Infertility

Infertility is defined as a couple's inability to achieve pregnancy after one year of unprotected intercourse. In Canada, one in every 15 couples experience fertility problems, and one in six couples seek medical help to conceive. In an attempt to conceive, these couples spend approximately $30 million every year on in vitro fertilization alone. Along with the financial investment, there is also an enormous emotional investment to conceiving a child using infertility treatments. This aspect, although important, will not be dealt with in this document.

Causes

Issues with infertility may come from the man, the woman or both partners.

There are three causes of infertility in women: failure to ovulate, obstruction of the fallopian tubes, inability for the embryo to implant in the uterus. Below are some of the factors that may be responsible:

• Sexually transmitted infection such as chlamydia or gonorrhea
• Endometriosis (tissue that normally lines the uterus grows outside the uterus, blocking the fallopian tubes)
• Hormonal imbalances
• Eating disorders
• Excessive exercise
• Cancer treatments
• Antiphospholipid syndrome (causes spontaneous abortions)
• Sperm allergy

There are also three causes of infertility in men: decreased number of sperm, complete absence of sperm, decreased mobility of sperm. Below are some of the factors that may be responsible:

• Varicoceles (dilated scrotal veins)
• Obstruction in the male reproductive tract
• Absence of the vas deferens
• Missing piece of the Y chromosome
• Hormonal imbalances

Persons most at risk

A woman's fertility rapidly declines after age 35 and, by the age of 45 years, her ability to conceive is almost non existent. At 35 years of age, men still have an 85% chance of procreating, but this number drops by 2% every year. In addition to age, other risk factors include smoking, alcohol abuse, illegal drug use, overweight, stress and anxiety. Contrary to popular belief, prolonged use of oral contraceptives ("the pill") does not affect fertility.

Diagnosis

A couple is considered infertile when they have been unable to conceive after 12 months of unprotected intercourse. This does not mean that they are unable to have children. It simply implies that their ability to conceive is being hindered. In order to accurately diagnose the problem, both partners should consult a physician. The physician will perform a full physical examination and will ask the couple to fill out a questionnaire. If necessary, they will be referred to a specialist such as a gynecologist or urologist.

Treatment

Several treatments options are available and depend on the actual or likely cause. Treatments include:

• Ovulation induction
• Intrauterine insemination
• In vitro fertilization
• Oocyte donation
• Reproductive surgery

Prevention

Preventing infertility means leading a healthy lifestyle. This includes having a healthy weight, exercising, learning how to manage stress and protecting oneself from sexually transmitted infections. Healthy eating habits are also important. These include increasing one's intake of fiber, vegetable protein and foods rich in iron and complete carbohydrates, while reducing one's intake of animal protein and foods high in trans fats and sugar.

For more information:

• Infertility Awareness Association of Canada