Infertility in Women: Brief Version

What is infertility?

Infertility is when you have had sex without using birth control for 1 year and you have not gotten pregnant. It can be caused by problems in a man's or a woman's body.

What is the cause of infertility in women?

Often the reason a woman cannot get pregnant is that no eggs come out of her ovaries. This can happen for many reasons. For example:

• Your hormones may not be balanced.
• You may have a tumor or cyst in your ovaries.
• You may have a problem with your thyroid, adrenal, or pituitary glands.
• You may be overweight.
• You may have lost too much weight.
• You may be losing too much body fat because you are exercising intensely (such as long-distance running).
• You may be under too much stress and worry.
• You may use street drugs or tobacco, or drink too much alcohol.
• You may have a medical illness such as diabetes.

The tubes that go from your ovaries to your uterus may have been damaged. This could have happened in many ways. For example:

• You may have had a disease that scarred your tubes.
• You may have a birth defect.
• You may have had surgery on your tubes.

You may have trouble with your uterus:

• You may have tissue from the uterus growing outside the uterus.
• You may have growths called fibroids or polyps in the uterus.
• Your uterus may not have a normal shape. It may not be in the right position.
• You may have scar tissue inside the uterus.
• Your opening of your uterus into your vagina (the cervix) may be very narrow or nearly closed.
• The mucus produced by your cervix may not be normal.

You may also have these problems:

• You may have DES syndrome because your mother took the medicine DES when she was pregnant with you.
• Your body may be allergic to sperm. It may kill sperm.
• You may have a problem caused by your genes.

You also become less fertile as you get older, especially after age 30.

How can I find out what is wrong?

You and your partner will have thorough exams. You both will be asked questions about:

• your sexual history and whether there have been pregnancies before
• your medical history
• your use of drugs and alcohol
• how often you have sex and if you use a lubricant
• any surgery on your sex organs or in your abdomen.

You may also have these tests:

• Tests of urine and blood. This checks for infections and your hormone levels.
• Tests of the mucus from your cervix and tissue from the lining of your uterus. This finds out if your ovaries work.

Your partner's sperm may be counted. He may be making too few sperm to get you pregnant.

Your health care provider may also want to make sure your tubes or uterus are not blocked. He or she may check for scar tissue in your pelvis with ultrasound, scopes, dyes, and x-rays.

How is it treated?

If your health care provider finds a problem that makes it hard for you to get pregnant, he or she will treat the problem.

You may need medicine or surgery.

• You may need to take hormones.
• You may need to take drugs to help your ovaries work.
• You may need surgery to remove scar tissue or unblock your tubes or uterus.

You may be asked to keep a record of your daily temperature. This will help you see if and when your eggs leave your ovaries.

Your partner may also need to be treated.

You have many choices:

• If your partner's sperm count is low, he may be able to collect sperm at different times. Then his sperm can be placed in your body at the same time your egg leaves the ovary.
• You can use sperm given by another man.
• Your egg and your partner's sperm can be put together in the lab. Then the growing egg can be put into your uterus. This helps if your tubes are blocked or damaged. This procedure can cost a lot, and it doesn't always work. You may become pregnant with more than 1 baby at a time.

You should know that all this can be hard for you and your partner. It can help to get counseling.

What can be done to help prevent infertility?

You can lower your chances of having these problems. Here's what you can do:

• Use latex condoms when you have sex. This helps prevent the diseases that people get from having sex. These diseases often cause problems later on.
• Have sex only with your partner.
• Do not use lubricants when you have sex.
• Do not drink alcohol.
• Do not use street drugs.
• Do not smoke.
• Ask your health care provider about the medicines you use.

Call your health care provider if you have any problems. Watch for:

• a discharge from the vagina that is not normal
• a pain in your abdomen
• fever
• bleeding from your vagina that is not normal
• a change in your periods
• pain when you have sex
• sores and itching in the vagina or rectal area.