National Infertility Awareness Week (NIAW) brings attention to a topic that many individuals and couples experience privately. According to the World Health Organization, approximately 1 in 6 people worldwide experience infertility in their lifetime. While this experience can feel isolating, many individuals and couples are going through something similar, even if it is not often talked about openly.
Infertility is typically defined as the inability to get pregnant after a period of unprotected intercourse. This clinical definition offers a starting point, but each situation is shaped by individual factors. Understanding the causes of infertility is the first step towards your next steps.
What Is Infertility?
Infertility refers to the inability to achieve pregnancy after 12 months of regular attempts to conceive. For individuals over the age of 35, evaluation is generally recommended after six months.
There are two types of infertility: primary infertility and secondary infertility. Primary infertility applies when pregnancy has never occurred, while secondary infertility describes difficulty becoming pregnant after a prior pregnancy. Both are common and fall within the broader definition of infertility.
Infertility involves both medical and lifestyle considerations, and early evaluation helps in identifying next steps. At Piedmont Reproductive Endocrinology Group (PREG), patients are able to schedule an infertility evaluation directly without a referral, allowing for a timely discussion of fertility treatment options.
What Are the Common Causes of Infertility in Women?
Female infertility causes often relate to ovulation, the female reproductive system, or hormonal regulation and sometimes involve more than one contributing factor. These factors are often evaluated together to better understand how they may be affecting fertility.
Ovulation disorders are a significant contributor to infertility in women. Clinical research conducted by the National Center for Biotechnology Information indicates that ovulatory dysfunction accounts for approximately 25% to 40% of infertility cases. Conditions such as polycystic ovary syndrome (PCOS) can affect the menstrual cycle and prevent regular ovulation, and when ovulation is inconsistent, it becomes more difficult for a fertilized egg to form.
Endometriosis can affect the reproductive organs by causing inflammation or scar tissue, which may interfere with how the fertilized egg implants within the uterine lining.
The fallopian tubes play a critical role in reproduction, as they carry sperm toward the egg and allow fertilization to occur. When fallopian tubes are damaged or blocked, often due to prior infection such as pelvic inflammatory disease or previous surgery, the egg and sperm may not meet. In these cases, blockage can prevent fertilization from occurring naturally.
Uterine conditions, including fibroids or polyps, can affect how the fertilized egg implants. The structure of the uterus and fallopian tubes together influences how pregnancy begins and progresses.
Hormonal imbalance involving reproductive hormones, including signals from the pituitary gland, can interfere with ovulation and the overall function of the female reproductive system.
Fertility in women can also change over time, particularly as egg quantity and quality naturally shift with age. This is one of several factors that may influence reproductive health.
What Are the Common Causes of Infertility in Men?
Male infertility causes are equally important when evaluating infertility in men and couples. Male factor infertility may involve sperm production, sperm quality, or the male reproductive system, and these factors are often assessed alongside female fertility to provide a complete picture.
Low sperm count is one of the more commonly identified issues, and when sperm count is reduced, the likelihood of fertilization decreases.
Sperm production and sperm quality are both essential. Abnormal sperm function, including poor motility or structure, can affect the ability of sperm to reach and fertilize the egg. Factors that affect sperm production may also influence overall male fertility.
Hormonal imbalance can interfere with sperm production too, and signals from the pituitary gland and other parts of the male reproductive system regulate how sperm develop.
A varicocele can affect sperm production by disrupting temperature regulation within the scrotum.
Additional male factors may include genetic disorders, chromosomal abnormalities, or structural concerns such as undescended testicles. In some cases, sexual dysfunction or erectile dysfunction may also contribute to infertility in men.
Lifestyle factors, including smoking, exposure to environmental toxins, or habits such as frequent heat exposure, can affect sperm production and overall reproductive health.
What Is Unexplained Infertility?
Unexplained infertility refers to cases where standard fertility testing does not identify a clear cause. This form of infertility is relatively common among infertile couples.
Fertility testing may appear normal even when infertility problems are present. This reflects the complexity of reproductive medicine rather than the absence of an issue.
Even when infertility with no known cause is identified, infertility treatment options are still available. Approaches such as intrauterine insemination (IUI) or in vitro fertilization (IVF) are forms of assisted reproductive technology that may be considered based on individual factors.
What Are the Risk Factors That Can Affect Fertility?
A number of risk factors can affect fertility in both men and women. These factors do not always cause infertility on their own, but they can influence reproductive health:
- Age, particularly in relation to female fertility
- Weight, including being underweight or overweight
- Smoking or exposure to environmental toxins
- Alcohol use or habits such as frequent heat exposure
- Chronic medical conditions or prior cancer treatment
Understanding what affects fertility allows for a more complete evaluation and guides fertility treatment decisions by infertility specialists at Piedmont Reproductive Endocrinology Group (PREG).
When Should You See a Fertility Specialist?
Knowing when to see a fertility specialist is an important part of addressing fertility problems.
Fertility evaluation is typically recommended after 12 months of trying to get pregnant, or after six months for individuals over age 35. Earlier fertility evaluation may be appropriate when there are irregular menstrual cycles, known conditions such as endometriosis, or prior reproductive concerns.
Both partners should be evaluated. Male and female infertility often involves shared or overlapping factors, and fertility testing both individuals allows for a more complete infertility diagnosis.
What Happens During Fertility Testing?
Fertility testing is the best way to diagnose infertility and understand contributing factors affecting reproductive health.
For women, testing may include bloodwork to assess reproductive hormones, ultrasound imaging of the reproductive organs, and procedures such as a hysterosalpingogram to evaluate the fallopian tubes.
For men, a semen analysis evaluates sperm count, sperm production, and sperm quality. This provides insight into male fertility and helps identify male factor infertility.
Based on the results, infertility treatment options may be discussed. These may include:
- Ovulation induction, a fertility treatment using medication (commonly Clomid or Letrozole) to stimulate ovaries to release eggs
- Intrauterine insemination (IUI), sometimes referred to as artificial insemination
- In vitro fertilization (IVF), an advanced form of assisted reproductive technology
- Third party reproduction, individuals or couples use donated eggs, sperm, embryos, or a gestational carrier to achieve pregnancy
- Preimplantation genetic testing (PGT), used during IVF to screen embryos for genetic abnormalities or chromosomal conditions before implantation
- Egg freezing or fertility preservation, a woman’s eggs are extracted, frozen, and stored to preserve reproductive potential for the future
Each fertility treatment plan at Piedmont Reproductive Endocrinology Group (PREG) is guided by each patient’s unique diagnosis and clinical needs. We take a personalized, compassionate approach to care (never one-size-fits-all) because every fertility journey is different.
You’re Not Alone During National Infertility Awareness Week
National Infertility Awareness Week (NIAW) is an opportunity to bring often-unspoken experiences into the open and empower individuals with knowledge about their reproductive health. If you’ve been wondering whether it’s time to seek answers, a fertility evaluation at PREG can provide clarity and direction. Many causes of infertility can be addressed with a personalized treatment plan from our fertility doctors tailored to your specific needs.
If you’re having difficulty trying to conceive or simply have questions about your fertility, we invite you to schedule a consultation with Piedmont Reproductive Endocrinology Group (PREG) at one of our fertility clinics across the Carolinas.
