Approximately 1 in 6 couples is thought to be affected with issues pertaining to infertility. However, this number may actually be an underestimate since so many couples never come forward to receive treatment. I think the lack of adequate and information to the mass public as well as primary care providers is unfortunate since there are so many options available to treat couples with infertility depending on their particular situation. Majority of couples entering treatment do eventually achieve a successful pregnancy. The key is to not lose hope and hang in there. To me as a Reproductive Endocrinologist, there is nothing more satisfying than the day a patient has a positive pregnancy test and when I perform their sonogram later on, I can see the intense joy on their faces once they see and hear the heart beat of their precious little baby. That is what makes it all worth it to me. There is nothing more rewarding than the journey I take together with each of my patients through their trials and tribulations to ultimately achieve their goal of building a family. I started private practice as a Reproductive Endocrinologist in 2006 and even since then there have been new developments in the field. We are learning new things everyday and are a cutting edge field with promises of so many new developments in the future to make it even more possible to help couples with infertility and recurrent miscarriages. My message to women is that if you are over 35 years old and have been trying for 6 months without success, please at least see a doctor and get evaluated. Fertility declines rapidly with age and if there is a problem you would want to know and treat it sooner than later. For women under 35 if they are having regular cycles and the couple is otherwise healthy, it is okay to try for one year before seeking care. 80% of young healthy couples will conceive within 1 year of trying. But it is important to seek help if needed. Causes of Infertility: There can be many causes for infertility. The most common causes are listed below: Anovulation – The lack of regular menstrual cycles is a sign of lack of appropriate ovulation. This is a very common cause of infertility. Many women with irregular cycles have polycystic ovary syndrome (PCOS). Other causes of cycle irregularity can be hormonal issues such as with thyroid or prolactin, diminished ovarian reserve, stress, hypothalamic causes, obesity, certain medications and some other conditions. The good news is that issues with ovulation are often easy to treat with simple medications such as the oral pill clomiphene citrate. If you have irregular cycles it is important to seek evaluation with your doctor. Polycystic Ovarian Syndrome (PCOS) - This is one of the most common diseases responsible for infertility. There are several hormonal imbalances in this disorder, causing menstrual irregularities and anovulation. In many cases of PCOS, medication can help reverse this imbalance and help a woman achieve ovulation. Also, studies have shown that even an 8-10% reduction in body weight in obese women with PCOS can significantly improve metabolic parameters and response to treatment as well as chances of conception. Blocked fallopian tubes – Tubal factor is another common cause of infertility. You may be ovulating normally and everything else checks out alright. However, a blockage in one or both of your uterine tubes can prevent sperm from reaching the egg. A blockage can be diagnosed with a hysterosalpingogram, or HSG. If tubal blockage is diagnosed, sometimes surgery can be undertaken to try and correct the anatomical abnormality, but often In-vitro fertilization is the best treatment. Endometriosis - Endometriosis is the presence and growth of functioning endometrial tissue in places other than the uterus. Women with endometriosis have lower chances of conception per cycle than those without. However the chances of conception are significantly improved with fertility treatments. If you have a known diagnosis of endometriosis and have not conceived successfully after trying on your own (barring other issues) for 6 months, it is reasonable to request your doctor give a referral to see an infertility specialist. Uterine abnormalities – There can be congenital or acquired abnormalities of the uterus such as a septum or intrauterine adhesions, fibroids, polyps etc which can hinder fertility or cause a miscarriage. These can be often diagnosed via an pelvic sonogram or hysterosalpingogram (HSG). Most infertility specialists will assess you for uterine abnormalities at the initial consultation and order testing as appropriate. Male factor - About 30-40% of the time when a couple has infertility it is due to abnormalities with partner’s sperm. A semen analysis is a basic part of infertility evaluation and if abnormal treatment options can range form intrauterine insemination to in-vitro fertilization with intracytoplasmic sperm injection to donor sperm. Unexplained infertility – Approximately 10% of couples have unexplained infertility where all the testing is negative. However the good news is that many couples are amenable to treatment and can achieve a successful pregnancy with some help. | 
Tweet me!
