What is Infertility?

Most people understand intuitively that infertility is the inability to conceive a child. There is, however, a time factor involved in the definition, which depends on the age of the mother-in-waiting. For women 34 years old and younger, infertility is generally defined as the inability to conceive after one year of trying without protection; for women 35 to 37, six months; 38 and older, three months. This is as true for women trying for a second or successive child as it is for women trying to get pregnant for the first time.

Fertility rates for women decline significantly after age 34: Close to 25 percent of women may be infertile by the time they reach the age of 36, and women older than 41 rarely conceive without fertility treatment. There is a biological basis for this declining fertility: Every woman is born with a finite number of eggs, and not only do they age with her but that supply is depleted steadily from the time a woman is born.

Of course, men may also be infertile. Although this is not as definitively age-related as infertility in women because men produce new sperm throughout their post-pubescent life, the number and quality of sperm decreases as men age.

Unrelated to age, infertility is also indicated immediately if a woman is trying to become pregnant and has irregular menstrual cycles, has lost two or more pregnancies to miscarriage, or if other infertility treatments have been unsuccessful.

Infertility may also be related to lifestyle. Women’s lifestyle choices that may contribute to their infertility include smoking, weighing too much or too little, following a strenuous exercise regimen that causes an irregular or interrupted menstrual cycle and eating a diet high in trans fats. Some medications can also adversely affect fertility.

Lifestyle factors that can affect both men and women include contracting a sexually transmitted disease, recreational drug use and excessive alcohol intake. Because sperm can be damaged by excessive heat, men should avoid wearing tight-fitting briefs that hold the testicles too close to the body and spending excessive time in a hot tub.

Among the leading anatomical reasons for a woman’s infertility are early menopause and other ovulatory problems; endometriosis; uterine fibroids or polyps; damage or blockage of the fallopian tubes; and pelvic adhesions, inflammation or infection. In men, common anatomical causes of infertility include low or no sperm count, impaired motility or ejaculatory problems.

There are many fertility treatment options available to couples today. Consulting a trained fertility specialist, your OB/GYN or your primary care physician to evaluate possible causes of infertility is the first step in determining a course of action.

Daniel F. Rychlik, M.D., is board certified in Infertility and Reproductive Endocrinology by the American College of Obstetricians and Gynecologists; is an Assistant Clinical Professor at the University of Arizona, College of Medicine – Phoenix Campus; and is the Associate Medical Director at the Fertility Treatment Center with offices in Scottsdale, Tempe and Glendale, AZ. Visit: www.fertilitytreatmentcenter.com for more information.