What is infertility?

Infertility means being unable to conceive within a year of starting to try. Most people who want to have a baby become pregnant well within a year, so if you or your partner have not become pregnant in that time, there could be an underlying medical cause. Both men and women can have fertility problems, so it’s important that both partners undergo fertility testing.

What causes male infertility?

Medical conditions that could result in male infertility include:

• Varicoceles
• Epididymitis
• Orchitis
• STDs
• Retrograde ejaculation
• Tumors
• Undescended testicles
• Hormone imbalances
• Male hypogonadism
• Chromosome defects
• Erectile dysfunction
• Celiac disease
• Having a low sperm count, poor quality sperm or low sperm motility (slow-moving sperm) 

What causes female infertility?

Ovulation disorders are a significant cause of female infertility. They cause you to release fewer eggs from your ovaries or sometimes stop you from producing any eggs at all. Conditions that can cause ovulation disorders include:

• Polycystic ovary syndrome (PCOS)
• Hypothalamic dysfunction
• Premature ovarian failure
• Excess prolactin

Other possible causes of female infertility include:

• Tubal infertility (fallopian tube damage)
• Pelvic inflammatory disease
• Previous pelvic surgery
• History of ectopic pregnancy
• Pelvic tuberculosis
• Endometriosis
• Uterine fibroids
• Cervical stenosis

What are the tests for infertility?

You and your urologist will determine which (if any) of these tests are appropriate to undergo.

Male Infertility Testing

• Semen analysis.
• Hormone testing
• Genetic testing - Is used to determine if a genetic defect is causing infertility.
• Testicular biopsy
• Imaging - Can include an MRI, transrectal or scrotal ultrasound, or vasography.

Female Infertility Testing

• Ovulation testing
• Hysterosalpingography - Assesses the condition of the uterus and fallopian tubes.
• Ovarian reserve testing - Evaluates the quantity of eggs that are available for ovulation.
• Hormone testing
• Imaging tests - Can include a pelvic ultrasound or sonohysterogram.

How is infertility treated?

Infertility treatment begins by ensuring that you and your partner are maximizing your chances of conception. By making simple adjustments to your lifestyle, such as cutting out smoking and drinking, exercising, and eating healthy, you can potentially increase your chances of becoming pregnant. 

You and your partner must also have sex regularly, specifically around the time of ovulation. There are apps that chart the ovulation cycle on your smartphone to make this easier and more accurate. 

When lifestyle modifications are not helping, your doctor may decide to administer more advanced treatments to increases your chances of fertility, including: 

• Hormone treatment (e.g. testosterone replacement therapy)
• Surgery - Such as removing uterine fibroids or undergoing a varicocelectomy to remove varicose veins in the scrotum.
• Testicular sperm extraction (TESE) - This involves harvesting sperm from your testicles for insertion into your partner. MicroTESE is a refined process that enables your provider to collect sperm from anywhere in your testicles. It’s an effective treatment even if your sperm count is very low.