Infertility

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	Male reproductive anatomy	Pelvic laparoscopy	Primary infertility
Sperm

Primary infertility describes couples who have never been able to become pregnant after at least 1 year of unprotected sex (intercourse).

Secondary infertility describes couples who have been pregnant at least once, but have not been able to become pregnant again.

Inability to conceive; Unable to get pregnant

Causes of infertility include a wide range of both physical and emotional factors. A couple's infertility may be due to female factors, male factors, or both:

FEMALE INFERTILITY:

Female infertility may be due to:

• Problems with a fertilized egg or embryo being able to survive once it is attached to the lining of the uterus
• Problems with the fertilized egg being able to attach to the lining of the uterus
• Problems with the eggs being able to move from the ovary to the uterus
• Problems with the ovaries producing eggs

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Female infertility may be caused by:

• Autoimmune disorders, such as antiphospholipid syndrome (APS)
• Clotting disorders
• Defects of the uterus and cervix (myomas or fibroids, polyps, birth defects)
• Excessive exercising, eating disorders, or poor nutrition
• Exposure to certain medications or toxins
• Heavy use of alcohol
• Hormone imbalance or deficiencies
• Long-term (chronic) disease, such as diabetes
• Obesity
• Ovarian cysts and polycystic ovary syndrome (PCOS)
• Pelvic infection or pelvic inflammatory disease (PID)
• Scarring from sexually transmitted infection or endometriosis
• Tumor

MALE INFERTILITY:

Male infertility may be due to:

• A decrease in the number of sperm
• Sperm being blocked from being released
• Sperm that do not work properly

Male infertility can be caused by:

• Environmental pollutants
• Exposure to high heat for prolonged periods
• Genetic abnormalities
• Heavy use of alcohol, marijuana, or cocaine
• Hormone deficiency or taking too much of a hormone
• Impotence
• Infections of the testes or epididymis
• Older age
• Previous chemotherapy
• Previous scarring due to infection (including sexually transmitted diseases), trauma, or surgery
• Radiation exposure
• Retrograde ejaculation
• Smoking
• Surgery or trauma
• Use of prescription drugs, such as cimetidine, spironolactone, and nitrofurantoin

In healthy couples both under age 30, having sex regularly, the chance of getting pregnant is only 25 - 30% per month. A woman's peak fertility occurs in her early 20s. As a woman ages beyond 35 (and especially after age 40), the likelihood of getting pregnant drops to less than 10% per month.

When to seek help for infertility depends on your age. For women under age 30, it is generally recommended to try to conceive for at least a year before seeking testing.

Review Date: 03/21/2010
Reviewed By: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).