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Infertility in men is most often caused by:
• problems making sperm — producing too few sperm or none at all.
• problems with the sperm’s ability to reach the egg and fertilize it — abnormal sperm shape or structure prevent it from moving correctly.
Sometimes a man is born with the problems that affect his sperm. Other times problems start later in life due to illness or injury. For example, cystic fibrosis often causes infertility in men.
The number and quality of a man’s sperm can be affected by his overall health and lifestyle. Some things that may reduce sperm number and/or quality include:
• alcohol
• drugs
• environmental toxins, including pesticides and lead
• smoking cigarettes
• health problems
• medicines
• radiation treatment and chemotherapy for cancer
• age
Many things can affect a woman’s ability to have a baby. These include:
• age
• stress
• poor diet
• athletic training
• being overweight or underweight
• tobacco smoking
• alcohol
• sexually transmitted diseases (STDs)
• health problems that cause hormonal changes
More and more women are waiting until their 30s and 40s to have children. Actually, about 20 percent of women in the United States now have their first child after age 35. So age is an increasingly common cause of fertility problems. About one third of couples in which the woman is over 35 have fertility problems.
Aging decreases a woman’s chances of having a baby in the following ways:
• The ability of a woman’s ovaries to release eggs ready for fertilization declines with age.
• The health of a woman’s eggs declines with age.
• As a woman ages she is more likely to have health problems that can interfere with fertility.
• As a women ages, her risk of having a miscarriage increases.
Most healthy women under the age of 30 shouldn’t worry about infertility unless they’ve been trying to get pregnant for at least a year. At this point, women should talk to their doctors about a fertility evaluation. Men should also talk to their doctors if this much time has passed.
In some cases, women should talk to their doctors sooner. Women in their 30s who’ve been trying to get pregnant for six months should speak to their doctors as soon as possible. A woman’s chances of having a baby decrease rapidly every year after the age of 30. So getting a complete and timely fertility evaluation is especially important. Some health issues also increase the risk of fertility problems.
So women with the following issues should speak to their doctors as soon as possible:
• Irregular periods or no menstrual periods
• Very painful periods
• Endometriosis
• Pelvic inflammatory disease
• More than one miscarriage
No matter how old you are, it’s always a good idea to talk to a doctor before you start trying to get pregnant. Doctors can help you prepare your body for a healthy baby. They can also answer questions on fertility and give tips on conceiving.
Sometimes doctors can find the cause of a couple’s infertility by doing a complete fertility evaluation. This process usually begins with physical exams and health and sexual histories. If there are no obvious problems, like poorly timed intercourse or absence of ovulation, tests will be needed. For a man, doctors usually begin by testing his semen. They look at the number, shape, and movement of the sperm.
For a woman, the first step in testing is to find out if she is ovulating each month. There are several ways to do this. A woman can track her ovulation at home by:
• Recording changes in her morning body temperature (basal body temperature) for several months
• Recording the texture of her cervical mucus for several months
• Using a home ovulation test kit
Doctors nowadays check if a woman is ovulating by doing blood tests and an ultrasound of the ovaries. If the woman is ovulating normally, more tests are needed.