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What is infertility?

Infertility refers to a reproductive system condition where individuals cannot conceive a pregnancy. It has diverse causes and can affect anyone. The process of conception involves several stages:

  • Production of reproductive hormones by the brain to regulate ovarian function.
  • Maturation of an egg in the ovary.
  • Release of an egg from the ovary (ovulation).
  • Collection of the egg by the fallopian tube.
  • Passage of sperm through the vagina, uterus, and into the fallopian tube.
  • Fertilization of the egg by sperm to form an embryo.
  • Transport of the embryo through the fallopian tube and implantation in the uterus.

A successful pregnancy hinges on each of these steps occurring.

For individuals under 35, infertility may be diagnosed after 12 months of trying to conceive through regular, unprotected intercourse. For those 35 and older, infertility may be diagnosed after six months of such efforts.

What are the types of infertility?

Types of infertility are categorized as:

  • Primary infertility: Inability to conceive after one year of regular, unprotected intercourse (or six months if aged 35 or older) for individuals who have never been pregnant.
  • Secondary infertility: Inability to achieve pregnancy again following at least one successful pregnancy.
  • Unexplained infertility: Lack of identifiable reasons for infertility despite fertility testing.

How common is infertility?

Infertility impacts individuals assigned male at birth (AMAB) and female at birth (AFAB) equally. It’s prevalent, with 1 in 5 women aged 15 to 49 facing primary infertility in the United States, and approximately 1 in 20 women dealing with secondary infertility. Globally, about 48 million couples grapple with infertility.

What are signs of infertility?

The primary indicator of infertility is the inability to achieve pregnancy after six months to one year of consistent, unprotected sexual intercourse. While some individuals may not exhibit any other symptoms, others may experience physical signs such as:

  • Pelvic or abdominal discomfort.
  • Irregular vaginal bleeding, erratic menstrual cycles, or absence of periods.
  • Penile issues or difficulties with ejaculation.

What causes infertility?

Infertility has numerous causes, often complex and requiring professional evaluation for accurate diagnosis and treatment planning.

  • 33% of infertility concerns the partner with a uterus and ovaries.
  • 33% of infertility concerns the partner with a penis and testicles.
  • 33% of infertility involves both partners or remains unexplained.
  • Twenty-five percent of infertile couples contend with multiple factors contributing to their infertility.

Infertility causes

Risk factors for infertility encompass various factors that can affect one or both partners:

  • Advanced age, especially for women in their late 30s or 40s, and for men, around 50 years old.
  • Eating disorders like anorexia nervosa and bulimia.
  • Excessive alcohol consumption.
  • Exposure to environmental toxins such as chemicals, lead, and pesticides.
  • Over-exercising.
  • Undergoing radiation therapy or chemotherapy.
  • Contracting sexually transmitted infections (STIs).
  • Smoking and using tobacco products, contributing to 13% to 15% of infertility cases.
  • Substance abuse.
  • Being overweight or underweight.
  • Abnormalities in hormone production centers in the brain, like the hypothalamus or pituitary.
  • Chronic health conditions and diseases.

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