Infertility: What You Need to Know
Guest Blog by Michael A. Thomas, M.D., Professor (Fellowship and Section Director, Division of Reproductive Endocrinology and Infertility – University of Cincinnati Academic Health Center)
Note from Patty’s desk: I’ve worked with Dr. Michael Thomas on behalf of the Patty Brisben Foundation for Women’s Sexual Health for almost a decade. He is a renowned fertility specialist and someone I personally look up to and admire. The Patty Brisben Foundation would not be where it is today without the genuine support of experts like Dr. Thomas. Pure Romance Consultants reading this blog should share in my pride that we are truly surrounding ourselves with nothing but the best, and also use this valuable information to challenge your health care professionals with questions and offer additional resources to your customers in the ordering room and beyond.
My name is Dr. Michael Thomas and I am a Professor at the University of Cincinnati Medical Center, as well as a fertility specialist. Though 75% of my day is spent helping couples get pregnant, the rest of my day is spent researching various topics including sexual dysfunction, contraception, menopause, pelvic pain, and the effect of environmental toxins on reproduction.
20-25% of couples have problems getting pregnant. Usually a doctor will tell a patient to wait for one year to get try to get pregnant if the female partner is less than 35 years old and has normal cycles (less than 35 days apart). Women who are older than 35, have longer cycles or have a known male partner with sperm issues, should see a doctor much sooner.
Experts generally divide infertility problems among patients to:
- Those that are caused by the male or absence of a male (40%)
- Those associated with problems with the female partner (40%)
- Problems related to the male and female (10%)
- No problems found in the male or female (10%)
Male problems are associated with the sperm. A semen analysis is an easy way to find out if the male partner has a problem with the sperm count, movement or shape. One or all of the problems can prevent fertilization of an egg. Examples which can cause a problem include something that the male has coming in contact with (toxic exposure), varicose veins around the testicles (varicocele), hormonal, genetic, or, sometimes, no reason for a sperm problem may be found.
Common female problems that may cause infertility include disorders of ovulation (difficulty in releasing an egg), blockage of the fallopian tubes, abnormalities of the uterus (womb), pelvic adhesions, or issues with the cervix (mouth of the womb) or vagina.
One of the most common disorders of ovulation that affects up to 15% of women is polycystic ovary syndrome or PCOS. PCOS is associated with having two of the following three symptoms:
1. Menses for more than 35 days
2. An increase in hair growth above the lip or under the chin
3. Polycystic appearing ovaries on ultrasound
Unlike some mistruths about PCOS that have been perpetuated, women with this condition can be of any weight and problems with PCOS usually present themselves after they start their menses as a teenager. Most of these women have to use medications in order to get pregnant. These hormonal preparations will allow her body to produce an egg in a more predictable way so that intercourse can be timed to increase the chance that an egg can be fertilized and implant in the uterus.
Another common problem that can cause infertility is blocked tubes. Previous surgery or a prior pelvic infection can predispose a woman to have both of her tubes blocked. If a blockage occurs, the egg and sperm can’t meet to allow an embryo to form. Specialized testing by your gynecologist or a fertility specialist needs to be performed to check if the tubes are open or closed. This test, called a hysterosalpingogram (or HSG), should be offered to anyone experiencing an infertility problem.
Doctors should also pay special attention to couples that go through infertility workups. Because the precise timing of intercourse to conceive can sometimes become more “pro-creational than recreational,” the fun of a normal sex life can lose its spark; therefore, the lines of communication must always remain open in couples who face fertility challenges. During this time, a frank and open discussion with each other or with a health professional is very important.
Through a grant totaling $50K from the Patty Brisben Foundation for Women’s Sexual Health, the University of Cincinnati has investigated the effect that infertility can have on a couple’s sex life. We have also researched the effect of birth control pills on decreasing a woman’s sex drive, how a new diagnosis of cancer can affect libido, and how women with vaginal pain can get relief with either the use of medicines that block certain nerves or physical therapy. These projects, and many others from leading academic institutions from around the country, have been funded by the Foundation.
In addition, I am very proud of the following UC Health video.
For more information on infertility, or to contact me for advice, please visit www.ucfertility.com.