Infertility is a condition that affects approximately 1 out of every 8 couples, according to the American Pregnancy Association. “When to seek help is really up to the couple,” says board-certified specialist in Reproductive Endocrinology and Infertility, Dr. William Ziegler, D.O., FACOG. Dr. Ziegler is Medical Director of the Reproductive Science Center of New Jersey.
“If a woman is feeling stressed about the length of time it is taking to conceive or is worried there is a problem, then they should seek help,” advises Dr. Ziegler. “By definition, a couple should seek help if they have failed to conceive after one year if the woman if under age 35, or within six months if the woman is older than age 35.” An infertility diagnosis is given to a couple that has been unsuccessful in efforts to conceive over the course of one full year.
Common Causes of Infertility
The most common causes of female infertility include problems with ovulation, damage to the fallopian tubes or uterus, or problems with the cervix. “Age can contribute to infertility because as a woman gets older, her fertility naturally tends to decrease,” says Dr. Ziegler.
Ovulation problems can be caused by:
• Hormone imbalance
• A tumor or cyst
• Eating disorders such as anorexia or bulimia
• Alcohol or drug use
• Thyroid gland problems
• Excess weight
• Intense exercise that causes a significant loss of body fat
• Extremely brief menstrual cycles
Female infertility factors contribute to approximately 50 percent of all infertility cases, and female infertility alone accounts for approximately one-third of infertility cases. Male infertility can be the result of low sperm production, abnormal sperm function or blockages that prevent the delivery of sperm, illnesses, injury, chronic health problems, and lifestyle choices.
“Overweight and underweight women have increased risk for infertility and less success with fertility treatments,” says Dr. Ziegler. “Consistent, moderate exercise and a healthy diet is good preconception care to help a woman maintain her reproductive health. “
Meeting Each Patient’s Special Needs
“There are many encouraging advances in fertility treatment, and every patient desiring to conceive should be treated individually, helping them to build a family in the best way specific to their needs and wishes” says Dr. Ziegler.
“A patient’s treatment is based on many variables,” says Dr. Ziegler. “This includes the cause for their infertility, other medical conditions, ovarian function, and results from prior fertility treatment.”
“Medications have evolved over the years, which helps us to fine tune a patient’s response so we can now decrease the risk of multiples and ovarian hyperstimulation,” adds Dr. Ziegler.
“For women that are older or if they are carrying a genetic abnormality, we are now able to test embryos for genetic issues prior to transferring them into a women’s uterus,” says Dr. Ziegler. “This has helped increase pregnancy rates in women with pregnancy losses and those at an increased risk for genetic issues.”
Cryopreservation is another exciting advance for women who may choose to delay pregnancy. A woman may choose to delay pregnancy for medical reasons such as cancer treatments including chemotherapy, radiation and surgery, which can speed up the natural decline in available eggs and increase the risk of infertility, or for personal reasons such as education, career, relationship and other social factors.
Cryopreservation is the freezing and storage of mature eggs or embryos for later use in assisted reproductive treatments. These treatment options help women address the disconnect between the readiness to have children and the biological limitations of aging eggs.
“At some point, maternal age becomes a factor in achieving the goal of parenthood” says Dr. Ziegler. “With egg and embryo cryopreservation, however, women can take a proactive role to protect their future fertility.”
William Ziegler, D.O., FACOG
By Christine Burke Eskwitt