Infertility
What is infertility?
Infertility is defined as the inability to conceive after one year of unprotected sex, or six months if a woman is age 35 or older. Infertility is also trouble staying pregnant. The NIH reports that about 11% of women and 9% of men in America have problems with fertility.
Generally a diagnosis of infertility means you have tried for a year (or six months) to conceive, or you have had multiple miscarriages. Infertility is a common problem that increases with age.
Infertility isn’t just a woman’s problem. It is caused by both male and female factors. Studies report that one third of infertility cases are caused by male reproductive issues, one third by female reproductive issues, and one third by both male and female reproductive issues or unknown factors. This is why both partners must be tested to identify the cause.
Getting pregnant is a multistep process. At any step of the way, a problem can result that causes infertility:
- The woman must release an egg from an ovary.
- The man’s sperm must meet with the egg and fertilize it.
- The fertilized egg must move through the fallopian tube and land in the womb.
- The embryo must attach to the wall of the uterus(implantation).
What causes infertility?
In some cases, the cause is unknown. The most common cause in women is ovulation problems. The most common cause in men is problems with sperm and how they function. Other important factors include age, lifestyle, and general health.
Common causes of infertility in cis women include:
- Ovulation disorders
- Hormone problems
- Tubal blockage or scarring from a previous STI or endometriosis
- Poor egg quality
- The shape of the uterus
- Endometriosis
- Uterine fibroids
- Pelvic inflammatory disease
- Thyroid or pituitary gland problems
- Untreated chlamydia or gonorrhea
Male factor infertility or common causes of infertility in cis men:
- low sperm count
- poor sperm motility
- defective sperm formation caused by a varicocele, a condition where the veins in a man’s testicles are enlarged which affects the number or shape of the sperm
- semen that is too thick and slows down sperm
- the absence of sperm
- sperm related problems due to hormones
- blocked testicles
- trauma to the scrotum or testes
- untreated chlamydia or gonorrhea
How is infertility diagnosed?
Dr. Patel will recommend an infertility evaluation which will include exams and tests of you and your partner. The goal is to attempt to find the cause of your infertility. She will take a detailed medical and family history and ask questions about your period, pain, any STIs, and past surgeries. She will check for diseases like thyroid disease and lifestyle factors that can affect reproduction. She will ask about your sexual history, any history of miscarriages, birth control, how often you have sex, and how long you have been trying to conceive. She may ask you to track your ovulation.
Dr. Patel will perform a physical exam and order basic lab tests to evaluate blood and hormones, in addition to a semen analysis. She will also order or perform imaging studies like ultrasound to look at the reproductive organs. She may refer your partner to a urologist for a more detailed analysis. She may recommend advanced testing and may refer you to a fertility expert.
Infertility is a life crisis. Finding the cause is a stressful, emotional process, and it takes time. Patients struggling to conceive report feelings of depression, anxiety, isolation, and loss of control. Dr. Patel may refer you for psychological counseling to support you through the process, which has been shown to lower your distress and increase your ability to conceive. Contact Dr. Patel to schedule a consultation today.
Dr. Dwaita Patel is a board-certified obstetrician and gynecologist at City OB+GYN in New York City, and a fellow of the American College of Obstetrics and Gynecology (FACOG). She specializes in women’s health, and the full scope gynecological services, including routine exams, contraceptive counseling, breast and ovarian cancer screenings, osteoporosis screening, premenstrual syndrome management and more.
Dr. Patel is kind and compassionate and finds great joy and fulfillment in her work. She offers the full scope of obstetrics including pre-pregnancy, prenatal, labor and delivery and postpartum care for low and high-risk patients. She also offer medical treatments and minimally invasive surgery for gynecologic conditions. All deliveries and major surgeries are performed at Tisch Hospital/NYU Langone Medical Center in Manhattan.
