Frequently Asked Questions
What is infertility?
What causes infertility in men?
What factors increase a man's risk of infertility?
What causes infertility in women?
What factors increase a woman's risk of infertility?
How does aging decrease a woman's chance of having a baby?
How is infertility tested?
How is infertility treated?
What is in vitro fertilization (IVF)?
Is in vitro fertilization expensive?
Does in vitro fertilization work?
Infertility is when a couple is unable to conceive after one year of unprotected intercourse. It affects approximately 12% of couples, that’s about 7 million American couples. Impaired fecundity, the inability to have a child, affects 6.7 million women in the U.S.—about 11% of the reproductive age population, according to the CDC. They also report that 7.5% of all sexually experienced men younger than age 45 saw a fertility doctor during their lifetime—this equals 3.3–4.7 million men. Of men who sought help, 18% were diagnosed with a male-related infertility problem, including sperm or semen problems (14%) and varicocele (6%).
Women with certain symptoms such as irregular menses or no menses, and women who are 35 years of age or older should also seek care from a specialist sooner. Approximately 40% of infertility cases is attributed to the male partner, 50% to the female partner, and in 10% of cases the cause is unknown. The good news is that at CHA Fertility Center, most will succeed in achieving parenthood with the appropriate medical management.
A man’s sperm count can be influenced by numerous factors. Lifestyle, including the excessive use of nicotine/cigarettes, alcohol and marijuana could have a strong impact on semen parameters. Certain medical conditions, such as diabetes, and medications could also impact sperm production. Congenital or anatomic abnormalities either from birth or as a result of surgery (hernia repair), hormonal imbalances, genetic conditions (cystic fibrosis), infections (mumps), testicular damage or trauma have all been known to impact sperm production. Inability to ejaculate normally can also prevent conception and can be caused by many factors including surgery of the prostate gland or urethra, diabetes, high blood pressure, medication or impotence. It should be noted that the cause of many cases of male factor infertility are unknown. The good news is that we are able to achieve successful outcomes in most male factor couples.
The number and quality of a man’s sperm can be affected by his overall health and lifestyle. Factors that may affect sperm count and quality include:
- Tobacco use (smoking, cigarettes)
- Environmental toxins, including pesticides & lead
- Medical conditions
- Radiation treatment & chemotherapy for cancer
Common causes of infertility in women include abnormalities in ovulation, blockage or disease of the fallopian tubes, and ovarian failure or diminished ovarian reserve. Uterine conditions, such as uterine adhesions and fibroids are conditions that rarely cause infertility. Lifestyle factors such as stress, extreme dieting or athletic training can affect a woman’s hormonal axis and hence result in infertility.
Certain medical conditions, such as thyroid gland abnormalities and pituitary gland tumors can also impact the reproductive system and hence resulting in infertility. Other conditions including endometriosis (the abnormal presence of uterine lining cells in other pelvic organs) and pelvic adhesions have been associated with infertility.
Many things can affect a woman’s ability to have a baby. These include:
- Age – this is by far the biggest factor in female infertility
- Tobacco use (smoking, cigarettes)
- Poor diet
- Athletic training
- Being overweight or underweight
- Sexually transmitted diseases (STDs)
- Health problems that cause hormonal changes
Aging affects a woman’s ability of achieving pregnancy in the following ways:
- The ability of a woman’s ovaries to release eggs ready for fertilization declines with age.
- The quantity and quality of a woman’s eggs decline with age.
- As a woman ages she is more likely to have health problems that can interfere with fertility.
- As a women ages, her risk of having a miscarriage increases.
Fortunately, advances in assisted reproductive technology and the thoughtful treatment approaches at CHA Fertility Center helps those who are facing these risks.
The first step in seeking treatments for infertility is to go through thorough infertility testing for both the man and the woman.
Generally, the first question we at CHA Fertility Center is whether the woman is regularly ovulating each month. This can be done by charting changes in morning body temperature using an FDA-approved home ovulation test kit (available over the counter), by a blood test for hormone levels, or by an ultrasound of the ovaries. At CHA Fertility Center, we prescribe these and other common tests to evaluate female infertility including:
- Hormonal Testing: This may include assessment of ovarian reserve, thyroid function and prolactin levels.
- Hysterosalpingogram: This procedure involves an X-ray to investigate the shape of the uterine cavity and the fallopian tubes after they are injected with dye.
- Laparoscopy: A miniature light-transmitting tube, also known as laparoscope, exams the tubes and other female organs for disease. Usually under general anesthesia, the tube is inserted into the abdomen through a small incision below the navel.
- Hysteroscopy: A miniature light-transmitting camera is inserted into the uterine cavity to evaluate for the presence of polyps, adhesions or fibroids, which can interfere with fertility.
Male infertility testing primarily includes semen analysis (sperm andrology).
At CHA Fertility Center, we understand that treatment of infertility varies for all couples depending on the information gathered from the consultation and the diagnostic testing. Common treatments include ovulation induction, which could be done with Clomid, a medication taken orally for five days in the beginning of a woman’s cycle. If appropriate, ovulation induction could also be done with gonadotropins, which are hormonal medications delivered through small injection shots. An intrauterine insemination (IUI) may also be recommended depending on the semen parameters.
If ovulation induction and IUI is not an option due to female and/or male factors or has previously not been effective, the next option for treatment would be in vitro fertilization (IVF). IVF offers the highest percentage of success rate and every protocol is customized to address the specific needs of the patient. Conditions that are amenable to surgical correction are approached through surgery. Surgeries involving a woman’s ovaries, fallopian tubes, or uterus are recommended only if there is a good chance of restoring fertility.
In vitro fertilization (IVF) is what is known as a “test tube baby.” Introduced in the Unites States in 1981, in vitro fertilization is the most common assisted reproductive technology procedure where medications are given to stimulate the ovaries to produce multiple mature oocytes (eggs). Once the follicles containing these oocytes are at a certain size, the eggs are removed from a woman’s body using a small needle. The eggs are then assessed for maturity and quality and then fertilized with the partner’s sperm in the embryology lab. The resulting embryos are grown for 3 to 5 days and then returned back to the woman’s uterus. A pregnancy test is performed approximately 10 days later.
According to the ASRM, the average cost of an IVF cycle in the United States is $12,400. IVF involves highly trained professionals with sophisticated laboratories and equipment. IVF only accounts for 0.03% of U.S. healthcare costs. At Cha Fertility Center, we offer various competitive and flexible payment options to address our patient’s individual situations. See our Pricing and Financial Options for more details.
Yes. In vitro fertilization currently accounts for more than 99% of ART procedures with GIFT, ZIFT and combination procedures making up the remainder. According to the CDC, the live birth rate for assisted reproductive technologies per retrieval cycle in 2012 was 29%, significantly better than the 20% chance in any given month that a reproductively healthy couple has achieving a pregnancy and carrying it to term. In 2012, more than 1.5% of all babies born in the U.S. were a result of IVF—that’s over 59,000 IVF babies—and this trend is only growing. We at CHA Fertility Center are proud to be at the forefront of assisted reproductive technology advances to continue to increase these success rates.
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