Why Can’t I Get Pregnant?

By the numbers, 35% of all infertility cases reside with the female partner, 35% with the male, 20% with both partners, and 10% are deemed “unexplained”.

In other words, infertility affects men and women equally. With that in mind, below you will find a snapshot of what it takes to make a baby and the most common male and female conditions that may hinder conception.

Fertility Basics

In order to fully understand the causes of infertility, it is helpful to first understand the causes of positive pregnancy. Before we discuss this in greater depth, let’s first review some basic yet crucial roles in the “baby-making” process.

Egg
A woman must produce a healthy egg

Sperm
A male must produce healthy sperm

Fallopian Tubes
A woman’s Fallopian tubes must be open (and not blocked) to ensure sperm can pass through and reach the egg

Fertilization
Healthy sperm must fertilize a healthy egg to become a healthy embryo

Implantation
A healthy embryo must implant to the uterus

Female Infertility 101

Female-factor infertility can be diagnosed through blood testing, ultrasound, and x-rays such as a hysterosalpingogram (HSG). Some common causes of female infertility include:

• Advanced maternal age
• Endometriosis
• Hormonal imbalances
• Polycystic ovarian syndrome (PCOS)
• Structural abnormalities of the uterus, fallopian tubes, or ovaries
• Previous pelvic infection or inflammation
• Diminished ovarian reserve
• Genetic abnormalities in an embryo
• Miscarriage
• Fallopian tube blockage or damage
• STD’s
• Stress

Male Infertility 101

Male-factor infertility is often diagnosed through a semen analysis test. Causes of male infertility include:

• Sperm production issues within the testicles: too many abnormally shaped sperm (poor morphology), low sperm count, and decreased sperm movement (poor motility)
• Past injury to testicles
• Varicocele: dilated veins in the scrotum that may cause low sperm production
• Previous infections
• Health conditions: high blood pressure, diabetes
• Hormonal abnormalities
• STD’s
• Stress

When it comes to maximizing your fertility success, it’s crucial that you feel confident in the quality of care you are receiving.

If you have received treatment at another center and are considering a change in care, NewLife Fertility can help consultation@newlifefertility.com

• We routinely diagnose and treat difficult fertility cases and rare reproductive disorders
• Each month our entire team of physicians joins together to sit down and review all intricate cases
• This is especially valuable for patients who’ve experienced IVF failure and instances of miscarriage or unexplained fertility while at other fertility centers
• We offer intracytoplasmic sperm injection (ICSI) for patients with male factor infertility or those who previously had low fertilization rates or fertilization failure
• We offer assisted hatching of embryos to increase the chance of implantation in the uterine cavity

Adhesions
Scar tissue that may be located in the abdominal cavity, fallopian tubes, or inside the uterus. Can interfere with the transport of the egg and implantation of the embryo in the uterus.

Amenorrhea
Lack of menstrual period for 6 months or more.

Andrologist
A physician who performs evaluations of male fertility.

Anovulation
The failure to ovulate. This is the most common cause of female infertility. There are many different causes for the failure to ovulate, including problems with the central nervous system or pituitary gland, and abnormalities within the follicles or ovaries.

Assisted Hatching (AH or AZH)
A micromanipulation procedure in which an opening is made into the hard outer surface of the early embryo with the use of chemicals, mechanical techniques, or lasers to improve implantation after the embryo is transferred into the uterus.

Assisted Reproductive Technology (Art)
A group of treatment methods used to improve fertility, which involves collecting the eggs and putting them in direct contact with sperm. Including IVF, ICSI, Assisted Hatching, egg freezing, and more.

Azoospermia
Semen that contains no sperm, either because the testicles can’t make sperm or because the man’s reproductive tract is blocked.

Basal Body Temperature (BBT)
The body temperature when taken at its lowest point, usually in the morning before getting out of bed. Charting a woman’s BBT is used to document ovulation. If the BBT pattern rises about a half degree during the latter half of the menstrual cycle, it suggests that ovulation has taken place.

Andrologist
A physician who performs evaluations of male fertility.

