American Society for Reproductive Medicine. Accessed April 4, Jameson JL, et al. Female infertility: Evaluation and management. In: Endocrinology: Adult and Pediatric. Philadelphia, Pa: Saunders Elsevier; Accessed April 27, Clinical management of male infertility.
Accessed March 25, Wein AJ, et al. Male infertility. In: Campbell-Walsh Urology. Philadelphia, Pa. Accessed May 5, Frequently asked questions. Gynecologic problems FAQ Treating infertility. American College of Obstetricians and Gynecologists. Infertility FAQs. Centers for Disease Control and Prevention.
Accessed May 2, Kuohung W, et al. Overview of infertility. Evans-Hoeker EA, et al. Major depression, antidepressant use, and male and female infertility. Fertility and Sterility. Evaluating infertility. Lobo RA. Infertility: Etiology, diagnostic evaluation, management, prognosis. In: Comprehensive Gynecology. Treatments for female infertility.
Committee Opinion No. Reaffirmed Use of certain medications and supplements. Cancer treatment involving the use of certain types of chemotherapy, radiation, or surgery to remove one or both testicles Medical conditions such as diabetes, cystic fibrosis, certain types of autoimmune disorders, and certain types of infections may cause testicular failure.
Hormonal disorders Improper function of the hypothalamus or pituitary glands. The hypothalamus and pituitary glands in the brain produce hormones that maintain normal testicular function. Production of too much prolactin, a hormone made by the pituitary gland often due to the presence of a benign pituitary gland tumor , or other conditions that damage or impair the function of the hypothalamus or the pituitary gland may result in low or no sperm production.
Although advanced age plays a much more important role in predicting female infertility, couples in which the male partner is 40 years old or older are more likely to report difficulty conceiving. Being overweight or obese. Excessive alcohol use. Use of marijuana. Exposure to testosterone. This may occur when a doctor prescribes testosterone injections, implants, or topical gel for low testosterone, or when a man takes testosterone or similar medications illicitly for the purposes of increasing their muscle mass.
Exposure to radiation. Frequent exposure of the testes to high temperatures, such as that which may occur in men confined to a wheelchair, or through frequent sauna or hot tub use. Exposure to certain medications such as flutamide, cyproterone, bicalutamide, spironolactone, ketoconazole, or cimetidine.
Exposure to environmental toxins including exposure to pesticides, lead, cadmium, or mercury. What causes infertility in women? Some women with PCOS have elevated levels of testosterone, which can cause acne and excess hair growth. PCOS is the most common cause of female infertility. Diminished ovarian reserve external icon DOR. Women are born with all of the eggs that they will ever have, and the number of eggs declines naturally over time.
Diminished ovarian reserve is a condition in which there are fewer eggs remaining in the ovaries than expected for a given age. It may occur due to congenital, medical, surgical, or unexplained causes. Women with diminished ovarian reserve may be able to conceive naturally but will produce fewer eggs in response to fertility treatments. Functional hypothalamic amenorrhea FHA. FHA is a condition caused by excessive exercise, weight loss, stress, or often a combination of these factors.
It is sometimes associated with eating disorders such as anorexia. Improper function of the hypothalamus and pituitary glands. The hypothalamus and pituitary glands in the brain produce hormones that maintain normal ovarian function. Production of too much of the hormone prolactin by the pituitary gland often as the result of a benign pituitary gland tumor , or improper function of the hypothalamus or pituitary gland, may cause a woman not to ovulate.
Premature ovarian insufficiency external icon POI. Although certain exposures, such as chemotherapy or pelvic radiation therapy, and certain medical conditions may cause POI, the cause is often unexplained. Menopause external icon. Menopause is an age-appropriate decline in ovarian function that usually occurs around age By definition, a woman in menopause has not had a period for at least one year.
She may experience hot flashes, mood changes, difficulty sleeping, and other symptoms as well. Fallopian tube obstruction whether fallopian tubes are open, blocked, or swollen Risk factors for blocked fallopian tubes external icon tubal occlusion can include a history of pelvic infection, history of ruptured appendicitis, history of gonorrhea or chlamydia , known endometriosis external icon , or a history of abdominal surgery.
Hysterosalpingogram is an X-ray of the uterus and fallopian tubes. A radiologist injects dye into the uterus through the cervix and simultaneously takes X-ray pictures to see if the dye moves freely through fallopian tubes. This helps evaluate tubal caliber diameter and patency. Chromopertubation is similar to an HSG but is done in the operating room at the time of a laparoscopy.
Blue-colored dye is passed through the cervix into the uterus and spillage and tubal caliber shape is evaluated. What increases a woman's risk of infertility? Female fertility is known to decline with Age. About 1 in 6 couples in which the woman is 35 and older have fertility problems. Aging decreases fertility because older women have fewer eggs left, the eggs are less healthy, and the woman is more likely to have health conditions that can cause fertility problems.
Extreme weight gain or loss. Excessive physical or emotional stress that results in amenorrhea absent periods. How long should couples try to get pregnant before seeing a doctor? So, couples with the following signs or symptoms should not delay seeing their health care provider when they are trying to become pregnant: Irregular periods or no menstrual periods.
Very painful periods. Endometriosis external icon. Pelvic inflammatory disease. More than one miscarriage. Suspected male factor i. How will doctors find out if a woman and her partner have fertility problems? How do doctors treat infertility? Doctors recommend specific treatments for infertility on the basis of: The factors contributing to the infertility.
Some men experience ejaculation problems that can make it difficult for them to release semen during sex ejaculate. Hypogonadism is an abnormally low level of testosterone, the male sex hormone involved in making sperm.
It could be caused by a tumour, taking illegal drugs, or Klinefelter syndrome a rare syndrome involving an extra female chromosome. Certain types of medicines can sometimes cause infertility problems. Illegal drugs, such as marijuana and cocaine, can also affect semen quality.
In the UK, unexplained infertility accounts for around 1 in 4 cases of infertility. This is when no cause can be identified in either partner. If a cause for your fertility problems has not been found, talk to your doctor about the next steps. The NICE guidance has more about unexplained infertility.
Find out more about fertility tests and how problems are diagnosed. Page last reviewed: 18 February Next review due: 18 February Infertility in women Infertility is commonly caused by problems with ovulation the monthly release of an egg from the ovaries. Ovulation problems can be a result of: polycystic ovary syndrome PCOS thyroid problems — both an overactive thyroid gland and an underactive thyroid gland can prevent ovulation premature ovarian failure — where the ovaries stop working before the age of 40 Scarring from surgery Pelvic surgery can damage and scar the fallopian tubes, which link the ovaries to the womb.
Cervical mucus problems When you're ovulating, mucus in your cervix becomes thinner so sperm can swim through it more easily. Fibroids Non-cancerous growths called fibroids in or around the womb can affect fertility.
Endometriosis Endometriosis is a condition where small pieces of the womb lining the endometrium start growing in other places, such as the ovaries. Pelvic inflammatory disease Pelvic inflammatory disease PID is an infection of the upper female genital tract, which includes the womb, fallopian tubes and ovaries. Sterilisation Some women choose to be sterilised if they do not want to have any more children. Medicines and drugs The side effects of some types of medicines and drugs can affect your fertility.
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