What is Infertility?
Defining Infertility
Infertility is medically defined as the inability to achieve pregnancy after 12 months of regular, unprotected sexual intercourse. For women over the age of 35, evaluation is recommended after 6 months due to the natural decline in fertility with age. Infertility also applies to individuals or couples who can conceive but experience recurrent pregnancy loss, such as multiple miscarriages or stillbirths.
How Common is Infertility?
Infertility is more common than many realize, affecting an estimated 1 in 6 couples worldwide. It can cause significant emotional, physical, and financial stress, but the good news is that many effective treatments are available.
Causes of Infertility in Women
Infertility in women can be linked to several health and reproductive factors:
- Ovulation Disorders: Irregular or absent ovulation (anovulation) is one of the most common causes of female infertility. Conditions such as Polycystic Ovary Syndrome (PCOS), thyroid dysfunction, and premature ovarian insufficiency can disrupt hormonal balance and prevent the release of eggs.
- Fallopian Tube Damage or Blockage: The fallopian tubes must be open for the egg to meet the sperm. Pelvic inflammatory disease, previous ectopic pregnancies, or endometriosis can cause scarring or blockages that prevent fertilization.
- Uterine or Cervical Abnormalities: Conditions such as fibroids, polyps, or a septate uterus can interfere with implantation or cause recurrent miscarriages.
- Age-Related Factors: As women age, both the quantity and quality of their eggs decline. Fertility begins to decline significantly after age 35 and more rapidly after age 40.
- Endometriosis: This condition occurs when the tissue that lines the uterus grows outside of it, leading to inflammation, scarring, and pain. Endometriosis can impact ovulation, egg quality, and tubal function.
- Lifestyle and Environmental Factors: Smoking, excessive alcohol, poor nutrition, high stress, and exposure to environmental toxins can all negatively impact reproductive health.
Causes of Infertility in Men
Male infertility is responsible for nearly half of all infertility cases. Common causes include:
- Low Sperm Count: A low number of sperm in the ejaculate (oligospermia) or no sperm at all (azoospermia) can make conception difficult.
- Poor Sperm Motility or Morphology
If sperm do not move properly (motility) or are abnormally shaped (morphology), they may not reach or fertilize the egg. - Varicocele: Enlarged veins in the scrotum can raise the temperature in the testicles, affecting sperm production and quality.
- Hormonal Imbalances: Low levels of testosterone or other hormone disruptions due to pituitary disorders can reduce sperm production.
- Genetic Factors: Certain inherited conditions, such as Klinefelter syndrome or Y chromosome deletions, may impact fertility.
- Obstruction or Injury: Blockages in the vas deferens or past trauma/infections can prevent sperm from being ejaculated.
- Lifestyle and Health Factors: Obesity, smoking, excessive alcohol, drug use, or exposure to heat and chemicals can impair sperm production.
When to See a Fertility Specialist
Early evaluation can save time, emotional distress, and improve treatment success. You should consider seeing a fertility specialist if:
- You’re Under 35 and Have Been Trying for 12 Months: After a year of trying without success, evaluation can help identify any underlying issues.
- You’re 35 or Older and Have Been Trying for 6 Months: Female fertility declines with age, so earlier intervention is recommended.
- You Have Irregular or Absent Periods: This may indicate an ovulation disorder that needs attention.
- You’ve Experienced Two or More Miscarriages: Recurrent pregnancy loss may point to anatomical, hormonal, or genetic issues.
- You or Your Partner Has Known Fertility Risk Factors: This includes prior cancer treatment, endometriosis, testicular issues, or STIs.
- You’re a Same-Sex Couple or Pursuing Single Parenthood: Fertility support and reproductive planning are available for LGBTQ+ individuals and single parents by choice.
Diagnosis and Testing
At NCCRM, we provide comprehensive diagnostic testing to determine the root causes of infertility and guide your personalized care plan. Testing may include:
- Hormonal Blood Work: To evaluate ovulation, thyroid function, ovarian reserve (AMH), and reproductive hormone levels such as FSH, LH, and estradiol.
- Semen Analysis: A basic test for male fertility that evaluates sperm count, motility, morphology, and volume.
- Ultrasounds and Imaging: Pelvic ultrasounds help assess uterine shape, ovarian follicles, and detect abnormalities like fibroids or cysts.
- Hysterosalpingography (HSG): An X-ray test using contrast dye to check whether the fallopian tubes are open and if the uterine cavity is normal.
- Genetic Testing: For couples with a history of miscarriage, failed IVF, or a family history of inherited disorders.
Treatment Options
We offer a full spectrum of fertility treatments tailored to your individual needs and diagnosis:
- Lifestyle Optimization & Ovulation Tracking: For some, lifestyle changes and timing intercourse with ovulation may be enough to achieve pregnancy.
- Ovulation Induction with Medication: Oral or injectable medications like Clomid or gonadotropins stimulate the ovaries to release eggs.
- Intrauterine Insemination (IUI): A procedure where washed sperm is directly inserted into the uterus during ovulation to increase the chance of fertilization.
- In Vitro Fertilization (IVF): Eggs are retrieved and fertilized with sperm in a lab, and the resulting embryos are transferred to the uterus. IVF is often used for blocked tubes, advanced maternal age, or unexplained infertility.
- Tubal Ligation Reversal: For women who previously had their tubes tied but now wish to conceive, this microsurgical procedure reconnects the fallopian tubes.
- Egg and Sperm Donation: Donor eggs or sperm may be recommended in cases of severe infertility, advanced age, or genetic conditions.
- Fertility Preservation: Egg, sperm, or embryo freezing is available for individuals who want to delay childbearing or are facing medical treatments that may impact fertility.
Support and Resources
Support Group
Free Fertility Support Group meetups at our Cary clinic help patients connect, learn, and find comfort among peers.
Advanced Treatment Plans
Access to our experienced providers, nurses, and coordinators who walk alongside you through every step of your treatment plan.
Mental Health Referrals
We connect patients with licensed therapists who specialize in fertility-related emotional wellness.
Free IVF Discovery Call
We offer a free 20-minute IVF discovery call to answer questions you may have and help you get started.
Find Out Where You are in Your Journey
We have several fertility quizzes to help ou establish your path to parenthood.
Free IVF Success eBook
Download our free IVF success ebook.