How Healthcare Providers Diagnose and Treat Infertility

Infertility is a condition impacting more than 7.3 million Americans, or 1 in 8 couples of childbearing age.  Approximately 10% of women in the US aged 15-44 have difficulty getting pregnant or staying pregnant. Infertility is defined as “not being able to get pregnant after one year of trying (or six months if a woman is 35 or older).” Women who can get pregnant but are unable to stay pregnant may also be diagnosed with infertility. This often misunderstood yet relatively common condition can be confusing and emotional.

Diagnosing infertility

There are many steps to diagnosing infertility. Before you jump into costly infertility treatments, it’s important to receive a complete fertility workup. First, your doctor will request that you finish a comprehensive and detailed medical history and physical exam. Following this, additional diagnostic tests may include:

• Blood and urine tests to check hormone levels
• Pap smear to check the health of the cervix
• Basal body temperature test, which determines if a woman is releasing eggs from her ovaries
• Endometrial biopsy where a small piece of uterine tissue is removed and checked if eggs have been released and levels of progesterone are tested
• Ultrasound to check for fibroids, masses, or cysts on the ovaries or in the uterus
• Post-coital test where a sample of vaginal mucous is sampled to determine if her male partner’s sperm can survive in the woman’s cervical mucous
• Hystereoscopy to detect uterus defects
• Laparoscopy to check for ovarian or fallopian tube scarring or endometriosis
• Hysterosalpingogram to check the condition of fallopian tubes and to check for fibroid tumors, structural abnormalities, and endometrial polyps

Factors of female infertility

There are numerous factors  that may contribute to female infertility:

• Damage to your fallopian tubes caused by scarring after pelvic infections, endometriosis, or surgery.
• Hormone imbalances may interfere with normal ovulation and menstruation processes.
• Cervical issues may prevent sperm from passing through the cervical canal.
• Polyps and fibroids in the uterus may negatively impact the ability to get or stay pregnant.
• Age is a growing cause of infertility. One third of couples where the women is over age 35 have fertility problems.
• Your weight affects your ability to conceive. 12% of infertility cases are due to weight issues.
• Smoking and excessive alcohol consumption may be linked to infertility.
• Sexually transmitted infections (STIs) may cause infertility.
• Stress and stress related to infertility may negatively impact the ability to get and stay pregnant.

For about 20% of couples who have infertility problems, the exact causes are never pinpointed.

Misconceptions about fertility

While fertility issues are relatively common, they carry many misconceptions. For example, did you know that overall health is not necessarily a factor in determining fertility? Another common misconception is that sexual position can increase your chances for conception. Position plays no role in getting or staying pregnant. Other factors that do not impact fertility include choice of underwear and eating specific foods or a specific diet.

Infertility treatment

Infertility treatments are determined based on a multiple factors. You doctor will consider your test results, how long you’ve been trying to get pregnant, your age, and treatments vary by gender.

Before attempting invasive surgical procedures that may increase fertility, doctors generally recommend trying medications first. These medications may treat irregularities with ovulation, menstruation, and hormone production. It is worth noting that many infertility treatments increase a woman’s chances of having twins, triplets, or other multiples.

Infertility is a complex issue with many contributing factors. Doctors, scientists, and researchers continue to dive deeper into causes and treatments for infertility and great strides have been made in the past several years. More recently, the negative stigma of infertility has shifted and with infertility impacting nearly 13% of couples of childbearing age, it is critical that we are empathetic and understanding to those that are going through it personally.

To learn more about infertility diagnosis and treatment, contact your physician. Northwest Primary Care offers comprehensive women’s healthcare and reproductive health services for individuals and couples.