Common Causes of Infertility

Common Causes of Infertility

Infertility is a diagnosis that about 15% of couples in the United States must grapple with and try to understand and overcome. Infertility is not only common, but it’s also becoming more frequent as couples delay starting their families.

At Noble Fertility Center in New York City’s Murray Hill neighborhood, our founder and fertility expert Peter L. Chang, MD, and our entire team are dedicated to helping you understand and overcome infertility. Following are some common causes of infertility.

Hormonal imbalances

The process of releasing eggs each month and maturing one that can be fertilized requires that your hormones are balanced. Aging, obesity, and certain health conditions can throw off the ratio of your hormones so you don’t ovulate regularly.

A condition called polycystic ovarian syndrome (PCOS), for example, causes women to have too much of the androgenic hormone testosterone. In addition to having problems with ovulation, women with PCOS may have visible facial hair and heavier than normal body hair, may struggle with acne, and may be overweight.

As you age, your hormonal balance shifts, too. Once you enter perimenopause, your levels of progesterone and estrogen may drop so that your menstrual cycle becomes irregular.

We evaluate your hormones and their ratio to one another as part of your fertility workup. This includes baseline hormone tests and another test on the third day of your menstrual cycle. The day three test helps us determine your ovarian reserve (how many eggs you have left).

We may recommend hormonal therapies to better regulate your cycle. We may also prescribe medications to help you produce and mature more eggs, which increases your chances of conception.

Your male partner may be low in the hormone testosterone. Men’s testosterone levels decrease with age and because of medical conditions, including obesity. He may also benefit from hormone replacement therapy to increase his testosterone levels. 

Blockages, scars, or other physical abnormalities

Just as a clog in the plumbing at your home can prevent water from flowing, scar tissue or other blockages in your fallopian tubes may prevent your eggs from traveling down toward your uterus. They also prevent sperm from traveling up toward the egg.

Your uterus could have abnormalities, such as fibroids, polyps, or other tumors. The shape of your uterus and the quality of the uterine lining (the endometrium) could prevent a fertilized egg from successfully implanting and growing.

We may administer a test called a hysterosalpingogram to evaluate your fallopian tubes and uterine cavity. During this test, we inject a dye that is visible on an X-ray so we can see if the dye travels freely through your tubes. 

The hysterosalpingogram also helps us determine how healthy and well-formed your uterus is. We use sonohysterography and hysteroscopy to further evaluate uterine health. Repairing any damage or removing scars or blockages can restore your reproductive system to health.

Males can also have scar tissue, growths, or physical abnormalities that inhibit the production of sperm or affect ejaculation. We may refer your partner to a urologist for evaluation and treatment.

Abnormal or not enough sperm

In about one-third of infertility cases, problems with the female’s hormones or reproductive organs causes infertility in a couple. In another third, the man’s hormones or structural abnormalities are the cause. In another third, both the female and male have abnormalities or imbalances that complicate conception.

We can conduct semen analysis of your male partner’s sperm. Only healthy, well-shaped sperm are energetic and strong enough to swim up the uterus and into the fallopian tubes to fertilize an egg.

Your partner must also have enough sperm. If his sperm counts are low, we may recommend intrauterine insemination, in which we inject his sperm directly into your fallopian tubes to increase chances of conception.

Underlying health conditions

You and your partner’s overall health affects your chances of conception. If you have underlying health issues — including obesity — we first recommend lifestyle changes and possibly medications to help manage or resolve the conditions. 

“Infertility” isn’t necessarily a lifetime label. To find out why you’re having trouble getting pregnant and to receive expert treatment and compassionate care, contact Noble Fertility Center by phone or use our online booking tool today.

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