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Reproductive Endocrinologists, who are the doctors that treat infertility, would define it as the biological inability of a person to contribute to conception. It is also the inability of a woman to carry a pregnancy to full term [3]. When a couple has been trying to conceive for a full year, and is still having trouble getting pregnant, one or both partners may have a fertility issue. Doctors generally say that a woman under 35 years of age that has not conceived after twelve months of contraceptive free sex should consult a specialist. Also, a woman over 35 years of age who has been trying for six months or longer, should see a specialist [4]. The fact of the matter is that, with age, the likelihood of fertility disorders increases dramatically. Couples who wait until their 30’s or 40’s to start a family have hit the point where natural fertility is on the decline [3]. There are three types of infertility which are primary, secondary, and subfertility. Primary infertility is where a couple has never been able to conceive. Secondary infertility is the difficulty getting pregnant after already doing so. The last kind is termed subfertility. This is a diagnosis to couples who have tried to get pregnant for a period of time, usually short, and have not been successful. Subfertility means
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less fertile than a typical couple. This does not necessarily mean the couple will have fertility problems [3]. For a female to get pregnant, there are a few things that must happen. First, the woman’s body must release an egg from one of her two ovaries. Secondly, the egg has to travel through the fallopian tube and into the uterus. Then, a man’s sperm must meet with the egg (this is fertilization). Finally, the egg must attach itself to the inside of the uterus. Infertility can happen if any of these steps cannot happen (Hossein 2011). In approximately a third of infertility cases, the woman’s reproductive system is the problem. The problem may be physical such as an obstruction in the fallopian tube that prevents the egg from getting through; ovulation problems where an egg is not released on a monthly basis; implantation problems where there are abnormalities in the uterus and it can’t support a fetus; or the cervix may be detrimental to sperm. However, most of the time, the problem is with ovulation. Without it, there are no eggs to be fertilized. Ovulation problems are often indicated by an irregular or non-existent period [4]. These problems can be caused by a few things. First is Polycystic Ovarian Syndrome (PCOS), which is a hormonal imbalance that can interfere with
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hormonal ovulation. This is the most common cause of female infertility. Primary Ovarian Insufficiency (POI) is another ovulation abnormality [3]. This is where a woman’s ovaries simply stop working normally before menopause. Some of the less common causes of infertility in women are blocked fallopian tubes due to Pelvic Inflammatory Disease (PID), endometriosis, ectopic pregnancies, physical problems with the uterus, and uterine fibroids [3]. There are many things that can put a woman at a higher risk of becoming infertile. These things include: age, smoking, poor diet, athletic training, excess alcohol use, being overweight or underweight, stress, and sexually transmitted diseases (STD’s)(Hill 2011). Age however, is the biggest problem. In today’s world, women are waiting longer and longer to have a baby. In fact, many women are starting a family in their middle 30’s to early 40’s. Statistics show that one third of couples where the woman is older than 35, will have a problem conceiving. Aging will decrease a woman’s chance of having a baby for the following reasons: ovaries are less able to release eggs; there are a smaller number of eggs; the eggs that are left are not as healthy [4]. 8
Male infertility also accounts for about a third of all cases [4]. It has many causes from hormonal imbalances, to physical