Infertility is classified as the inability to conceive pregnancy after trying for at least 12 months if you are younger than 35, or for 6 months, if you are older than 35. Infertility can also be associated with recurrent pregnancy loss (3 or more consecutive miscarriages).
Infertility can be caused by both female factors (approximately 50% of the time), male factors (approximately 40% of the time), or by a combination (approximately 10% of the time).
Infertility is more commonly seen than most people are aware of. According to the CDC, greater than 7.3 million Americans, both men, and women are affected by infertility.
Infertility is not typically preventable, but there are steps that can be taken to help increase your chances of pregnancy.
- Age – fertility declines with age, the earlier you decide to start a family, the more likely you are to conceive. If you are not ready to conceive fertility preservation can increase your success rates later in life.
- Women should avoid smoking, excessive alcohol use, extreme weight gain or loss, and excessive emotional or physical stress.
- Men should avoid drug, tobacco and excessive alcohol consumption. They should also avoid high temperatures and exposure to toxins. It is also important to exercise moderately to improve sperm production.
Infertility can be caused by a variety of factors from ovulation disorders to issues with sperm production; sometimes infertility can just not be explained. Conditions such as Endometriosis and PCOS can often affect fertility in women but are not the only cause. It is important to speak with a provider at RMI if you have had problems conceiving in order to determine if there is an underlying condition.
There is never a wrong time to consider fertility preservation and many reasons to discuss preservation with your provider. If you are facing a medical condition that may impact your ability to conceive, or if you are not ready to start a family until later in life, it is important to speak with a provider at RMI to see if egg freezing is a good option for you.
The most common treatments for infertility are Intrauterine Insemination (IUI) and In Vitro Fertilization. It is important to speak with a Reproductive Endocrinologist at RMI to determine the most effective treatment plan for you.
Fertility testing should be scheduled if: a woman is younger than 35, and has been trying to get pregnant for one year with no success; or if a woman is over the age of 35 and has been trying to get pregnant for six months with no success.
Most insurance plans in Illinois have coverage for infertility treatment. If you are unsure if your insurance carrier covers fertility treatment, contact RMI and we would be happy to help you review your insurance coverage. If your insurance does not cover infertility care, we can assist you in finding an option that is right for you.
Aneuploidy: When an abnormal number of chromosomes are present (too few or too many). Aneuploidies can be the cause of problems during or after pregnancy and can also lead to miscarriage. Example: Trisomy 21 or Downs Syndrome.
Anti-Mullerian Hormone (AMH): A hormone that can help to give an estimate on a woman’s responsiveness to fertility treatments (or ovarian reserve). AMH is measured using a blood test from the female.
Antral Follicle Count: An ultrasound performed between days 2-4 of the menstrual cycle show the quantity of follicles that are existing. The follicles can help to determine how many eggs may respond to fertility treatments.
Assisted Reproductive Technologies (ART): A procedure prior to fertilization, that removes eggs from the ovaries. Examples: In Vitro Fertilization (IVF), Cryopreservation (Egg Freezing), etc.
Beta HCG (BHCG): A test performed using blood from a female to determine if there is a positive pregnancy. During pregnancy, the HCG hormone (or Human Chorionic Gonadotropin) rises.
Cervix: Located at the lower end of the uterus, the cervix acts as an opening/tunnel into the uterus. During intercourse, sperm passes through the cervix.
Clomiphene Citrate (Clomid/Serophene): Fertility medication taken orally, it is a synthetic hormone that helps women ovulate by causing an increased production of natural Follicle Stimulating Hormone (FS) and Luteinizing Hormone (LH). This can also be used in men to help increase production of sperm.
Cryopreservation: Procedure used on eggs, embryos, and sperm to freeze prior to preserving and storing.
Comprehensive Chromosome Screening (CCS): A genetic testing process that allows for embryos without abnormalities in the chromosomes to be transferred during IVF treatment. CCS can lead to high implantation rates and fewer problems with successful pregnancies.
Cycle: The time frame when one menstrual cycle begins until the following menstrual cycle begins. Lasting approximately one month, it refers to the time when fertility treatment begins to when it ends.
Donor Egg: An egg from a fertile woman, either an anonymous or known source, used to achieve pregnancy.
Donor Sperm: Sperm from a fertile male, either an anonymous or known source, used to achieve pregnancy.
Egg: Also known as Oocyte; an ovum produced by the woman’s ovary. When fertilized by sperm, it will turn into an embryo.
