Infertility 101: Understanding the Basics and Female Infertility
The Center for Reproductive Medicine is committed to providing the best care possible to patients who are struggling to conceive. But many people are unsure of the difference between normal physiological processes and signs of potential fertility problems. At our offices in Lake Mary, Celebration, and Orlando, Florida, we believe that understanding infertility, its common causes, and how we are able to treat it helps patients who are undergoing treatment as well as couples who are trying to conceive naturally.
What Is Infertility and What Causes It?
Generally, infertility is defined as an inability to conceive within one year of unprotected, well-timed intercourse. Infertility can be primary, in which case the couple has never had children, or secondary, in which case the couple has been able to have children in the past but is now unable to conceive.
There are numerous problems that can cause infertility, which is why we perform thorough testing procedures on all of our patients. In roughly one-third of infertility cases, the problem is a type of male factor infertility. Another third is represented by problems in the female reproductive system. The final third is made up of unexplained infertility and cases in which there is a combination of both male and female infertility.
Below are some of the most common causes of female infertility. For detailed information about common causes of infertility in men, please visit our Male Factor Infertility page.
Causes of Infertility
Polycystic Ovarian Syndrome
A common endocrine condition that causes infertility is polycystic ovarian syndrome, or PCOS. Instead of developing a dominant follicle and releasing a mature egg each menstrual cycle, polycystic ovaries develop multiple follicles that do not produce any eggs. Women with PCOS generally have signs of excess male hormone production, are often overweight, and may develop insulin resistance. At our Orlando-area practice, PCOS can be treated with medication that triggers normal ovulation.
Endometriosis is a condition in which sections of the uterine lining, or endometrium, are attached to tissues outside of the uterine cavity. These endometrial lesions build up and break down each month, just as the normal uterine lining does. This causes inflammation, cysts, and severe menstrual pain.
The connection between endometriosis and infertility is unclear, but treating the condition, usually through minimally invasive surgery, often improves a patient's chances of becoming pregnant.
Irregular or absent ovulation is a common cause of infertility and is primarily caused by some kind of hormonal imbalance which may be due to an endocrine disorder, weight problems, or other factors. Because menstruation may continue despite a lack of ovulation, many women do not realize that they are not ovulating. Ovulation can generally be restored by either treating the underlying condition, or through the use of fertility medications.
Blocked or Damaged Fallopian Tubes
A blockage in both fallopian tubes prevents an egg from coming into contact with sperm cells, resulting in infertility. Certain types of blockage, such as a buildup of mucus and debris, can be cleared by a minimally invasive surgical technique known as a tubal cannulization. Blockages caused by scar tissue or actual malformations of the tubes may be corrected with surgery or may be bypassed with in vitro fertilization.
Any irregularity of the uterus, including congenital malformations, adhesions, fibroids, or polyps, can potentially be a source of infertility or recurrent miscarriage. In many cases, minimally invasive surgery can be performed to correct the problem. If part or all of the uterus is absent, or if the damage is too extensive to be repairable, IVF with a gestational carrier may be recommended.
Low Ovarian Reserve
Unlike men, who continue to produce new sperm cells throughout their reproductive lives, women have a substantial but finite supply of eggs. Although only one or two eggs are released during any given cycle, several will begin to ripen, and those that are not released will disintegrate. Over time, a woman's egg supply gradually diminishes and may eventually reach a point where infertility is the result.
A woman with low ovarian reserve is unlikely to respond well to ovulation induction medications, and there is a chance that any eggs that are collected will not be of good quality. In many cases, IVF with donor eggs offers the best chance for success.
Do I Need a Reproductive Endocrinologist?
The majority of couples are advised to attempt to conceive naturally for one full year before seeking medical intervention. However, certain people should seek a reproductive endocrinologist after no more than six months of trying to conceive or earlier in some cases. This includes anyone with a known reproductive condition or a history of infertility, as well as women over the age of 35.
Contact Our Orlando, Florida Infertility Center
Contact us in Celebration, Lake Mary, or Orlando, Florida for additional infertility information.
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