The most common causes of infertility

Many women when they start looking for a pregnancy realize that it is not as simple as one might think. Years are spent taking precautions to be careful not to conceive, and when the time comes the stork does not appear on the horizon.

Twist of fate ? And what are the most common causes of infertility?

Most couples are able to achieve pregnancy within the year of focused attempts:

• 86% of women between the ages of 20 and 24
• 78% of women between 25 and 29 years old
• 63% of women between 30 and 34 years old
• 52% of women between 35 and 39 years of age
• 36% of women between 40 and 44 years of age
• 5% of women between 45 and 49 years of age

(source : A. Toledo, MD, Reproductive Biology Associates)

If you are part of the remaining percentage, it is advisable to carry out checks after a year of attempts if you are under 36 years old, already after 6 months of targeted attempts if you are over 36 years old in order not to waste time given that with the increase in age decreases the chances of getting pregnant per menstrual cycle.

What are the most common causes of infertility?

Early menopause and POF

We speak of premature ovarian insufficiency (POF) in women under the age of 40, of early menopause between 40 and 48 years.

The cause is often genetic but this does not necessarily mean that you can no longer get pregnant. Through hormonal stimulation pathways some women still manage to produce good quality oocytes that can be fertilized in vitro. For many women who find themselves in this situation, however, the only way remains egg donation.

Premature menopause and POF can lead to obvious symptoms for which you go to the doctor (menstrual irregularity, vaginal dryness, hot flashes, irritability…) or show no obvious symptoms other than unexplained infertility.

A gynecological and endocrinological check-up can highlight the situation.

Anovulation

Difficulty ovulating is one of the most common causes of infertility and is often treated with medications such as clomiphene citrate (commonly known as Clomid). Anovulatory cycles can occur a couple of times a year in conditions of normal fertility and shouldn’t be a cause for concern, unlike if they become more frequent.

Endometriosis

Endometriosis occurs when the tissue lining the inside of the uterus (the endometrium) grows into other organs in the body, such as the fallopian tubes, or the abdominal cavity. Even if located in other “wrong” areas, this tissue still responds to the hormonal stimulation typical of the menstrual cycle, causing internal bleeding, inflammation, adhesions, pain and in many cases infertility.

Women suffering from endometriosis should consult a specialist to evaluate forms of drug treatment or surgery.

Micropolycystic ovary syndrome (PCOS)

Micropolycystic ovary syndrome (PCOS) is a hormonal disorder that reduces the ovaries’ ability to mature and release egg cells into the fallopian tubes. there is no definitive cure but some treatments that can help improve ovulation, such as inositol for example or specific drugs such as metformin.

However, recent studies have shown how lifestyle changes, weight loss (PCOS sufferers are often overweight), the adoption of a low-carbohydrate diet with a preference for those with a low glycemic index, can improve the situation clearly. So a consultation from a nutritionist as well as an endocrinologist may be the best way forward in this situation.

Male infertility

Recent studies have shown that male infertility problems exist in nearly half of couples struggling with fertility problems . For this reason, when the pregnancy is late in arriving, the couple is always advised to carry out both tests, which initially consist of a spermiogram for the man.

When there are male fertility problems that compromise natural fertilization, assisted fertilization treatments take over, especially in vitro fertilization. In the most serious cases of complete absence of viable or normal sperm, donation can be used ( heterologous fertilization ).

Uterine fibroids

Uterine fibroids are benign tumors inside or outside the uterus that can lead to abnormal bleeding and infertility. The placement and size of the fibroid indicate whether it needs to be surgically removed. Fibroids that grow inside the uterine cavity can often be removed during outpatient surgery.

Closure of the tubes

Tubal closure can be total or partial. Approximately 20-25% of all infertility cases diagnosed in the United States are caused by a diagnostic test (hysterosalpingography) to evaluate the state of the tubes. Reconstructive surgery can remedy slightly damaged tubes. In the most serious cases, in vitro fertilization is used.

Low ovarian reserve

It results in a low number and low quality of oocytes. In assisted fertilization treatments in these cases fewer embryos and lower pregnancy rates are obtained. The reduced ovarian reserve can be evaluated with appropriate hormonal dosages that allow us to understand which is the best treatment to do.

Reports on the wrong days

Many couples fail to correctly identify the fertile days or have too little intercourse. In these cases the solution is much simpler, just help yourself with the various methods that help identify fertile days and then have intercourse every other day.