Overcome Fertility Challenges and Make Conception Conceivable

By Robert A. Skaf, MD, Virtua Reproductive Endocrinologist and OB/GYN

The desire to have a child is one of the most powerful human impulses. But trouble conceiving can bring blame, self-doubt, and frustration to an otherwise loving relationship. While infertility can be challenging, there are more solutions than ever before.

Couples should consult an infertility specialist if they have been unable to get pregnant after a year of trying without birth control (or 6 months if the woman is older than age 35). Difficulty conceiving can be due to a number of reasons that affect the man or woman, or it can be an issue involving both partners.

Women's fertility issues

For women, most infertility cases stem from problems with ovulation. The most common ovulation problem is a hormonal disorder called polycystic ovary syndrome (PCOS). It also can be caused by poor fertilization by the sperm or implantation failure in the uterus. Other reasons may relate to physical conditions that prevent the natural process of an egg being released from the ovary and picked up by the fallopian tubes.

These include:

• Pelvic inflammatory disease
• Endometriosis
• Uterine scarring
• Uterine fibroids

Often, hormones that stimulate egg production are prescribed to solve ovulation issues. To treat the other disorders, doctors often recommend another type of hormone therapy, surgery, or in vitro fertilization.

Supportive measures like healthy eating, relaxation, and acupuncture can improve a woman's chance of conceiving.

Men's fertility issues

For men, the primary causes of infertility are issues with low sperm count or sperm motility (ability to move).

Causes include:

• Absence of sperm production in the testicles
• Smoking tobacco or marijuana
• Alcohol abuse
• Environmental toxins like pesticides or lead
• Medical conditions like mumps or kidney disease

An infertility specialist can help with these issues, but improved sperm quality often comes from living a healthy lifestyle including eating a nutritious diet and exercising. 

Fertility issues for both women and men

When medical and surgical treatments are ineffective, in vitro fertilization (IVF) may be the answer. IVF involves taking eggs and sperm from a couple and using them for fertilization outside of the body. After fertilization, an embryo grows for 3-5 days, and then is implanted into the woman’s uterus where it can continue to grow and develop.

Maternal age (considered advanced at older than age 35) is also an important factor affecting fertility. While it’s still possible to have a successful pregnancy after age 35, the challenges increase. As women get older, fertility declines due to normal age-related changes that occur in the ovaries. Unlike men, who continue to produce sperm throughout their lives, women are born with all the eggs they will ever have in their ovaries. Women use this pool of eggs from birth until menopause. So, in addition to the decreased number of eggs, the quality of eggs deteriorates with age. In addition, as both men and women get older they are increasingly susceptible to other medical issues affecting fertility.

The good news is that fertility science has seen vast improvements in the last 30 years. And, couples have access to more information and support than ever before. In fact, couples (under age 35) having issues getting pregnant who seek fertility treatments have an 80% or more chance of conceiving.

Infertility can be challenging, but by taking the right steps, it doesn't have to be permanent for many couples.

Updated December 19, 2017