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Fertility Difficulties

Eighty percent of couples conceive within one year. Generally, 25 percent conceive within the first month, 60 percent within 6 months, 75 percent by 9 months and 90 percent by 18 months, although this varies depending on the woman’s age.

A couple is considered infertile after unsuccessfully attempting pregnancy (having carefully timed intercourse without birth control) for one year. For women over 35, this time is reduced to six months. This is because remedies for infertility should be thought about sooner for these women, as their chances of conceiving are reduced once they get into their early forties. Primary infertility means that a couple without any prior pregnancy is unable to conceive, while secondary infertility refers to a couple who already has children but is unable to conceive again. Subfertility is the term used to describe the sum of a couple’s fertilities: if one partner has strong fertility the couple may conceive, if both partners have weaker fertilities, the couple may not be able to conceive. Ten to 15 percent of couples experience infertility of some type.

Fertility problems arise for many different reasons. For men, the problems can be related to sperm amount or quality; anatomical problems, such as testicle abnormalities, retrograde ejaculation (ejaculation into the bladder instead of into the urethra; this results in no ejaculation at the time of orgasm), and blocked vas deferens (which can exist from birth or result from infection); or immunological problems, such as the presence of antibodies which attack the sperm as though it were foreign to the body. Couples’ fertility problems can be attributed to the male in about 30 percent of cases.

Environmental factors are also often significant. Recent studies suggest that polychlorinated biphenyls (PCBs), which were used in the ’50s and ’60s in the plastics industry and as electrical insulators, still exist in the environment and in the food chain despite their being banned in the ’70s. Because PCBs are stored in fat cells and have a mild effect similar to estrogen, it is believed that they may affect sperm production. Smoking , drinking alcohol , and drinking caffeine can all affect sperm production, as can stress. Drugs such as marijuana and cocaine not only cause a drop in sperm count, but also increase the number of defective sperm.

Female infertility has been studied extensively and is generally caused by hormonal problems, ovarian problems, or fallopian tube blockage. Hormonal problems (either excess or lack of hormone production) affect ovulation, and though they can often be treated by fertility drugs which result in ovulation for 90 percent of women who take them, only 65 percent of those women will become pregnant. A woman’s egg supply can be reduced if her ovaries have been damaged from cysts, infection, or side effects from radiation. Fallopian tube damage can occur from previous ectopic pregnancy, pelvic inflammation, surgery, or infection (such as sexually transmitted disease ). Abnormalities of the uterus are the cause of about 10 percent of infertility cases.