Why am I not pregnant yet? Common Infertility Diagnoses
Infertility affects approximately 1 in 6 couples who are trying to conceive, creating emotional and physical challenges. In roughly one-third of infertility cases, the problem is a type of male factor infertility, while another third is represented by problems in the female reproductive system. The remaining third involves unexplained infertility or a combination male and female infertility.
Understanding the most common infertility diagnoses can provide insight and clarity for those navigating this journey.
Polycystic Ovary Syndrome (PCOS)
Overview: PCOS is a common endocrine condition affecting women of reproductive age that can lead to infertility. It's characterized by irregular menstrual periods, excess androgen levels, and polycystic ovaries.
Symptoms:
- Irregular or missed periods
- Signs of excess male hormone production
- Weight gain or difficulty losing weight
- May develop insulin resistance
Impact on Fertility: PCOS affects ovulation. Polycystic ovaries develop multiple follicles that do not produce any eggs, instead of developing a dominant follicle and releasing a mature egg each menstrual cycle.
Treatment Options:
At the Center for Reproductive Medicine, we treat PCOS with medications that triggers release of eggs.
Endometriosis
Overview: Endometriosis occurs when sections of the uterine lining (endometrium) attach to tissues outside of the uterine cavity. Similarly to the normal uterine lining, these endometrial lesions build up and break down each month, causing pain and potentially impacting fertility.
Symptoms:
- Severe menstrual pain
- Inflammation
- Cysts
- Pain during intercourse
- Heavy or irregular periods
Impact on Fertility: The connection between endometriosis and infertility is unclear but abnormal tissue growth can cause inflammation, affecting the ovaries, fallopian tubes, and the uterus, which can hinder the egg’s journey.
Treatment Options:
At the Center for Reproductive Medicine, we usually treat endometriosis through minimally invasive surgery which often improves a patient’s chances of becoming pregnant.
Ovulation Disorders
Overview: Ovulation disorders are primarily caused by some kind of hormonal imbalance which causes irregular or absent ovulation. Many women do not realize that they are not ovulating because menstruation may continue.
Common Causes:
- Hormonal imbalances
- Endocrine disorders
- Weight problems
- Underlying health issues that affect the ovulation cycle
Impact on Fertility: Ovulation disorders disrupt the release of a woman’s egg so they cannot be fertilized by sperm.
Treatment Options:
- Treating underlying conditions
- Fertility medications to restore ovulation
Tubal Factor Infertility
Overview: Tubal factor infertility occurs when the fallopian tubes are blocked or damaged, preventing the sperm from reaching the egg.
Common Causes:
- Pelvic inflammatory disease (PID)
- Previous surgeries in the pelvic area
- Endometriosis
Impact on Fertility: Blocked or damaged tubes can prevent natural conception.
Treatment Options:
- A minimally invasive surgical technique known as a tubal cannulization can clear certain types of blockages, such as a buildup of mucus and debris and unblock the fallopian tubes.
- IVF, which bypasses the fallopian tubes entirely.
- Surgery to correct blockages caused by scar tissue or actual tubal malformations.
Low Ovarian Reserve
Overview: Low ovarian reserve occurs when a woman’s egg supply gradually diminishes and may reach a point where infertility is the result. Low ovarian reserve can occur due to age or other factors because women have a finite supply of eggs.
Symptoms:
- None
Impact on Fertility: Reduced quantity and quality of eggs can make conception more difficult.
Treatment Options:
- Women with low ovarian reserve are unlikely to respond well to ovulation induction medications. There is also a chance that any eggs collected will not be of good quality.
- In vitro fertilization (IVF) with egg donation, often offers the best chance of success.
Male Factor Infertility
Overview: Male infertility contributes to about one third of all infertility cases. It can be caused by a wide range of factors and often stems from issues with sperm count, motility (movement), or morphology (shape).
Common Causes:
- Environmental and lifestyle factors - Sperm quality is easily affected by environmental exposure and poor health choices such as smoking, heavy alcohol consumption, certain medications, infections, exposure to toxins and prolonged overheating of the testicles. This can cause temporary male infertility.
- Physical Irregularities - Blocked or missing vas deferens or epididymis causes very low sperm count or no sperm at all.
- Varicocele - Varicose vein in the scrotum. It can diminish the number and quality of sperm produced due to overheating caused by excess blood pooling in the vein.
- Hormonal imbalances – Hormonal imbalances interfere with sperm production and are usually caused by gland malfunctions, genetic conditions, or unhealthy body weight.
Impact on Fertility: Poor sperm quality or low count can reduce the chances of fertilizing an egg through natural conception.
Treatment Options:
- Lifestyle changes (diet, exercise, avoiding toxins)
- Medications to address hormonal imbalances
- Surgical procedures for varicocele
- Assisted reproductive technology (ART) methods like IUI or IVF
Unexplained Infertility
Overview: Sometimes, despite thorough testing, no specific cause of infertility can be identified. Unexplained infertility is the cause of roughly one third of infertility cases.
Symptoms: There are no distinct symptoms as the cause is not identifiable.
Impact on Fertility: The lack of a clear cause can make treatment challenging and stressful.
Treatment Options:
- Lifestyle modifications and timing intercourse
- Fertility medications to stimulate ovulation
- ART methods like IUI or IVF
Is it time to get help?
If you’ve been trying to conceive without success, you should consider scheduling a consultation with a fertility specialist.
- Under 35: If you have been trying to conceive for 12 months without success.
- 35 and older: If you have been trying to conceive for 6 months without success.
- Recurrent pregnancy loss: If you have had two pregnancy losses.
Conclusion
Understanding the common diagnoses of infertility can demystify the challenges many face when trying to conceive. Each condition has unique implications and treatment options, which is why personalized treatment plans are critical during your fertility journey.
If you are struggling with infertility, get help from one of our board-certified fertility specialists. They can provide valuable guidance, support and individualized care plans to help you achieve your family building goals.
You are not alone.
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About the Blog
Welcome to the Center for Reproductive Medicine Blog! Nationally and internationally recognized for providing exceptional reproductive care, our team believes in empowering people with the knowledge they need to navigate their unique fertility journeys.
From information on the latest fertility treatments to valuable insights on egg donation, surrogacy, and everything in between, the Center for Reproductive Medicine Blog is your ultimate resource for all things reproductive care and support. Read on to learn more, and contact us today if you have any questions or want to schedule a new patient appointment.