Anovulation
The failure to ovulate. This is the most common cause of female infertility. There are many different causes for the failure to ovulate, including problems with the central nervous system or pituitary gland, and abnormalities within the follicles or ovaries.

Assisted Hatching (AH or AZH)
A micromanipulation procedure in which an opening is made into the hard outer surface of the early embryo with the use of chemicals, mechanical techniques, or lasers to improve implantation after the embryo is transferred into the uterus.

Assisted Reproductive Technology (Art)
A group of treatment methods used to improve fertility, which involves collecting the eggs and putting them in direct contact with sperm. Including IVF, ICSI, Assisted Hatching, egg freezing, and more.

Azoospermia
Semen that contains no sperm, either because the testicles can’t make sperm or because the man’s reproductive tract is blocked.

Basal Body Temperature (BBT)
The body temperature when taken at its lowest point, usually in the morning before getting out of bed. Charting a woman’s BBT is used to document ovulation. If the BBT pattern rises about a half degree during the latter half of the menstrual cycle, it suggests that ovulation has taken place.

Clomiphene (Clomid, Serophene)
Often the first line of treatment to stimulate and induce ovulation. Clomid binds to estrogen receptors in the hypothalamus. When their sites are occupied, the hypothalamus responds by telling the pituitary to release more FSH.

Conception
The fertilization of an egg by sperm that leads to the creation of a baby.

Congenital
Conditions present from birth, either hereditary or environmental.

Corpus Luteum
A yellow-colored cyst that forms from the ovarian follicle after it releases an egg. Once formed, the cyst produces estrogen and progesterone to prepare and support the uterine lining for implantation.

Cryopreservation
The process of freezing tissues or cells and then storing them in liquid nitrogen at very low temperatures. This process is used to store sperm, embryos, and unfertilized eggs. They are stored in small vials or straws that can last for decades.

Donor Insemination (DI)
A type of artificial insemination using sperm, not from a male partner.

Donor Sperm
Semen specimens donated and used in an ART procedure.

Ectopic Pregnancy
Also called a tubal pregnancy, this is a condition in which the embryo implants outside of the uterus, usually in the fallopian tube, although it can also occur in the ovary or abdominal cavity. If such a pregnancy is allowed to continue, it may eventually rupture the fallopian tube and cause life-threatening hemorrhage. Such a pregnancy can never be sustained and often leads to decreased or complete loss of function in the affected tube.

Egg Donation
Process in which eggs from a fertile woman are donated to an infertile woman for use in an ART procedure.

Egg Retrieval
A procedure used to collect eggs from a woman’s follicles for use in IVF usually performed with ultrasound-directed needle aspiration during IVF.

Embryo
A term that describes the time from fertilization of the egg until the first few weeks of pregnancy.

Embryo Freezing
See Cryopreservation

Embryo Transfer
Placing an embryo into a woman’s uterus or into the fallopian tube after IVF

Endometrial Biopsy
Removal of a small piece of the uterine lining for microscopic study.

Endometriosis
A chronic condition in which some of the normal cells that line the internal cavity (endometrial tissue) are found outside the uterus – most often in the pelvic area involving the ovaries. Endometriosis may interfere with ovulation and with the implantation of the embryo.

Epididymis
A coiled, tubular organ attached to and lying on the testicle that stores the sperm before ejaculation.

Estradiol
A natural estrogen produced by the ovary and released through reproductive life. It supports the development of the uterine lining and is important to breast and other female organ development

Fallopian Tubes
Hollow ducts through which eggs travel to the uterus once released from the follicle.

Fertility Clinic
A program of fertility specialists offering a range of fertility services, usually including ART.

Fertility Drugs
A group of drugs given to women to improve fertility. Fertility drugs are also used to treat some men with male factor infertility. See Fertility Drug Glossary.

Fertility Specialist
A doctor who specializes in the diagnosis and treatment of infertility.

Fertilization
Penetration of the egg by the sperm cell.

Fetal Reduction
A technique that reduces the number of fetuses in a multifetal pregnancy to reduce the risks of multiple pregnancies.

