35. In addition, women who have undergone chemotherapy or radiotherapy may experience short- or long-term infertility issues as a side effect of these treatments.

The most common causes of male infertility is related to abnormal semen, including low sperm count, no sperm, low sperm mobility and abnormal sperm. There are many issues that can cause abnormal semen, such as testicular infection, abnormalities or disease; overheating the testicles; ejaculation disorders and testosterone deficiencies. Certain drugs, medications and therapies may also impact male fertility, such as chemotherapy or radiotherapy, anabolic steroids, and sulfasalazine anti-inflammatory medications.

Your OB/GYN can help you to identify potential causes of infertility and refer you to a fertility specialist as needed. You can also search Hoag's Find A Doctor resource for Hoag staff OB/GYN physicians and fertility specialists.

Treatment Options

Because fertility issues can affect both men and women, it’s important for both partners to seek the care of a physician.

For both men and woman, your physician will perform a thorough physical/pelvic examination, discuss your medical history, and order blood work. For men, your physician may also order a semen analysis and ultrasound study to determine if there are any structural abnormalities.

For women, your physician may also order an ultrasound study to check for structural abnormalities. In addition, your physician may recommend a minimally-invasive diagnostic procedure, such as laparoscopy or hysterosalpingography to check the structure and function of the uterus and fallopian tubes. Other tests your physician may recommend include: thyroid function test, ovarian reserve testing and genetic testing.

When it comes to treatment, the majority of infertility cases are treated with conventional therapies such as medication treatment or surgical repair of the reproductive organs. In more complex cases, reproductive endocrinologists (physicians who specialize in the diagnosis and treatment of infertility) often utilize assisted reproductive technologies, such as intrauterine insemination and in vitro fertilization to assist couples in becoming pregnant.

Expert Care

At Hoag, our multidisciplinary team of board-certified gynecologic health experts includes gynecologists, urogynecologists, reproductive endocrinologists and other subspecialists who work together to provide a coordinated approach in the treatment of uterine fibroids, including the latest progressive treatment options personalized to meet the needs of the individual patient.

If surgery is necessary, Hoag’s expert team is well versed in the full gamut of minimally invasive laparoscopic techniques, including robotic-assisted surgery utilizing the state-of-the-art da Vinci® Surgical System.

For more information about the diagnosis and treatment of uterine fibroids, please speak with your physician, or locate a Hoag-affiliated physician near you.