Coping with Infertility

Lesson 1: Suspecting and Diagnosing Infertility

Reasons to Suspect Infertility

Let me again remind you what infertility is not:

• Infertility is not when you can't get pregnant after trying for a couple of months.
• Infertility is not when you fail to conceive after having sex once a month on day 14.
• Infertility is not a woman's problem.
• Infertility is not all in your head.
• Infertility is not caused by stress alone.

With the above out of the way, let's take a look at some of the reasons to suspect infertility.

• Pregnancy not achieved after 12 months of unprotected, well-timed intercourse.
• Irregular periods
• Cycles shorter than 24 days or longer than 36 days
• Recurrent pregnancy loss
• History of STD or PID
• First period occurred at age 14 or later
• Women 35 or older, trying for 6 months or longer without success
• Mumps or chicken pox after puberty
• Undescended testicle
• Painful periods (can be a sign of endometriosis)
• Family history of infertility

Irregular periods, late first period, short cycles, and long cycles can all be warning signs of ovulatory disorders. Ovulatory disorders include a lack of ovulation, irregular ovulation, and luteal phase defects. Ovulation problems can be caused by several things including excessive weight, lack of appropriate body fat (underweight), thyroid disorders, hormonal imbalances, PCOS, and higher than normal amounts of prolactin.

STD's, if not treated, can cause infertility by scaring the reproductive organs of both men and women. When an STD travels into the uterus and fallopian tubes of women, it can cause PID. About 13% of one time cases of PID result in infertility, and those women that have had PID three times have a 75% risk of resulting in infertility. This is why it is so important to protect yourself against getting an STD.

As women age, their fertility declines until they finish menopause, at which time they will no longer produce any eggs. It is thought that a woman's fertility begins to decline as early as the late 20's, but it does not become an issue until the woman has reached the age of 35 or 36. The reason for only trying for 6 months at this age or older is because of the time involved and needed for infertility diagnosis and treatment.

Mumps and/or chicken pox in males after puberty can cause reproductive problems resulting in low or no sperm production. If the male has not had chicken pox or mumps during childhood, this should be discussed with the doctor. If the male has or had an undescended testicle, this can also cause low or no sperm production.

Painful periods alone are not usually a cause for concern about fertility. However, if the pain is moderate to severe, this should be seen as a warning sign that needs to be examined and discussed with your doctor. You and your partner should also discuss any family history of difficulty conceiving that is known with each other and with your doctor.

You should be aware of the warning signs, but do not assume that because you have one or even two of them that you are infertile or will have a problem conceiving. The good thing to know is that about 85% of couples have no problems and conceive during the first year of trying.

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