Causes of Infertility and When Egg Donation May Help
There are many causes of infertility that can cause patients to seek fertility treatments such as egg donation. However, not all infertile couples are good candidates for IVF using donor eggs. An in-depth medical evaluation of patients’ reproductive health is required to determine the appropriate course of treatment. At Santa Monica Fertility, we encourage patients to seek a consultation as soon as possible if they are having difficulty conceiving. Timely intervention can make a significant difference in the success of fertility treatment.
What Are Common Causes of Infertility in Men and Women?
Infertility is evaluated based on the ability of a couple to conceive a child together, so it is critical to assess both partners. In approximately one third of cases, only the male has an underlying condition leading to infertility. In one third, the underlying cause is the female partner. In the remaining cases, both partners have fertility problems or the underlying cause is unidentifiable. A fertility workup to uncover the potential cause(s) of infertility explores a number of different factors.
The vast majority of female patients who do not have regular menstrual bleeding have ovulatory problems. The causes of this condition are hormone problems such as hypothyroidism, hyperthyroidism, hyperprolactinemia, and Polycystic Ovarian Syndrome (PCOS). Stress, anorexia nervosa, marked loss or gain of weight and premature menopause also cause ovulation problems. Ovarian function can be evaluated by measuring the appropriate hormones and performing a pelvic examination and ultrasound. In some cases, an MRI of the pituitary gland may be required.
Uterine, Tubal, and Pelvic Factors
Endometriosis, pelvic adhesions, blocked fallopian tubes, and uterine fibroids or polyps can all impair fertility. Women with endometriosis, pelvic inflammatory disease as a result of STDs, or a history of pelvic surgeries that could cause fallopian tube damage should see a fertility specialist as soon as possible in order to access the best therapeutic options available.
Male fertility problems usually have to do with the quantity or quality of sperm, or blockage of the vas deferens (the passageway for sperm to leave the testicles). For men, a history of trauma to the genital region, undescended testicles, hernia surgery, childhood mumps with swelling of the testicles, changes in libido and sexual function, or the use of testosterone supplements or certain other classes of medications could all contribute to male factor infertility.
The quality and quantity of eggs is a common cause of infertility in women over the age of 40. It can also affect younger women. Testing can reveal information about the quantity of eggs available, and indicate if IVF using the patient’s own eggs might be a viable solution. If not, or if traditional IVF has failed, egg donation may prove to be a better option.
Additional Causes of Infertility
There are also sexual behaviors that may reduce conception rates. For example, the use of vaginal lubricants (which by their nature are spermicides) can reduce the incidence of fertilization. Frequent douching can change the vaginal environment to one less favorable for sperm survival. Infertility can also be caused by poor timing of intercourse or infrequent intercourse. Since the egg is only viable for 24 hours each month, timing of intercourse is critical. Sperm can live for days within the reproductive tract, so repetitive intercourse on the days before and day of ovulation may be helpful.
What about Women with a History of Miscarriage?
Although recurrent miscarriage is not the same as infertility, there are overlapping factors that merit evaluation by a fertility specialist. Common causes of recurrent miscarriage include uterine malformations and fibroids, maternal or paternal chromosomal rearrangements, and autoimmune conditions. Couples should seek the care of a fertility specialist before attempting another pregnancy if they have experienced two or more miscarriages. Identifying and treating the underlying cause is essential for improving the chances of a successful pregnancy. Using donated eggs would not improve the chances of carrying a pregnancy to term if unaddressed uterine malformation or fibroids are present. However, chromosomal abnormalities may be avoided by using donor eggs and screening embryos with Preimplantation Genetic Diagnosis.
To receive further information about infertility and your options for treatment, contact Santa Monica Fertility at 310-566-1470 schedule a consultation.