Infertility is defined as not being able to get pregnant despite having frequent, unprotected sex for at least a year. Many cases of infertility are caused by STIs, so it is important to practice safe sex. Early detection and treatment of STIs can help prevent future infertility.

Things to remember while trying to get pregnant:

  • Your body releases an egg once each month, this is called ovulation and happens on average 14 days before your period. When this egg is fertilized by a sperm, you become pregnant.
  • Keeping track of when you get your period each month can help you predict when you might release an egg. This tracking is most helpful if your cycle is around the same number of days each month.
  • In general, you are most fertile on the 8th through 19th day after your period starts. Having unprotected sex every 2-3 days during this time increases your chances of becoming pregnant.
  • Some lubricants may decrease the ability of sperm to reach the egg. Avoid using saliva or commercial lubricants, use vaseline if lubricant is needed.

Common causes of infertility (in women):

  • Problems with the release of an egg from the ovary (ovulation): some hormonal problems interfere with the ovaries’ ability to release an egg (thyroid problems, polycycstic ovary syndrome, excess prolactin)
  • Problems with reproductive organs (uterine or cervix): the shape of the uterus, or growths (polyps and fibroids) in the uterus can interfere with the implantation of a fertilized egg
  • Damage to the fallopian tubes: pelvic inflammatory disease can cause inflammation of the fallopian tubes and inhibit a fertilized egg from reaching the uterus. This inflammation is usually caused by a sexually transmitted infection
  • Age: As women age, so do their eggs, making it difficult to conceive. The ovaries stop producing eggs altogether at menopause, which occurs around age 50. In some women, the ovaries may stop producing eggs early (called “early menopause”). This may be caused by smoking or cancer treatments
  • Formation of scar tissue in the reproductive tract (pelvic adhesions): scar tissue can constrict the reproductive organs after a pelvic infection, surgery or appendicitis.

Common causes of infertility (in men):

  • Low sperm count: some men produce fewer, viable sperm released in the semen
  • Abnormal sperm shape, movement or function: due to undescended testicles, diabetes or sexually transmitted infections
  • Problems delivering sperm: damage or injury to the reproductive organs or a blockage in the testicle may prevent sperm from being released with ejaculation
  • Exposure to toxins: smoking cigarettes or marijuana, and alcohol use can affect sperm production
  • Cancer or cancer treatment: disease, radiation or chemotherapy can impair sperm production

Risk factors for infertility:

  • Age: fertility declines with age, and men and women over 40 experience more problems with infertility
  • Tobacco use: smoking tobacco or marijuana (by either partner) increases the risk of infertility
  • Alcohol use: heavy alcohol use increases risk of infertility (in both partners). Women should avoid all alcohol when trying to become pregnant
  • Being over or underweight: being obese or malnourished can cause infertility in both men and women. Maintain a healthy weight when trying to become pregnant

Some infertility tests include:

  • Hormone testing
  • Imaging tests (x-rays, pelvic ultrasound)
  • Biopsy (testicular or ovarian)
  • Seminal analysis

Treatment of Infertility

Treatment depends on…

  • The cause of infertility
  • Your age and your partner’s age
  • The length of time you have been trying to conceive

Treatments for men include…

  • Changing lifestyle behaviors like reducing tobacco and alcohol intake
  • Medications can improve sperm count and testicular function
  • Surgery may be needed to reverse a blockage and restore fertility

Treatments for women include…

  • Fertility drugs to stimulate or induce ovulation
  • Intrauterine insemination is a procedure in which sperm are placed directly in the uterus when the woman has released an egg
  • Surgery to remove uterine polyps or scarring may restore fertility

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