About Infertility
Infertility is defined as the inability to achieve pregnancy after one year of unprotected intercourse. Because age can have a significant impact on fertility, women who are 35 years or older should see a reproductive specialist after six months of trying to conceive without success. Other reasons for seeking a fertility evaluation may include:
We at Elite IVF Solutions understand that not being able to conceive on your own in a timely fashion can be stressful. You may experience feelings of anxiety, frustration, guilt and insecurity. That is why we developed our Infertility Program. These feelings are perfectly normal and our expert staff understands what you are going through. However, we feel that after your initial visit and evaluation, your mind will be eased upon learning that simple infertility treatments are available and if a more complex one is needed you have come to the right place.
More information about Infertility:
Conception — the science
For Conception to occur, the following steps must occur:
Infertility results when a problem develops in any part of this complex process. One out of eight couples has trouble conceiving. The first step in overcoming infertility is to seek out an experienced reproductive endocrinologist who will make an accurate diagnosis and treatment plan.
A single female factor is the cause of infertility in 40 percent of the cases. Interestingly, a single male factor is the culprit in an additional 40 percent of the cases. Both male and female factors occur in 10 percent of the cases. In the remaining 10 percent of the cases diagnostic tests do not give us the answer. This is called unexplained infertility. There is scientific data that suggests that many couples who have unexplained infertility may in fact have a fertilization problem. The good news is that IVF with ICSI often overcomes this problem.
Fertility Factors
Age
Age is a major factor in female fertility. As a woman approaches her mid-30s, her fertility begins to decline. This decline in fertility is because there are fewer eggs in the ovaries and the quality of the eggs diminish as a woman gets older. Not only does age affect a woman’s ability to get pregnant and carry the pregnancy to term, age can also affect the pregnancy itself by increasing the risk of genetic abnormalities in the embryo.
Age, however, is not as much of a factor for a male as reduction in fertility generally does not occur until his mid 50s. Men are able to produce sperm throughout their lifetime, though problems can affect sperm quantity and quality regardless of a man’s age.
Infertility Female
There are several factors that contribute to female infertility. These include anovulation, tubal and cervical-uterine issues.
Anovulation
Problems with ovulation are a common cause of infertility, accounting for approximately 25 percent of all female infertility cases. In order to conceive, a woman must ovulate (release an egg from the ovary into the fallopian tube). Ovulation is connected to a woman’s menstrual cycle, or period, which takes place every 28-34 days depending on the individual. Women who experience a period more than 35 days, or not at all, are probably ovulating infrequently or not ovulating at all.
The causes of ovulatory problems can include:
Ovulation can be determined through charting, over-the-counter ovulation predictor kits and through additional hormonal testing.
If a woman is not ovulating or ovulating irregularly, Dr. Lindheim may prescribe fertility medications to stimulate ovulation.
Tubal Factor
Open (patent) and functioning fallopian tubes are necessary for Conception to occur. There are risk factors that can affect tubal function and account for 35 percent of female infertility including:
The test that is typically performed to assess tubal patency, or open fallopian tubes, is referred to as a Hysterosalpingogram (HSG). An HSG is an X-ray picture of the pelvis. A thin tube-like instrument is passed into the cervix and then an X-ray dye is injected into the uterus. As the dye enters the uterus and fallopian tubes, an assessment can be done to look at the uterine and fallopian tube anatomy.
Cervical-Uterine Factor
The cervix is located in the lower part of the uterus. Conditions of the cervix can affect fertility but are rarely the sole cause of infertility. The following might contribute to cervical health and are important to inform Dr. Lindheim.
Cervical problems are generally treated with antibiotics, fertility medications or by IUI.
The uterus (womb) is where the fertilized egg implants and develops. Uterine abnormalities can account for 20 percent of female infertility and can include:
Problems within your uterus may interfere with implantation of the embryo or may increase the incidence of miscarriage. The test(s) typically performed to assess the uterine cavity include a hysterosalpingogram or Sonohysterogram (SHG or SIS). Similar to the HSG, a thin tube-like instrument is passed into the cervix. Small amounts of saline are injected into the uterus under ultrasound guidance to assess the uterine cavity. This the preferred test for uterine abnormalities.
Surgery may be required to further evaluate and possibly correct uterine cavity abnormalities.
Infertility: Male
The male partner is either the sole or a contributing cause of infertile couples. Evaluation for the male is a detailed sperm analysis. This can determine the volume (amount), motility (movement) and morphology (shape) of the sperm.
The cause of abnormal sperm can be:
Additional testing including blood, semen cultures and a comprehensive examination with a urologist can help identify the cause.
Treatment for male factor infertility may include:
In many cases, no direct treatment for decreased sperm counts is effective and IVF with ICSI may be recommended.
Unexplained Infertility
For approximately 10 percent of infertile couples, no identifiable abnormality can be found in spite of all testing. Fortunately, unexplained infertility can often be treated successfully with prescribed fertility medications and IUI or IVF with ICSI. A leading theory suggests that many couples with unexplained infertility may have a fertilization defect whereby the sperm cannot penetrate the egg after intercourse. This may explain why IVF with ICSI is so successful in these couples.
Recurrent Pregnancy Loss
Miscarriage is one of the most devastating experiences that can happen to a woman. Approximately two out of every 10 pregnancies may result in a miscarriage. Therefore, after having one miscarriage, most women go on to have a healthy pregnancy.
Women are considered to have recurrent pregnancy loss when they have two or three miscarriages in a row. Only about 1 percent of women will have three consecutive miscarriages or more. In about two out of three cases, we are able to determine the cause of recurrent pregnancy loss.
The causes of recurrent pregnancy loss include:
Treatments vary depending on the cause of recurrent pregnancy including hormonal-anticoagulant medications, surgery, IVF and PGS-PGS.
Emotional Support
Our caring staff at Elite IVF Solutions understands that not being able to conceive on your own and undergoing fertility treatments can be stressful. Our experienced and compassionate staff understands what you are going through and is here to assist you by providing you the emotional support and resources that you might need along the way. We understand that each patient and couple reacts to stress differently.
With each step of the process there are physical, emotional and financial stressors that can become magnified should there be any setbacks or disappointments. Oftentimes, feelings of anxiety, frustration, guilt and, sometimes, insecurity can be experienced. These feelings are perfectly normal and commonly felt by patients and couples struggling with infertility or undergoing fertility treatment. Sharing your feelings with someone including your partner, a family member or a friend can help to ease emotional stress. Fertility problems can strain even the best relationships. Be sure to:
In some situations, we may recommend that you seek the support of a dedicated counselor or therapist that specializes in fertility care. We also encourage all of our patients and couples dealing with fertility issues to join local support groups. These support groups can help keep you from feeling alone as you draw from the experiences of others.
RESOLVE and The American Fertility Association are nonprofit national organizations that offer group support.