Egg Donation: Also known as Oocyte Donation; the process of removing eggs from one woman’s ovaries for use by another.
Egg Retrieval: Also known as Oocyte Retrieval; a procedure in which eggs are collected from the ovary. The procedure is performed under sedation, a small needle is placed inside the ovary under ultrasound guidance to collect eggs.
Embryo: Considered the earliest point in pregnancy, an embryo is present when a fertilized egg has begun the process of cell division. This period lasts from fertilization to the 8th week of pregnancy.
Endometriosis: A condition caused by endometrial tissue (or uterine lining) found outside of the uterus causing pain and infertility. To diagnosis endometriosis, patients may need surgery.
Endometrium: Lining of the uterus. During the menstrual cycle, the lining will thicken in anticipation of the implantation of an embryo. If implantation occurs, the lining stays at its thickened state. If implantation does not occur, the lining will shed, resulting in menstruation.
Estradiol (E2) level: Estradiol is produced by the follicles. Prior to ovulation, estradiol levels will be highest. Estradiol levels can be measured in the blood to predict when ovulation will occur.
Fallopian Tubes: Found in the female reproductive system, a pair of tubes that carry the egg from the ovary to the uterus. Eggs are fertilized when in the fallopian tube before traveling to the uterus.
Female Factor Infertility: When the cause of infertility is due to a female-related condition.
Fertilization: The process in which sperm enters the egg.
Fetus: The development stage of the baby lasting from 8 weeks to 40 weeks. This is the stage following the embryo.
Follicle: Fluid-filled sacs in the ovary, which contain eggs. During ovulation, the follicle releases eggs. During Assisted Reproductive procedures, eggs can be extracted from a follicle with egg retrieval.
Follicle Stimulating Hormone (FSH): A hormone produced by the anterior pituitary gland that will stimulate follicle growth within an ovary prior to ovulation.
Gestation: The time period between conception and birth when the fetus is developing, typically lasting approximately 40 weeks.
Gestational Carrier: A women who undergoes IVF, carries a pregnancy, and gives birth to a child for another women or couple with the eggs and/or sperm of the intended mother/father. There is no biological connection between the Gestational Carrier and the intended Mother and/or Father of the child. Donor eggs and sperm can be used as well.
Hormone: A substance that is produced by one organ to control or regulate another organ.
Hysterosalpingogram (HSG, Hysterogram, Tubogram): Examines the fallopian tubes and uterus through use of an x-ray procedure. Dye is injected through the cervix into the uterus, as the dye moves though the uterus and into the fallopian tubes, series of x-ray pictures are taken. This procedure can help determine any abnormalities of the uterus or fallopian tubes.
Hysteroscopy: Examination of the uterus through a surgical procedure. A small endoscope (camera-like device) is inserted through the cervix and into the uterus. Hysteroscopy can be performed in conjunction with other procedures.
Hysterosonogram: Performed under ultrasound guidance, saline is injected into the uterine cavity in order to determine any abnormalities of the uterus.
Infertility: The inability to conceive or sustain pregnancy over a significant time period. Fertility testing should be scheduled if: a woman is younger than 35 years old and has been trying to get pregnant for one year with no success; or if a woman is over the age of 35 and has been trying to get pregnant for six months with no success.
Intrauterine Insemination (IUI): The placement of sperm (either partner or donor) into the uterus through the use of a catheter. After the sperm has been prepared for insemination, a catheter is placed through the cervix and into the uterus.
In Vitro Fertilization (IVF): Procedure performed under sedation which involves removing one or more eggs from follicles (found within the ovary). The eggs are then fertilized by sperm outside of the body (in a laboratory) and reinserted back in the uterus after approximately 5 days.
Laparoscopy: Surgical procedure that examines the pelvic cavity, ovaries, fallopian tubes and uterus using a camera-like device inserted through a small incision in the navel.
Luteinizing Hormone (LH): Hormone that is produced by the anterior pituitary gland. In females, LH stimulates ovulation (the ovary to release a mature egg). In males, LH will simulate the production of testosterone.
Male Factor Infertility: When the cause of infertility is due to a male related condition.
Multiple birth: When two or more births occur after the same gestational period.
Multiple Gestation/Multiple Pregnancy: When two or more fetuses are conceived at the same time, multiple gestation/multiple pregnancy does not indicate multiple birth in all cases.
