Infertility
Infertility is a relatively common problem that affects between two and four million American couples or approximately 10% to 15% of the reproductive age range population. More couples now seek infertility evaluations, which may reflect the increased availability of infertility-related services and an increased media focus on medical advances in reproductive technology. The definition of infertility is one year of unprotected coitus without conception. Presently, the mean age of a woman who first gives birth is now three years older than that of a woman born 20 years ago. Postponement of pregnancy after marriage is the most significant change that has led to a decline of fertility in the United States. Thus, couples are seeking to have children at later ages in life, ages at which it is the most difficult to achieve a pregnancy.
Each ovulatory cycle in a normal couple without a fertility problem results in a 20% to 25% chance of conception. In couples with regular, unprotected intercourse, 57% conceive in three months, 72% in six months, 85% in one year, and 93% in two years. One of the first evaluations performed in an infertile couple is to assess the woman's ability to ovulate consistently. Approximately 40% of women with infertility fall into the ovulatory dysfunction category.
Approximately 40% of infertility problems are associated with male factor etiologies. Production of sperm can be injured or impaired by testicular injuries, surgery, infection, allergies, toxins, undescended testes, varicoceles, drugs, hernia, and athletics. It is well worth the time to ask questions regarding these factors at the time of an infertility evaluation. A semen analysis is obtained early in the infertility workup.
With regard to additional female contributions to infertility, a comprehensive history includes collecting data with regard to prior illnesses, surgeries, infections (including sexually transmitted diseases), allergies, drug use (prescription and recreational), rubella, or on utero diethylstilbestrol exposure. Approximately 30% to 50% of females visiting an infertility clinic have tubal/pelvic factors such as adhesions or endometriosis which may play a role in their infertility. Cervical factors such as hostile cervical mucus or previous cone biopsy that affects cervical mucus are rare causes of female infertility. The anatomic tract in a woman is evaluated early in the workup through a variety of procedures to insure that there is a functional conduit for sperm to meet eggs and an appropriate uterine cavity for implantation.
Your reproductive endocrinologist is highly skilled in evaluating all factors associated with infertility and devising a cost effect plan to help you achieve your goals. Their training and experience includes the full range of infertility treatments including the most advanced assisted reproductive technologies. The Utah Center for Reproduction has been serving the Intermountain West since 1983, and provides take-home baby rates ranked among the highest levels in the world. This is accomplished in a highly cost conscious environment to spare couples the significant financial burdens associated with infertility treatments. Finally, The Utah Center for Reproductive Medicine boasts one of the lowest high order multiple pregnancy rates in the United States.
