According to the CDC, 7.5 million American women between the ages of 15–44 struggle with infertility or fecundity (ability to become pregnant or carry a baby to term). April 23–29, 2017, is National Infertility Awareness Week, an initiative that strives to help people understand and overcome infertility. If you’re struggling to conceive, you may need to see a specialist to understand the causes in your individual situation.
What Is Infertility?
Infertility is defined by the World Health Organization as the inability to conceive or carry a pregnancy to term after 12 months of actively trying to conceive. The National Infertility Association shortens the time period to six months for women over 35 years old.
In the United States, 10–15% of couples experience difficulty becoming pregnant. Infertility can be caused by conditions in either partner's body or a combination of both; in general, the causes are medically linked equally to male and female partners—if it is possible to identify a cause at all. Because a wide variety of contributing factors can lead to infertility, couples may need to consult with a fertility specialist, a reproductive endocrinologist, an OB/GYN, and/or a urologist for tests.
What Causes Infertility?
For men, infertility is commonly linked to abnormal sperm production, function, or delivery. Abnormal sperm production or function can be caused by, among other things, undescended testicles, genetic defects, health problems such as diabetes, or infections such as chlamydia, gonorrhea, mumps, or HIV, or enlarged testicular veins. Frequent exposure to heat or physical damage to the groin can also impair production. Delivery problems can encompass premature ejaculation, blockages in the testicles or other anatomical issues, or certain genetic diseases, such as cystic fibrosis.
For women, fertility problems can be caused by a wide variety of disorders of the reproductive system, including these common problems.
- Ovulation disorders affect the release of eggs from the ovaries. These include polycystic ovary syndrome (PCOS) and hormonal disorders like hyperprolactinemia, hyperthyroidism, and hypothyroidism.
- Uterine or cervical abnormalities can prevent fertilization or implantation. These include abnormalities with the opening of the cervix, polyps in the uterus, or issues with the shape of the uterus.
- Blockages or damage in the fallopian tubes can prevent fertilization or implantation. These can be caused by noncancerous (benign) tumors in the uterine wall (uterine fibroids) or by inflammation of the fallopian tube (salpingitis), which can arise from pelvic inflammatory disease.
- Endometrial tissue growing outside of the uterus (endometriosis) may cause painful irritation, scarring, adhesions, and cysts called endometriomas. This condition can interfere with conception directly by obstructing the fallopian tubes, preventing fertilization, and in less direct ways, including possibly causing damage to the sperm or egg.
- Early menopause occurs when the ovaries stop working and menstruation ends before age 40.
- Pelvic adhesions, composed of scar tissue that can form around organs following a pelvic infection, appendicitis, or abdominal or pelvic surgery, can interfere with conception or successful completion of pregnancy.
Medical conditions associated with delayed puberty or the absence of menstruation, including celiac disease, diabetes, and autoimmune diseases, can also impact fertility in women.
Environmental factors like pesticides, chemicals, and radiation, cancer treatment (including radiation and chemotherapy), and many drugs including antibiotics, antihypertensives, and anabolic steroids can reduce fertility. Lifestyle factors like cigarette smoking, alcohol, being overweight or obese, eating disorders, and a sedentary lifestyle can also impact fertility. Fertility in both sexes naturally declines with age, especially in women after their mid 30s and men over age 40, and the risk of certain medical conditions in their offspring goes up.
How Sonohysterogram & Hysterosalpingogram (HSG) Can Help
Your physician may recommend diagnostic imaging tests to determine if your infertility may be caused by physical issues in your reproductive system, like polyps or fibroids. A sonohysterogram is a minimally invasive ultrasound imaging procedure that allows a radiologist to examine the interior of your uterus and identify abnormalities. If the results indicate that you may have a blockage in your fallopian tubes, your doctor may recommend a follow-up hysterosalpingogram (HSG). In this test, a contrast material is injected and observed on X-ray as it flows into the fallopian tubes, revealing whether they are clear or have blockages or abnormalities. These tests can help explain or rule out potential causes of your infertility and can help your doctors develop a plan for further treatment.
If you are struggling with infertility, talk to your doctor about what you can do to overcome this common, frustrating issue.
Iowa Radiology provides a wide range of women's imaging services in the Des Moines metro area, including sonohysterography, hysterosalpingography, breast imaging and biopsy, and bone density scanning. We believe in helping you get all the information you need about your health. Our caring team members are available to answer any questions you have about procedures at our clinics. Don’t hesitate to contact us if you have questions or concerns.
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