Myomectomy: Surgical procedure in which non-cancerous tumors are removed from the uterine wall.
Ovarian Hyperstimulation Syndrome (OHSS): A side effect that can occur when taking hormone medications to stimulate the development of the follicles. These medications are typically taken to prepare for procedures such an IUI or IVF. Hyperstimulation (or too much hormone medication) can lead to the ovaries becoming swollen and painful. In severe OHSS, women can have rapid weight gain, abdominal pain, vomiting, and shortness of breath.
Oocyte: An ovum produced by the woman’s ovary. When fertilized by sperm, it will turn into an embryo.
Oocyte Donation: The process of removing eggs from one woman’s ovaries for use by another.
Oocyte Retrieval: A procedure in which eggs are collected from the ovary. The procedure is performed under sedation, a small needle is placed inside the ovary under ultrasound guidance to collect eggs.
Ovarian Reserve: The responsiveness of a woman’s eggs to fertility treatment.
Ovulation: Release of a mature egg from the follicle. The egg will leave the ovary and travel through the fallopian tube.
Ovulation Induction: Use of hormone medications in females to simulate ovulation.
Polycystic Ovarian Syndrome (PCO, PCOS): A condition affecting women in which ovulation does not occur regularly. When all other causes for an ovulation have been ruled out, PCOS is diagnosed if a woman meets two of the following criteria: (1) irregular periods (2) evidence of excess male hormone (3) polycistic appearing ovaries on ultrasound. Symptoms may not be present but can include: irregular cycles, excess of facial and/or body hair (hirsutism), acne, cysts, and infertility.
Pre-Implantation Genetic Testing for Monogenic Single Gene disorders (PGT-M): The testing of embryos to determine if there is a specific disease. This testing is done only if both parents are known carriers for a specific disease and can be used during in vitro fertilization to ensure that healthy unaffected embryos are being transplanted into the uterus.
Pre-Implantation Genetic Testing for Aneuploidy (PGT-A): The testing of embryos to determine if there is a normal complement of chromosomes (i.e. to minimize the possibility of transferring an embryo with an abnormal number of chromosomes, such as one with an extra copy of chromosome 21, which is also known as Down’s syndrome). This testing can be used during in vitro fertilization to shorten the time to pregnancy, and for some couples, maximize the chance for live birth and reduce the chance for miscarriage.
Premature Ovarian Failure (POF): Occurs when women under the age of 40 have a loss of ovarian function. Common symptoms include complete loss of menstrual cycles.
Progesterone: Hormone that prepares the lining of the uterus for implantation of the embryo. Produced by the ovary’s corpus luteum after ovulation.
Recurrent Pregnancy Loss: When 3 or more consecutive pregnancy losses occur during the 1st trimester of pregnancy. If recurrent pregnancy loss occurs, it is important to seek treatment with a reproductive endocrinologist, as testing can be initiated after the 2nd loss.
Reproductive Endocrinologists (RE): A doctor that is specially trained in the diagnosis and treatment of fertility. Reproductive Endocrinology is a subspecialty of Obstetrics and Gynecology.
Secondary Infertility: Affects people who have conceived and carried one or more pregnancies, but who suddenly experience the inability to conceive or carry a subsequent pregnancy.
Semen: Ejaculated during an orgasm, contains the sperm and seminal secretions.
Semen Analysis (SA): Examination under a microscope of recently ejaculated sperm. Assesses the count (number of sperm), motility (percentage of moving sperm), and the morphology (size and shape of the sperm).
Sperm: A male sex cell that when combined with an egg will cause fertilization, producing an embryo.
Surrogate: When a woman carries a pregnancy for a couple who is unable to have a child. Surrogates can conceive following embryo transfer from an IVF cycle (see Gestational Carrier).
Testicles: Male sex glands that are in the scrotum; produces the hormone testosterone and sperm.
Testosterone: Male sex hormone that is produced in the testicles. Testosterone is also found in lower amounts in women.
Transvaginal Ultrasound: Test performed by placing a probe inside a woman’s vagina. Helps to examine a woman’s uterus, ovaries, fallopian tubes, cervix, and pelvic cavity.
Ultrasound: The use of sound waves to obtain medical imaging. Helps to examine a women’s uterus, ovaries, fallopian tubes, cervix, and pelvic cavity.
Uterus: Organ in women that holds and nourishes a fetus as it grows.
Zygote: Early states of a fertilized egg or embryo.