Understanding Infertility

Approximately one in six couples are unable to have a baby.  The cause might lie with the female partner, for example blocked fallopian tubes, or with the male partner, perhaps a low sperm count.  In approximately 40% of couples a female factor is identified and in 40% of couples a male factor is identified.  In the remaining 20% of cases, doctors are unable to detect any obvious cause and call the infertility unexplained (idiopathic).   It is important to note that even if the cause remains unexplained treatment can be successful.

The tests to determine a specific cause of infertility will include assessing hormone levels, ovulation, the patency of the fallopian tubes, and the shape of the uterus in women; sperm production (numbers, movement and shape) and delivery in men.

Approximately 40% of infertile men identified with abnormal sperm characteristics will have no known causes for these abnormalities.  In these cases there are no known treatments to improve the quality of the semen.  In another group of infertile men known or suspected causes may have been treated, but the semen quality may still not be adequate for conception to occur.  However, many men with abnormal semen characteristics have fathered children.

Often, both partners have abnormalities, which are contributing to the infertility.  It is important for the woman to be investigated even if the man has an identified abnormality.  If both partners have been treated for all known causes of infertility or if they have unexplained infertility and are still unable to conceive, a variety of assisted conception methods may be considered.  At this point, the usual approach is to help the woman to optimize her fertility; increase the woman’s egg production in order to give the sperm more potential eggs to fertilize and increase the chance of fertilization by bringing the best sperm in closer contact with the egg.