What is infertility?
Infertility is defined as the biological inability of a woman or man to contribute to conception. Many experts define infertility as not being able to get pregnant after at least one year of trying. Women who are able to get pregnant but then have repeat miscarriages are also said to be infertile. According to the National Center for Health Statistics, roughly 12% of women in the United States—up to 7.3 million—had difficulty getting pregnant or carrying a baby to term in 2002.
Although it is commonly believed that infertility is heavily related to female factors, only about one-third of cases of infertility actually stem from the woman. About one-third of cases originate with the male partner and the remaining cases are a combination of unknown factors or a mix of male and female complications.
Infertility in Women:
Most women who suffer from infertility have a problem with ovulation, meaning there is a complication with the eggs being released to be fertilized. Other causes of infertility include:
- Ovulation issues
- Problems with the uterus lining
- Uniterin fibroids
- Blocked fallopian tubes because of endometriosis, ectopic pregnancy, or pelvic inflammatory disease.
Factors that increase a woman's risk of infertility:
- Athletic activity
- Overweight or underweight
- Alcohol consumption
- Sexually transmitted diseases (STDs)
- Health problems that cause hormonal changes
- Celiac Disease
Infertility in Men:
Infertility in men is generally caused by producing too few or no sperm. The problem may also be the sperm's ability to travel to the female's egg and fertilize it. This is typically caused by abnormal sperm shape that prevents it from traveling in the correct form.
Factors that increase a man's risk of infertility:
- Alcohol consumption
- Toxins in the environment such as lead and pesticides
- Chemotherapy and radiation treatment for cancer
- Celiac disease
Celiac Disease and Infertility Link:
Over the last 10 years, several studies have examined the link between celiac disease and infertility and found that women suffering from unexplained infertility may have clinically silent celiac disease.
- One study conducted by physicians at Thomas Jefferson University Hospital in Philadelphia found that the rate of recurrent spontaneous abortion (RSAB) and infertility in celiac disease patients is at least four times higher than the general population. They suggested that patients who experience unexplained infertility or RSAB should be screened for celiac disease.
- Another study from the Department of Medicine at Tampere University Hospital and Medical School at the University of Tampere Finland found that the rate of celiac disease among women reporting infertility was 4.1%. Although the exact reason for the increased risk remains unknown, the researchers suggested that female celiac patients who are not adhering to a gluten-free diet have a shortened reproductive period and early menopause. Males with celiac disease have shown gonadal dysfuction, which could also contribute to fertility complications.
- The link between celiac disease and infertility is currently being evaluated by researchers at Molinette Hospital in Turin Italy. Early reports from their research suggest that the prevalence of celiac disease among women with unexplained infertility is 2.5% to 3.5% higher than the control population. They suggest that celiac disease represents a risk for abortion, low birth weight babies and short-breast feeding periods, all of which can be corrected with a gluten-free diet.
Tests for Infertility:
- Hysterosalpingography: Physicians use x-rays to check for physical problems of the uterus and fallopian tubes. They inject a special dye through the vagina into the uterus, which shows up on the x-ray. This will allow the physician to determine if the dye moves normally through the uterus into the fallopian tubes. With these x-rays, doctors can find blockages that may be causing infertility.
- Laparoscopy: During this surgery doctors use a tool called a laparoscope to see inside the abdomen. The doctor makes a small cut in the lower abdomen and inserts the laparoscope. Using the laparoscope, doctors check the ovaries, fallopian tubes, and uterus for disease and physical problems. Doctors can usually find scarring and endometriosis by laparoscopy.
There are several ways to treat infertility including:
- Medicine (clomiphene, Human menopausal gonadotropic, follicle-stimulating hormones, gonadotropic releasing hormones, metformin, and bromocriptine).
- Artificial insemination or assisted reproductive technology.
- Often times treatments are combined.