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Infertility is medically defined as occurring when a woman is unable to get pregnant despite having unprotected sex for a year or longer. Because barriers fertility can exist in both men and women, it is often said that the couple, rather than the woman, is experiencing infertility.

What Is Infertility?

According to the current clinical definition, if, after having unprotected sex, a woman is unable to conceive or carry a baby to term, and the condition remains unchanged for at least a year, she may be infertile. In the United States, about 12 percent of women between ages 15 and 44 fit this label. After a year of trying to conceive, couples should consider infertility as a possible reason and seek professional help.

When should you start to worry about infertility?

Women who are actively trying to get pregnant may wish to consult a doctor if they are over the age of 40, have irregular or painful periods, have a history of miscarriages, have been diagnosed with pelvic inflammatory disease or endometriosis, or have been treated for cancer.

Is infertility just a woman’s problem?

Women are not always the source of a couple's infertility—in approximately one-third of cases, men may have difficulty with conception. In another third of cases, men are a contributing factor, along with female infertility and other problems. Men should be evaluated by a physician if there is a family history of infertility, if they have undergone cancer treatment, if they have small testicles, a swollen scrotum, or a low sperm count, or if they have any other testicular, prostate, or sexual problems.

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Infertility Causes and Treatments

Every woman is born with a set number of eggs, which declines as she ages. To get pregnant, an egg released from a woman’s ovaries must be fertilized by sperm, travel down the fallopian tube, and attach to the side of her uterus. At any stage along the way, a problem may occur, resulting in a case of infertility.

Couples experiencing infertility have a range of treatment options. However, infertility treatment can come with many obstacles, including high costs, time burden, physical pain, shame and embarrassment, and social stigma. Talking to a trusted family member, friend, or therapist can often help men and women process the mix of complex emotions.

What causes infertility in women?

For women, the most common causes of infertility are primary ovarian insufficiency (early menopause), ovulation disorders affecting egg release, uterine or cervical abnormalities, endometriosis (where tissue grows outside of the uterus), fallopian tube blockage or damage, polycystic ovary syndrome, and various hormonal imbalances. Certain cancers and their treatments can also negatively impact a woman’s fertility.

What causes infertility in men?

Male infertility may be caused by trouble with sperm delivery due to structural difficulties like testicle blockage or damage to the reproductive organs, sexual function concerns such as premature ejaculation, or genetic conditions including cystic fibrosis. Another root of male infertility may be abnormal sperm function or production, often due to genetic defects or health problems including diabetes or certain sexually transmitted diseases. Other risk factors include overexposure to certain environmental factors, such as alcohol, cigarette or marijuana smoke, chemicals, and pesticides, as well as frequent exposure to high temperatures (hot tubs and saunas). Specific cancers and their treatments can also be harmful to male fertility.

Infertility and Mental Health

Infertility can have a profound impact on one’s mental health. When men and women find out that they can’t conceive, they may experience the same painful emotions as anyone coping with grief or profound loss. Common reactions include shock, frustration, grief, anger, decreased self-esteem, anxiety, and depression, but feelings about infertility can vary greatly depending on the source of the problems. Men, in particular, find it far easier to deal with a partner’s infertility than with their own.

How do fertility treatments affect people emotionally?

Along with being physically demanding, fertility treatments can also spark a roller-coaster of emotions each month, including hope, anger, disappointment, sadness, and guilt. Just the sight of a pregnant woman can evoke strong negative and stressful feelings. During this time, those struggling with infertility may pull away from friends and family who remind them of their difficulty with reproduction; some of their closest relationships may suffer.

How do fertility treatments affect sex and intimacy?

Couples might also find that their sex life suffers from the high expectations and routines of fertility treatment, as they may experience dips in self-esteem, desire, and performance. Sex, which was once a source of joy and emotional connection, can become a source of frustration and failure. Sharing complicated feelings and separating lovemaking from babymaking can help couples stay sexually connected during infertility treatment.

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