Infertility

OB/GYN Care Orlando is a comprehensive medical center situated in Oviedo, FL, and serving the larger Orlando area. Struggling to conceive can be a deeply emotional experience, and the compassionate team at OB/GYN Care Orlando, located in Winter Park, Florida, is dedicated to helping you address the underlying causes of infertility. From initial laboratory tests to advanced laparoscopic procedures, their experienced team is committed to diagnosing and treating any barriers preventing successful pregnancy.

Infertility Q & A

Understanding Infertility

What is defined as infertility?
Infertility refers to the inability of a couple to achieve pregnancy after a year of unprotected intercourse.
Around 10-15% of reproductive-aged couples face infertility challenges.
Infertility becomes more likely with age: 11% of 34-year-old women, 33% of 40-year-old women, and 87% of 45-year-old women experience infertility.
Hence, women over 35 years of age might consider infertility evaluation after 6 months of unprotected intercourse, while the timeframe is 12 months for women under 35.

What are the causes of infertility?
Successful conception relies on healthy eggs, sperm, fallopian tubes, and a uterus. Damage to any of these components can lead to infertility.

Ovulatory problems contribute to 27% of infertility cases. Factors like polycystic ovarian syndrome, ovarian cysts, thyroid issues, hormone imbalances, and pituitary disorders can affect ovulation.

Approximately 22% of infertility cases result from scarring or damage to the fallopian tubes. This damage can stem from conditions like endometriosis, pelvic inflammatory disease, infections, or previous abdominal surgeries.

Sperm-related issues account for 25% of infertility cases. Elevated temperatures (e.g., fever or hot tub use), trauma, infections (such as mumps or STDs), and certain medications can damage sperm.

Other factors, including uterine conditions like fibroids or scarring, contribute to 9% of infertility cases.
17% of infertility cases remain unexplained.

How can patients enhance their fertility?

• Prioritizing overall health is crucial.
• Cigarette toxins can accelerate egg loss and increase miscarriage risk.
• Even moderate alcohol consumption (5-8 drinks weekly) can decrease pregnancy chances.
• Marijuana usage disrupts the brain-ovary communication pathway and might affect male fertility.
• Maintaining a healthy weight, quitting smoking, limiting alcohol intake, avoiding marijuana, and tracking menstrual cycles can all boost fertility.
• Ovulation occurs approximately two weeks before menstruation, with the best time for intercourse being the five days leading up to and including ovulation.
• Ovulation predictor kits can aid in timing intercourse.

What does an infertility evaluation entail?

A comprehensive assessment includes:
Detailed medical history to address medical conditions that may require optimization before attempting pregnancy and to identify any infections linked to infertility.
Surgical history to identify potential abdominal or uterine scar tissue.
Family history to detect genetic disorders that could impact future children.
Social history to uncover behaviors affecting fertility.
Lab tests to ensure hormonal balance is appropriate for the patient’s age.
If sperm issues are suspected, a semen analysis can assess sperm quality, quantity, and motility.
Ultrasound to evaluate uterine shape and ovarian follicle count.
A hysterosalpingogram (HSG) may be conducted to examine the uterus, fallopian tubes, and ensure tube openness for egg passage.
Laparoscopic surgery, if necessary, to explore the abdominal cavity and address scar tissue.

How is infertility treated?
Treatment approaches vary based on the cause of infertility.

Ovulation dysfunction:
Medications or surgical procedures can stimulate proper ovulation.
In vitro fertilization (IVF) is an option if ovulation issues persist.

Tubal factor infertility:
Procedures can sometimes reopen closed tubes.
Surgical removal of abdominal scar tissue may be necessary.
In severe cases, removing the tubes and pursuing IVF may be recommended.

Uterine factor infertility:
Surgical procedures can address scar tissue or fibroids within the uterus.

Male factor infertility:
Techniques like intrauterine insemination (IUI) can help improve sperm proximity to eggs.
Medications might boost sperm count.
IVF can directly combine sperm and eggs in cases of severely low sperm count or motility.