Struggling with infertility can be a lot to deal with. By now, you’re probably diligently tracking your cycle, hoping for the best each month. People might send you wishes and prayers, tips and tricks. “Give it time”, they say, but how much more time can you possibly give? It’s easy to throw the towel in, but know that there are infertility treatments out there.
The tricky part is finding the cause. Is it a problem with your body or his? And if so, what can it possibly be? Searching for answers can be long and confusing, so do consult a fertility doctor. In the meantime, learn about the possible reasons behind infertility. This will give you the tools and knowledge to ask the right questions.
What Is Infertility?
Infertility is defined as the inability to get pregnant after trying for 1 year. If you’re 35 or older, that time frame drops to 6 months. If you can conceive but can’t stay pregnant, you’re also considered infertile. In the United States, 10 percent of women between 15 to 44 years old have pregnancy troubles.1
Causes Of Infertility
One-third of infertility cases are caused by the woman. Another one-third is caused by the man, while the rest are affected by problems with both or known issues.
Infertility Causes In Women
- Ovulation problems (most common)
- Polycystic ovarian syndrome
- Blocked fallopian tube (from pelvic inflammatory disease, endometriosis, or surgery for ectopic pregnancy)
- Physical problems with uterus or cervix
- Uterine fibroids
Infertility Causes In Men
- Varicocele (large veins on testicles)
- Low sperm mobility or count
- Illness, such as cystic fibrosis 2
Infertility Treatments For Women
Having problems with ovulation? You may be prescribed clomiphene, or Clomid. It works like estrogen and makes the pituitary gland release gonadotropin, or GnRH. In turn, luteinizing and follicle stimulating hormones are released, a vital process for ovulation.
However, know that clomiphene makes your ovaries release more than one egg at a time. Twins, triplets, and even quadruplets are possible! Of all the successful pregnancies, 6.9 percent were twins, 0.5 percent were triplets, and 0.3 percent were quadruplets. The risk is even higher if you have a family history of multiple births.
2. Human Menopausal Gonadotropin
If clomiphene doesn’t do the job, your doctor might prescribe injected hormones. The go-to choice is human menopausal gonadotropin (hMG), which contains equal parts luteinizing and follicle stimulating hormone. Again, these are needed to ovulate.3 For 58.6 percent of hMG patients, pregnancy is successful.4
3. Follicle-Stimulating Hormone
Similarly, follicle-stimulating hormone (FSH) induces ovulation. It works by stimulating follicle growth in the ovaries.5 Multiple pregnancies are also likely.
4. Gonadotropin-Releasing Hormone Analog
If you don’t ovulate each month, you’ll likely get gonadotropin-releasing hormone analog, or Gn-RH. And if you ovulate before the egg is ready? Gn-RH will also lend a hand. It’ll force the pituitary gland to change the actual timing of ovulation. Aside from injections, Gn-RH is also available as a nasal spray.
Metformin is a pill that’s best known for controlling blood glucose in type 2 diabetes. But for ladies with PCOS, it can lower high levels of male hormones. This may help re-start ovulation and get things back on track.6 When taken with hormone injections, metformin may limit the risk of multiple pregnancies.7
6. In Vitro Fertilization
In vitro fertilization, or IVF, joins the egg and sperm in a laboratory dish. The fertilized embryo is then implanted into the uterus where it can grow. Success rates are quite high, with about 1.6 percent IVF babies born each year.8 But like other infertility treatments, IVF increases the chances of a multiple pregnancy. Plus, at $12,000 to $17,000 for a single cycle, it’s very expensive.9
7. Intrauterine Insemination
An intrauterine insemination is similar to IVF, but fertilization happens in a woman’s body. Sperm is placed inside the uterus to boost the chances that sperm will reach the fallopian tubes. Compared to IVF, it’s less expensive and invasive.
But that also translates to a lower success rate. According to the American Pregnancy Association, about 20 percent of IUI cycles end in pregnancy.10
Keep in mind that age, reproductive history, and health status make a world of a difference. For women over 30, success rates are typically lower. Talk to your doctor about what’s right for you.
|↑1, ↑2||Infertility. Women’s Health. U.S. Department of Health and Human Services.|
|↑3||POLAN, MARY LAKE, ANNUNZIATA DANIELE, JEFFREY B. RUSSELL, and ALAN H. DECHERNEY. “Ovulation induction with human menopausal gonadotropin compared to human urinary follicle-stimulating hormone results in a significant shift in follicular fluid androgen levels without discernible differences in granulosa-luteal cell function.” The Journal of Clinical Endocrinology & Metabolism 63, no. 6 (1986): 1284-1291.|
|↑4||Schwartz, Moshe, Raphael Jewelewicz, Inge Dyrenfurth, Pamela Tropper, and Raymond L. Vande Wiele. “The use of human menopausal and chorionic gonadotropins for induction of ovulation: sixteen years’ experience at the Sloane Hospital for Women.” American journal of obstetrics and gynecology 138, no. 7 (1980): 801-807.|
|↑5||Infertility Medications. American Pregnancy Association.|
|↑6||Polycystic Ovary Syndrome. Women’s Health. U.S. Department of Health and Human Services.|
|↑7||Bordewijk, Esmée M., Marleen Nahuis, Michael F. Costello, Fulco Van der Veen, Leopoldo O. Tso, Ben Willem J. Mol, and Madelon van Wely. “Metformin during ovulation induction with gonadotropins followed by timed intercourse or intrauterine insemination for subfertility associated with polycystic ovary syndrome.” The Cochrane Library (2017).|
|↑8||ART Success Rates. Centers for Disease Control and Prevention.|
|↑9||In Vitro Fertilization. American Pregnancy Association.|
|↑10||Intrauterine Insemination (IUI): Uses Risks And Success Rate. American Pregnancy Association.|