Infertility

When should you schedule an infertility evaluation?

Women aged 35 years and younger are infertile when they’re not pregnant after one year of unprotected intercourse. Women older than 35 years are infertile if they’re not pregnant after six months of trying. You should consider scheduling an infertility evaluation with Dr. Tsai if you meet either criteria.

In some cases, it’s best not to wait six months because you may need earlier medical intervention.

Women with irregular menstrual cycles or who are over 40 should talk with their doctor as soon as they plan to get pregnant. You may also need immediate fertility support if either partner has a health problem that affects their fertility.

Why is age an important factor in infertility?

Age affects fertility in men and women, but its impact is more severe in women.

Women reach their peak fertility between the ages of 20-30 years. Fertility begins to slowly drop after 30, then starts to decline more rapidly after age 35. By the time a woman is 40, her chance of getting pregnant drops each month.

What causes infertility?

Each partner in a relationship has about an equal chance of having an underlying problem that contributes to infertility.

Causes of infertility in women

Polycystic ovary syndrome and endometriosis are two of the top causes of female infertility. About 24-50% of women who have trouble getting pregnant have endometriosis.

Uterine fibroids, ovarian cysts, and blocked fallopian tubes are also possible causes. Excessive exercise, stress, and low body weight may lead to hormone imbalances that cause infertility.

Causes of infertility in men

Men may not produce enough sperm, or their sperm may not be able to fertilize an egg due to problems like an irregular shape or motility issues. Many problems can affect sperm, including hormone imbalances, diabetes, medications, steroid use, and alcohol abuse.

What happens during an infertility evaluation?

For women and men, an infertility evaluation begins with a thorough review of your medical history and a complete physical examination. Dr. Tsai also discusses each woman’s menstrual history, and asks about exposure to tobacco, alcohol, environmental toxins, and sexually-transmitted diseases, as they can affect fertility.

Additional testing is performed based on the results of your exam. Some of the most common tests done during an infertility evaluation include:

• Transvaginal ultrasound
• Sonohysterography
• Hormone testing
• Hysteroscopy
• Semen analysis
• Endometrial biopsy
• Genetic testing