By Michele Sinopoli, MD
Department of OB-Gyn
Reliant Medical Group

April 19^th – 25^th is National Infertility Awareness Week. So we thought it would be a good time to talk about this very common problem. It is believed that nearly one in five couples experience some form of infertility.

Conception… It’s Complicated

It’s no wonder that becoming pregnant doesn’t always go perfectly – it’s a complex process. In order for conception to take place, a series of hormonal, chemical and physical events must occur in exact order. First, healthy sperm must be produced and released by the male, make their way up through the woman’s cervix, into the uterus, and then into a fallopian tube. Once in the fallopian tube, the sperm must encounter a viable egg. Then, the sperm must attach itself to the egg, penetrate it, and fertilize the ovum. After migrating in the fallopian tube for approximately two days, the fertilized egg descends into the uterus, grows and divides, and then finally implants itself on the uterine wall where it becomes a fetus. During this series of events, a single disruption such as non-viable sperm, a blocked fallopian tube or hormonal imbalances can cause a break in the process, resulting in infertility.

Finding Answers

Keep in mind that conditions that lead to infertility can be caused by either the male or female partner. In fact, in approximately 40% of infertility cases the cause rests solely with the male partner. In about 30% of cases, both partners have conditions that may lead to infertility. With some couples, the exact cause of infertility may never be known.

Many people wonder at what point they should begin seeking treatment if they are having trouble starting a family. Doctors recommend following these guidelines:

• If you are under the age of 35 and you and/or your partner have been trying to conceive for a year without success, you should contact a fertility doctor to discuss the matter and come in for an evaluation.
• If you are over the age of 35 and have been unable to conceive for six months, it is recommended that you come in for a fertility evaluation.

Evaluating Your Infertility

Once a diagnosis of infertility has been confirmed, you and your partner will need to be carefully evaluated to determine the cause of your infertility, including patient history evaluations and laboratory tests. Your complete physical will include Pap smear and vaginal cultures, hormone testing levels, pelvic ultrasound, immunization checks, semen analysis, and STD and infectious disease testing. Once your infertility problem is better understood, your doctor will recommend the proper course of treatment that offers the best chance of you and your partner enjoying a healthy, happy baby.

Determining the Best Treatment Option

Infertility treatment is in many ways a journey that is unique to each individual patient. In many cases, only medication is needed to correct problems and allow a patient to become pregnant. Some patients will need more advanced procedures such as intrauterine insemination to achieve pregnancy. For patients who suffer from such conditions as blocked fallopian tubes, severe endometriosis, polycystic ovary syndrome or male potency factors, a procedure known as in vitro fertilization (IVF) may be required to help you realize your goal of starting a family. During IVF, mature eggs are collected from the ovaries and fertilized with sperm in a lab. Then the fertilized egg (embryo) is implanted in the uterus. IVF can help women achieve pregnancy when other methods have failed.

Although treatment for infertility can be expensive, under Massachusetts law all insurers are required to provide coverage for fertility treatment and procedures, including in vitro fertilization. This has helped many Massachusetts couples realize their dream of starting a family. If you are having a problem conceiving, be sure to talk to your doctor about receiving a comprehensive evaluation from an obstetrician/gynecologist.

You can learn more about infertility treatments here:

www.marchofdimes.org/pregnancy/thinking-about-fertility-treatment.aspx#

https://reliantmedicalgroup.org/medical-services/reproductive-medicine/fertility-program-at-reliant/