Infertility Awareness Week

April 18-24 is National Infertility Awareness Week, a movement to raise awareness and educate the public about the challenges infertility presents when trying to build a family. R. Stan Williams, M.D., the Harry Prystowsky Professor of Reproductive Medicine, shares his thoughts:

When should someone talk to a doctor about infertility testing?

If a woman is younger than 35 years old and has not gotten pregnant after one year of intercourse without contraception, she should talk to her doctor about infertility testing. If she is 35 or older, she should consult her doctor if she has not gotten pregnant after six months of unprotected intercourse.

What are the common causes for infertility?

1. The male factor is responsible for about 40% of infertility. It could be caused by low sperm counts, poor sperm mobility or abnormal morphology of the sperm.
2. About 20%-30% of infertility is due to a woman not ovulating regularly.
3. Tubal infertility causes another 20%-30% of infertility and occurs when something is wrong with a woman’s fallopian tubes; typically they are blocked.
4. Endometriosis, even mild cases, can lead to infertility. Endometriosis is a painful disorder in which tissue that normally lines the uterus grows on the outside of the uterus.
5. The incidence of advanced reproductive age of the woman is increasing these days. That can sometimes lead to infertility. Women start losing some of their fertility after age 30 and it accelerates after age 35. So, for women in their mid- to late 30s and certainly early 40s, their age could be the main cause.

How is infertility diagnosed?

Common testing for infertility is a sperm count for men or evidence of ovulation issues in women, which could be as simple as a history of having irregular periods. Women who are having regular periods can use an at-home ovulation predictor kit or get a progesterone blood test in the last week of their menstrual cycle. Progesterone is a hormone made by a woman’s ovaries after ovulation that helps make the uterus ready to support a fertilized egg. Detecting a blocked tube typically requires an X-ray called a hysterosalpingogram or a special ultrasound that passes bubbles through the tubes. The quality and quantity of the eggs can be measured in older women with specially timed hormone tests and an ultrasound on Day 2, 3 or 4 of the menstrual cycle.

What happens in a fertility evaluation?

We have both partners come to the first visit to answer a few questions so we can get an accurate history from them for risk factors that might be leading to one of the causes of infertility.

Does birth control have any effects on a woman’s body that would lead her to have trouble getting pregnant after she stops taking it?

There is no evidence that any type of birth control will lead to infertility. A common misconception is that when people are on oral contraceptives for a long time, it can cause disruptions in ovulation after stopping the pill. What actually is happening is the pill makes women have artificial periods every month, masking any irregular cycles that would be naturally occurring. When women stop taking the birth control, irregular periods become evident. It’s not that the pill caused the irregular periods. The pill was just masking them all along.

After having a baby, can a woman have trouble conceiving in the future?

Yes, but it is more common to have primary infertility where there are problems with the first pregnancy. Women can certainly have secondary infertility, which is when there is trouble conceiving again after a successful pregnancy.

What does UF Health Reproductive Medicine offer for infertility?

We do everything from determining risk factors, which includes a complete evaluation and testing of the patient and her partner, to providing treatment. What differentiates us from the average OB-GYN practice is that our expert physicians have had two to three years of extra training specifically in infertility. We are called reproductive endocrinologists. We can provide simple treatments, from ovulation induction with oral medications to help the woman ovulate better, to more advanced treatments such as intrauterine inseminations. That involves washing a sperm sample and placing it into the uterus. We can also do embryo biopsies for genetic defects and can use donor eggs and sperm. We also offer the most advanced infertility techniques, including in vitro fertilization, or IVF, and all of its variations. One variation of IVF is called intracytoplasmic sperm injection, or ICSI, where we inject sperm into the eggs. Essentially, we provide every infertility treatment that anyone could possibly need.

Do women need a physician referral to be seen at UF Health Reproductive Medicine or can they call to make a consultation appointment?

No referral is needed. They can call us directly.

Call UF Health Reproductive Medicine at 352.265.2229 or visit us at our website for more information or to schedule an appointment.