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For one in eight couples in the United States infertility is one of the most challenging experiences of their relationship. Anyone can have difficulty conceiving, regardless of age, gender, or access to quality health care. Conception is a process with many steps leading to pregnancy, and if a health condition affects any of these steps, fertility can be impaired. Infertility can cause serious emotional strain for a couple, and awareness of fertility issues helps to remove the stigmas and shame that often surround them.
Infertility is thought of as a women's health issue, but male conditions can be a factor as well:
A woman's reproductive system requires ovaries, fallopian tubes, and a uterus for pregnancy, and conditions in any of these organs can be a factor in infertility.
Disruption of ovarian function -- anovulation (lack of ovulation) can be caused by a number of conditions:
Fallopian tube obstruction: tubal occlusion, or blocked fallopian tubes, can occur because of a history of pelvic infection, history of ruptured appendicitis, history of gonorrhea or chlamydia, endometriosis, or a history of abdominal surgery.
Abnormal uterine contour: the presence of fibroids (benign tumors) or other abnormalities in the shape of the uterus.
Infertility is a complicated condition and can spring from many different factors in men as well as women. In men, these can include:
Disruption of testicular or ejaculatory function -- Conditions that affect the function of the testes or the amount and condition of sperm present within them, as well as a man's ability to transfer them:
Hormonal disorders: Conditions that affect the proper functioning of the hypothalamus or pituitary glands, which produce the hormones that maintain testicular function. These can include tumors, exposure to excessive estrogen or testosterone, congenital adrenal hyperplasia, Cushing’s syndrome, and chronic use of glucocorticoids
Genetic disorders: These can include Klinefelter’s syndrome, Y-chromosome microdeletion, myotonic dystrophy, or other disorders that reduce sperm count.
Many different factors can increase a person or couple's risk of fertility complications, and these factors can result from both lifestyle behaviors and genetics. Some of these risk factors affect both genders:
Risk factors for women include:
Risk factors for men include:
Treatments for infertility are available. When making recommendations, doctors take into account the contributing factors, duration of infertility, and the age of the woman. Couples who undergo counseling about treatment options often have preferences, as well. These treatment options include: