#71 Causes of Infertility

There are many reasons women have trouble getting pregnant. Some women get pregnant but lose their babies to miscarriages time and time again. Only you can decide whether or not you have been trying unsuccessfully to get pregnant long enough or have had enough miscarriages that it’s time to try to find a cause for the problem.

In the United States, about 15 percent of couples struggle to conceive.  About 20 percent of pregnancies end in miscarriage, but many miscarriages happen before a woman misses her first period. It’s estimated that as many as 40 percent of pregnancies end in miscarriage if one considers those occurirng before a first missed period.

If you are having trouble getting pregnant or carrying a baby until you can deliver it successfully, there are some of common risk factors for infertility which may help you figure out the reasons for your pregnancy problems.

Age can affect fertility for both men and women. For women your fertility can decrease as you reach 35 or 40. Getting pregnant after 40 involves your body’s follicle stimulating hormone (FSH). If your levels of FSH are high, it indicates that the FSH hormone is calling for the release of an ova, but your body may not have any more eggs to release. Your FSH hormone increases to try to stimulate the release of an egg which may not be there. Actually, a high level of FSH indicates you are entering pre-menopause. If this is your situation, you are not likely to become pregnant without donor eggs. Women with polycystic ovary syndrome (PCOS) often have trouble becoming pregnant between 18 and 38, the years when pregnancy usually occurs. Women with PCOS can become pregnant at 50 or more years of age with the increase in FSH as they age. FSH acts as a fertility drug so for a short time you may have the risk of pregnancy with twins or triplets. I have heard of a 55-year old woman pregnant with triplets.

Tobacco and alcohol use can contribute to your infertility. Tobacco and alcohol seems to have less effect on women than men. In men, smoking and alcohol can decrease sperm count and increase the risk of erectile dysfunction.

The issue of whether endometriosis interferes with pregnancy hasn’t been resolved. Some say up to 80 percent of pregnancies in people with endometriosis result in miscarriages (loss of pregnancy before 20 weeks). The definitive study is yet to be done as to whether endometriosis does or does not cause infertility.

Another important common cause of pregnancy loss is recurrent infection with organisms so common patients are seldom treated for them. Common pathogens (any organism producing disease) include mycoplasma, ureaplasma, and strep B.

One big problem with these infections is they can cause physical symptoms that look like endometriosis. This opens up the possibility of surgery to remove the endometriosis lesions which create adhesions (scar tissue), and this may further inhibit pregnancy.

The American College of Obstetricians and Gynecologists (ACOG) feels these infections are so common they do not cause problems in pregnancy. It’s true that in many women they do not, but in others they do. Forty years ago I began treating these common infections in my patients with great success.

I will never forget a couple who came to me to do something about their inability to get pregnant. They had had in vitro treatments several times, never resulting in a pregnancy. and were heading for a foreign country in three weeks. I tested for the common pathogens I knew caused problems in pregnancy. The test for ureaplasma came back positive. This organism can make a woman’s vaginal mucous very hostile to sperm. I treated both the woman and her husband with doxycycline.

Six weeks later I received a call from the woman that she was pregnant. Eight months later I received a call that she had delivered a healthy girl with normal weight and normal Apgars.

There is an important lesson here for woman suffering from infertility and multiple miscarriages. Never overlook the obvious and the simple $300 successful maternity treatment.