Definition Infertility is defined as the inability of a couple to become pregnant after 1 year of unprotected sex.
What is going on in the body? About 10% of all couples in Australia are unable to become pregnant. In some cases, a couple may have never been able to have children. In other cases, couples may have trouble getting pregnant after having one or more children. At present it is possible to find the cause of infertility in 80% of couples.
Certain events must take place in a woman's body for pregnancy to occur. These are:
ovulation, which is the release of an egg from the ovary. This usually occurs about 14 days before a women's next period.
the uniting of the egg and a man's sperm.
the attachment of a "fertilised" egg to the lining of the uterus.
The inability to become pregnant may be due to problems in either partner. It is thought that about 30% of the time, a couple cannot get pregnant due mainly to female factors. Thirty percent (30%) are due to male factors. The remaining cases are a combination of both female and male factors.
What are the signs and symptoms of the condition? Affected couples are unable to become pregnant. This may result in emotional and psychological distress. In some cases, the definition of infertility includes couples that become pregnant, but the pregnancies do not produce living children. This may occur with repeated miscarriages, for example.
What are the causes and risks of the condition? There are many female factors that can make a couple unable to become pregnant. These may include:
Reducing the spread of STDs can help prevent some cases. Having fewer sexual partners and practicing "safer sex," such as using condoms, can reduce STDs. Many cases cannot be prevented.
not delaying a family until after age 35
How is the condition diagnosed? For female factors, a history and physical examination of the woman is the first step. This may be done by specialists or a family doctor. Testing on the woman may include:
ovulation testing, which tries to detect the presence of egg release from the ovary.
a postcoital test, which is done after sex partly to check for problems with the female secretions.
obtaining a biopsy, or tissue sample, of the lining of the uterus.
special x-ray tests.
pelvic laparoscopy. This is a procedure that uses a special tube with a camera on the end of it. The tube is inserted through a small cut in the abdomen. In this way, the tube can be used to see the pelvic organs directly.
What are the long-term effects of the condition? The long-term effects of not being able to get pregnant are mostly psychological. The stress of testing and procedures may mount. Emotions can become strained and sex may become less spontaneous. The process of evaluating and treating this condition is also expensive. The reason a couple cannot get pregnant is found in 85% of couples. However, some couples may never be able to have children, despite full treatment. Adoption may be an option.
What are the risks to others? This is not a contagious condition. Others are not at risk.
What are the treatments for the condition? Treatment of this condition will depend on the cause. Without treatment, 15% to 20% of affected couples will eventually become pregnant. Treatment for female factors may include:
ovarian hyperstimulation syndrome, which is associated with enlarged ovaries and fluid shifts in the body. This can rarely be life threatening.
Antibiotics all have possible side effects. These include allergic reactions, stomach upset, and others. Specific side effects depend on the drugs used. Surgery carries a risk of bleeding, infection, and reactions to pain medication.
What happens after treatment for the condition? Between 80% to 85% of treated couples get pregnant within a year of diagnosis. If pregnancy has not occurred, artificial fertilisation methods may be an option. Support services are available to assist with psychological issues.
How is the condition monitored? Should a pregnancy occur after treatment, early pregnancy testing and x-ray tests will show if it is a healthy pregnancy. If treatment is unsuccessful, a specialist can be consulted.
Author: Eva Martin, MD Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 12/06/2005 Contributors Potential conflict of interest information for reviewers available on request
This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice. All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.