Coping with infertility
When you are ready to start a family, you may not think having a baby might be a challenge. For many couples, though, getting and staying pregnant may not be just a frustrating inconvenience, it might be a medical condition that may affect both physical and emotional health. If you’re struggling with infertility, you're not alone. Approximately 1 in 8 couples have trouble conceiving within 6 to 12 months of unprotected intercourse.1
What causes infertility?
It might seem like the stars have to be perfectly aligned in order to have a baby. In some ways, that’s true. Even in a perfectly healthy young woman, the odds of conceiving in any given month are only 20-25%.2 In general, one-third of infertility issues are a male-factor, one-third are female-factor, and in the remaining cases, there’s either an issue with both the male and female or no cause is determined, also known as unexplained infertility.3
Common causes of female infertility
According to the Cleveland Clinic, to get pregnant, women need to have functioning ovaries, healthy fallopian tubes and a healthy uterus.4 If something interferes with the process of ovulation, fertilization or implantation, it may be a cause for infertility. The most common cause of infertility is a lack of ovulation.5 Other common problems may include:6
Tumor or cyst(s)
Eating disorders such as anorexia or bulimia
Alcohol or drug use
Thyroid gland problems
Intense exercise that causes a significant loss of body fat
Damage to fallopian tubes or uterus
Pelvic inflammatory disease
A previous infection
Polyps in the uterus
Endometriosis or fibroids
Scar tissue or adhesions
Chronic medical illness
A previous ectopic (tubal) pregnancy
A birth defect
Common causes of male infertility
What causes infertility in men? Problems that may affect how the testicles work are the most common issues that may lead to infertility in men. Other issues might include hormone imbalances, male reproductive abnormalities and lifestyle factors.7
Low sperm count due to genetic defects, diabetes or infections
Certain genetic diseases (cystic fibrosis)
Blockage in the testicle or undescended testicles
Damage or injury to the reproductive organs
What are some infertility risk factors for men and women?
Some risk factors, like age, may not be able to change infertility. Others, like lifestyle, may help.
- Infertility risk increases after age 30 for women, due to quality and number of eggs
- Sperm quality decreases in men between 40-458
- Chronic diseases, including diabetes and lupus
- Congenital issues
- Genetic issues
What steps can I take to increase my chances of conceiving?
The risk factors you might change to boost your chances of getting pregnant may involve changing your lifestyle.9 How can you do this? Here are some actions that may help.
- Getting to a healthy weight
- Improving diet/exercise habits
- Eliminating alcohol
- Quitting smoking, if you smoke
- Cutting back on caffeine
- Take prenatal vitamins
Talk with your doctor if you feel you need additional guidance on how to make lifestyle changes that may help increase your chances of getting pregnant.
How do I know it’s time to talk to a specialist?
When first trying to conceive, it’s common to see your general practitioner, urologist or gynecologist. If you’ve been struggling to get pregnant for more than a year without success, though, it may be time to see a fertility specialist for a fertility evaluation.
You may want to consider seeing a specialist sooner if:10
- You’re a woman 35 or older and have been trying to get pregnant for six months
- You’ve had three or more miscarriages
- You have irregular, painful or heavy periods
- You have endometriosis or a pelvic inflammatory disease
- You have a chronic medical condition
- You’re experiencing depression or other mental health issues as a result of infertility
What’s done during fertility testing?
Common tests for women include a pelvic exam, ultrasound to check the ovaries and uterus and blood test to check hormone levels. A hysterosalpingogram (HSG) can show whether the fallopian tubes are open or closed. Men will likely have a semen analysis and blood test.11
How is infertility treated?
- Fertility medications
- Injectable hormones to increase ovulation
- Surgery for women with cysts, fibroids, endometriosis or blocked tubes
- Assisted reproductive technology (ART)12 , such as in vitro fertilization, or IVF. In vitro fertilization involves surgically removing eggs from the ovaries, combining them with sperm in a controlled setting, then — if the eggs become fertilized — returning them to the woman’s body, or donating them to another woman.13 It can be expensive and complex.
- Intrauterine insemination (IUI). IUI is a procedure that involves removing sperm and placing it directly into the uterus around the time of ovulation. It’s a shortcut for the sperm to get to the egg.14 This is common for same-sex couples who want to become pregnant.
- Donor options such as donor sperm, donor egg or donor embryo.15
- Gestational or host surrogacy, in which one intended parent is related to the child.16
Psychological impact of infertility
Infertility doesn’t just affect couples in a physical way, it may also cause emotional pain. There are high highs and low lows. It’s not uncommon to experience anxiety or depression during this time in your life, particularly when others announce a pregnancy. Remember, another person’s ability to get pregnant may not necessarily take away from your own. The process of trying to conceive may become all-consuming — with baby thoughts on your mind all the time. This stress may take a toll. Lean on friends and family, join a support group or find a professional to help you process your feelings and cope with emotions while experiencing fertility treatment (and try to be patient when people offer up the well-meaning advice to “stop thinking about it”). If you may feel emotionally and physically spent, your relationship may be suffering or you may be having trouble sleeping, you may want to consider talking to your doctor about possibly taking a short break from the demands of appointments, tests and treatments.