The nurse practitioners at Laramie Reproductive Health can assess your need for basic infertility services and develop your plan of care. We counsel our clients about ways to maximize natural fertility. We offer the basic infertility care in accordance with the recommendations of professional medical organizations such as American College of Obstetricians and Gynecologists (ACOG), American Society for Reproductive Medicine (ASRM), and the American Urological Association (AUA).
What is infertility?
Infertility is defined as not being able to conceive after one year or longer of unprotected sex. Since fertility in people with a uterus tends to decline steadily with age, providers evaluate and then treat individuals over the age of 35 after six months of unprotected sex.
In order for pregnancy to occur, there is a process that must take place:
- An egg must be released from one of the ovaries.
- Sperm must join with the egg along the way to result in fertilization.
- The fertilized egg must then travel through the fallopian tube, towards the uterus.
- The fertilized egg, or embryo at this stage, must then implant itself into the uterine lining.
For someone to get their partner pregnant, the following must also occur:
- At least one functional testicle must produce healthy sperm.
- Sperm must be carried into the semen before ejaculation.
- There needs to be enough sperm in the semen.
- The sperm must be fully functional and capable of effective movement.
Infertility for individuals may result from a problem with one or more of these steps.
What causes infertility?
Infertility can be the result of multiple factors, and there are multiple tests that can be done for both assigned male at birth (AMAB) and assigned female at birth (AFAB) people.
AMAB individuals are evaluated with a semen analysis. The concentration of sperm, movement, and shape are assessed during this evaluation. If the semen analysis is slightly abnormal, this doesn’t mean that the individual is necessarily infertile. Instead, the analysis helps determine what factors are contributing to infertility.
There are multiple disorders, both hormonal and genetic, that can attribute to infertility in AMAB people, as well as disruption of testicular or ejaculatory function, and general medical causes.
AFAB individuals need functioning ovaries, fallopian tubes, and uterus in order to become pregnant. An evaluation can be done to determine the conditions affecting any of these organs that result in infertility.
How can lifestyle affect fertility?
The health and lifestyle history will include birth control use, menstrual and pregnancy history, current and past sexual practices, medication use, surgical history, and the couple’s work and living environment.
Some factors that can contribute to infertility includes:
- Smoking tobacco
- Use of alcohol
- Use of certain illicit drugs
- Being overweight or underweight
- Having certain past or present infections
- Exposure to toxins
- Overheating of testicles
- Trauma to testicles
- Prior vasectomy
- Major abdominal or pelvic surgery
- Genetic fertility disorders or having a blood relative with a fertility disorder
- Certain medical conditions, including tumors and chronic illnesses
- Certain medications or medical treatments, such as radiation used for treating cancer
Additional Resources:
- http://www.marchofdimes.org/pregnancy/trying_fertility.html
- http://www.nlm.nih.gov/medlineplus/infertility.html
- http://www.path2parenthood.org/
- http://www.pcoschallenge.com/