Fetus
A term used to describe a human in utero development, from the period of time when the embryo is fully formed at around 8 weeks, until birth.

Fibroid/Myoma
Benign tumors of the uterine muscle and connective tissue.

Fimbria
Finger-like projections at the end of the fallopian tube nearest the ovary. When stimulated by the fluid released from the follicles during ovulation, the finger-like ends grasp the egg and sweep it into the tube.

Follicle Stimulating Hormone (FSH)
A reproductive hormone that stimulates sperm production in a man; in a woman, FSH stimulates the growth of the ovarian follicle and the production of eggs.

Follicular Phase
The portion of a woman’s cycle before ovulation during which a follicle grows and high levels of estrogen cause the lining of the uterus to grow.

Follicle
A fluid-filled sac in the ovary that contains the eggs.

FSH Follicle Stimulating Hormones
Fertility medications like Bravelle, Follistim, Gonal-F stimulate follicle growth.

Gamete
The term for either a sperm or an egg.

Gamete Intra-Fallopian Tube Transfer (Gift)
A technique in which the egg and the sperm are brought together by retrieving the eggs, placing them with sperm into a catheter, and immediately delivering them into the fallopian tube for fertilization using laparoscopy.

Gestation
The medical term for pregnancy.

Gestational Carrier
A type of surrogacy in which a surrogate mother is implanted with the genetic offspring of another couple and then turns the baby over to them at birth.

Gn-RH Agonist (Lupron, Synarel)
These drugs inhibit premature ovulation.

Gn-RH Antagonist (Cetrotide, Ganirelix)
These drugs inhibit premature ovulation.

Gonadotropin
The hormones that stimulate the growth of the follicle, i.e. FSH and LH.

Gonads
The gender-neutral term for the ovaries and testicles.

Gynecologist
A physician whose specialty is health care for women, especially the treatment of the female reproductive organs.

Hormone
A chemical substance that travels via the bloodstream and carries a signal from one part of the body to another.

Human Chorionic Gonadotropin
Medication (Ovidrel, Novaryl, Pregnyl) used to trigger ovulation.

Human Menopausal Gonadotropin
Fertility medications (Menopur, Repronex, Luvens) that stimulate follicle growth.

Hypothalamus
A part of the brain that regulates hormones, located next to the pituitary gland at the base of the brain.

Hysterectomy
A surgical procedure involving the removal of the uterus, and which usually removes the cervix but not necessarily the ovaries and fallopian tubes.

Hysterosalpingogram (HSG, Hysterogram, Tubogram)
An X-ray of the pelvic organs while a radio-opaque dye is injected through the cervix into the uterus and fallopian tubes. This test is used to check for malformations of the uterus or blocked fallopian tubes in suspected infertility.

Hysteroscopy
A surgical procedure to check for abnormalities within the uterus. It is performed by placing a small, thin telescope-like instrument through the cervical canal to inspect the inside of the uterus. The procedure can be used both to diagnose and treat problems since minor surgical repairs also can be done during operative hysteroscopy.

Implantation
The process of attachment of the embryo to the maternal uterine wall.

Infertility
The inability to conceive after a year of unprotected, well-timed intercourse, or the inability to carry a pregnancy to term.

Intracytoplasmic Sperm Injection (ICSI)
A lab procedure in which a single sperm is injected through the outer shell of the egg to enable fertilization.

Intrauterine Insemination (IUI)
An Assisted Reproduction Technique which deposits washed sperm directly into the uterus, bypassing the cervix, and allowing the sperm to enter the fallopian tubes (where fertilization normally occurs).

In Vitro Fertilization (IVF)
Literally meaning “in glass,” the term refers to fertilization that takes place outside the body in a small glass dish. This procedure involves stimulating the ovaries, retrieving eggs, fertilizing the eggs and then implanting the embryos in the woman’s uterus.

Laparoscopy
A minimally invasive surgical procedure in which a telescope-like instrument called a laparoscope is inserted through a small incision in the abdominal wall to view the inner organs in order to diagnose and sometimes treat suspected reproductive problems.

