What to know about male and female infertility - Ruth Health

What to know about male and female infertility

Fast facts:

  • Infertility is defined as the inability to get pregnant after a year or more of regular, unprotected sex.
  • 9% of men and 11% of women of reproductive age in the U.S. have experienced infertility.
  • Conception may be possible after pursuing fertility treatments such as IVF, oral and injectable medications, and artificial insemination.
  • Consult a reproductive specialist if you are 35 or older and have tried unsuccessfully to conceive for six months. Or, if you are younger than 35 and tried unsuccessfully to conceive for a year.

If you have struggled to conceive naturally, know that you’re not alone. 9% of men and 11% of women of reproductive age in the U.S. have experienced infertility. This is defined as the inability to get pregnant after a year or more of regular, unprotected sex.

Infertility isn’t exclusively a women’s health issue. It can affect anyone regardless of gender. 

  • One-third of infertility cases are attributed to a female reproductive factor
  • One-third attributed to a male reproductive factor
  • One-third attributed to a combination of both or to unknown causes.

While these challenges may feel difficult to navigate, it is possible to have biological children after pursuing fertility treatment. A reproductive specialist can identify the underlying causes of your or your partner’s infertility and recommend the best treatment option.

Here’s an overview of male and female infertility, including signs of infertility and treatment options.

What are some common infertility issues?

Female infertility often stems from an issue with the ovaries, fallopian tubes, or uterus. There are several types of complications that may occur.

  • Disruption of ovarian function and issues with ovulation, the release of a mature egg from the ovaries
    • This may occur as the result of hormonal disorders such as polycystic ovary syndrome (PCOS), excessive exercise, eating disorders, stress, or aging.
  • Uterine or cervical abnormalities that block the fallopian tubes or prevent a fertilized egg from implanting in the uterus
    • Contributing factors include benign growths such as uterine fibroids and polyps as well as endometriosis and adenomyosis. 
  • Fallopian tube obstruction
    • This may be caused by a history of pelvic inflammatory disease, ruptured appendix, or endometriosis.

Certain types of cancer, particularly those of reproductive organs, and their treatment may also impact a woman’s risk of infertility.

There are also contributing factors unrelated to reproductive function, including the following:

  • Liver and kidney diseases
  • Blood diseases
  • Diabetes
  • Obesity
  • Nicotine and narcotic usage
  • Exposure to radiation

Most cases of male infertility relate to issues with sperm production, including sperm quantity and quality. A low sperm count is typically defined as less than 15 million sperm per milliliter of semen. Male infertility can also be an issue of sperm delivery. 

In some cases, there may not be an explanation for contributing factors. Around one in four couples affected by infertility will receive an unexplained diagnosis. This can be emotionally taxing and frustrating. 

Finding support is crucial throughout the fertility journey. Resources like RESOLVE: The National Infertility Association can help you connect with others facing similar challenges.

Read Understanding the Causes of Infertility for a closer look at common fertility issues.

Are there any signs of infertility?

It isn’t uncommon to first discover a fertility issue after unsuccessfully trying to get pregnant for more than a year. While many cases of infertility lack noticeable symptoms, there are some infertility warning signs to watch for.

Most health experts suggest consulting a healthcare professional if any of the following applies to you.

  • You are 35 or older and have tried unsuccessfully to conceive for six months.
  • You are younger than 35 and have not become pregnant after a year of regular, unprotected sex.
  • You’ve experienced at least two successive pregnancy losses.
  • You have a key risk factor for infertility such as a health condition linked to infertility.

The following symptoms may be linked to a fertility issue.

  • Irregular or absent menstrual periods
  • Abnormally light or heavy bleeding during menstrual periods
  • Pelvic pain or pain during sex
  • Erectile dysfunction or low libido in men

How is infertility in women diagnosed?

Your doctor will ask questions about your health history, including factors related to your reproductive health and fertility.

Several tests may then be used to confirm a diagnosis of infertility.

  • A hysterosalpingogram (HSG) uses a special type of x-ray to identify potential issues within the uterus and fallopian tubes.
  • Blood tests check for levels of hormones related to ovulation and female fertility such as progesterone and prolactin.
  • Ovarian reserve testing determines the quality and quantity of eggs that may be used for ovulation. These blood and imaging tests are recommended for women at a greater risk of a low egg count. This includes those over 35.

How is infertility in men diagnosed?

An evaluation for male infertility begins with a conversation about a man’s medical history. This may include any factors related to reproductive health and fertility.

The most common next step is a semen test. This helps a doctor understand sperm count and overall sperm function including mobility. For many men, this is the only test required during the diagnostic process. Additional tests may be recommended in some cases.

  • Blood tests check for levels of testosterone, thyroid, and other hormones related to male fertility.
  • Genital ultrasounds can identify testicular problems.

What are the most common infertility treatments for women?

IVF often comes to mind at the mention of fertility treatment, but it is one of many options. 80-90% of couples facing infertility are treated with medications or surgery.

The right fertility treatment for you depends on the cause of your or your partner’s infertility. Treatment encompasses medications, surgery, lifestyle changes, and forms of assisted reproductive technology (ART) including IVF.

These are some of the common infertility treatments.

  • ART including IVF, gamete intrafallopian transfer (GIFT), and zygote intrafallopian transfer (ZIFT)
  • Injectable fertility medications including gonadotropins (Gonal-F®, Follistim®, Ovidrel®) and oral fertility medications including Arimidex®, Clomid, and Femara®
  • Forms of artificial insemination including intrauterine insemination (IUI)
  • Surgical procedures including laparoscopic surgery and ovarian drilling
  • Treatment of an underlying health condition related to infertility

If you have additional questions regarding infertility, consult your physician or trusted healthcare professional to discuss diagnosis and treatment options.

Ruth Health is here to provide you with expert, evidence-based maternal care and advice. Interested in learning more about a particular topic? Send us an email at hello@ruthhealth.com.

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