Causes of Infertility
About one-third of infertility is the female factor (medical issues in the woman), one-third is the male factor (medical issues in the man), and one-third is combined (both partners involved).
For a woman, the first question is, are you ovulating? If you’ve been trying to conceive, you’re probably already tracking your periods. If your cycles come predictably between 25 and 35 days apart, you’re probably ovulating. If you’re not having menstrual cycles or if your cycles are irregular, it’s likely you aren’t ovulating normally.
Other physical conditions may lead to problems ovulating, including polycystic ovary syndrome, thyroid disease, smoking, being underweight or overweight, or other illnesses. The health of a woman’s eggs begins to significantly decline after age 35, which is why conception becomes more difficult for a woman above this age.
Ovulation test kits are widely available and are quite accurate in detecting the hormonal signal telling your ovaries to release a mature egg. Blood tests for certain hormones done on specific days of a woman’s menstrual cycle can also give a more complete picture of what a woman’s ovaries are doing.
Conditions affecting a woman’s uterus or fallopian tubes may also impede her from getting pregnant. Endometriosis, significant uterine fibroids, pelvic infections including sexually transmitted diseases, or past pelvic or abdominal surgeries are among the more common reasons. Pelvic pain, pain with intercourse, or painful or heavy periods indicate a medical evaluation is needed to evaluate for these conditions.
For a man, it’s all about the sperm. Poor sperm quality or even the absence of sperm can be related to certain genetic or hormonal conditions or past trauma to genital organs. It can also be related to the use of alcohol or drugs, certain medications, or illnesses including diabetes, thyroid problems, or others. Difficulties with sexual performance are sometimes a clue to underlying hormonal issues that also affect sperm production.
At-home kits are available to evaluate sperm count and motility. A more extensive semen analysis and blood tests can be done through a laboratory with a doctor’s order.