Leuprolide Acetate (Lupron)
A fertility drug containing a Gonadotropin-releasing hormone analog that, following an initial stimulation, suppresses premature ovulation.

LH Surge
A sudden large release of Luteinizing Hormone from the pituitary gland that culminates in the release of a mature egg from the follicle about 36 hours after the surge begins.

Luteal Phase
The second half of the menstrual cycle that occurs between the release of an egg and the menstrual period.

Luteinizing Hormone (LH)
A pituitary hormone that stimulates the ovaries or testicles.

Menstrual Cycle
The monthly series of physiologic reproductive changes in the uterus and other female organs that averages about 28 days, measured from the one menstrual flow to the next.

Micromanipulation
The use of high magnification and special instruments to manipulate sperm, eggs, and embryos during IVF.

Miscarriage
The spontaneous loss of an embryo or fetus before the 20th week of pregnancy. Most miscarriages occur during the first 14 weeks of pregnancy.

Myomectomy
The surgical removal of fibroid tumors from the uterus.

Oligomenorrhea
An irregular menstrual cycle that occurs in intervals longer than 35 days. This condition is usually caused by irregular coordination between the hypothalamus, the pituitary gland, and the ovaries.

Oligospermia
The term for a low sperm count in the ejaculate.

Oocyte
The biological term for an egg.

Ovarian CYST
A fluid-filled sac within or on the surface of the ovary. The majority of ovarian cysts are not related to any disease and disappear without treatment within a few months.

Ovarian Failure
A condition involving a loss of normal ovarian function in which the ovaries don’t produce eggs, so estrogen levels drop and follicle-stimulating hormone levels rise.

Ovarian Hyperstimulation Syndrome (OHSS)
A complication occasionally was seen in women who take certain fertility medications that stimulate egg production. Ovarian hyperstimulation can cause ovarian enlargement and discomfort and fluid can leak into the abdominal area. Most cases are mild.

Ovulation
The release of a mature egg from a follicle.

Ovulation Induction
Drug treatment that stimulates the development and release of one or more mature eggs from the ovaries.

Pap Smear
A microscopic examination of cells scraped from the cervix to detect cancerous or precancerous conditions of the cervix.

Pelvic Inflammatory Disease (PID)
A general term for infection of the female reproductive organs

Pituitary Gland
The small gland found at the bone of the brain that secretes many hormones, including FSH and LH.

Polycystic Ovarian Syndrome (PCOS)
A metabolic condition associated with irregular ovulation. The condition may include obesity, infertility and excess hair growth.

Preimplantation Genetic Diagnosis (PGD)
Genetic testing of an embryo during IVF to determine potential genetic abnormalities of the embryos prior to transfer to the uterus.

Progesterone
An important ovarian hormone that is normally secreted after ovulation and during pregnancy. Progesterone triggers thickening of the lining of the uterus so it can accept implantation of a fertilized egg.

Prolactin
The pituitary hormone that stimulates the production of milk in breastfeeding women. It also circulates in low levels in the bloodstream of non-pregnant women. High levels of prolactin in non-pregnant women can cause anovulation.

Prostate Gland
The gland encircling the urethra in men that produces a third of the fluid in the ejaculate.

Pyospermia
High white blood cell count in the sperm.

Reproductive Endocrinologist
An obstetrician-gynecologist who has completed additional training in reproductive endocrinology. Reproductive endocrinologists are qualified to manage imbalances in the complex hormonal reproductive system, including infertility and recurrent pregnancy loss.

Salpingectomy
Surgical removal of one or more fallopian tubes. Salpingectomy is usually performed if the tube has become infected or to treat an ectopic pregnancy.

Salpingitis
Inflammation of the fallopian tube.

Semen
The fluid of the male reproductive tract, containing sperm and a number of other substances such as water, simple sugars, alkaline chemicals, and prostaglandins.

Semen Analysis (SA)
A laboratory test used to assess the amount and quality of a man’s sperm and semen.

Sperm Bank
A service that maintains frozen sperm samples.

Sperm Count
The number of sperm in the ejaculate also called sperm concentration and given as the number of sperm per milliliter. A low sperm count is called oligospermia. A sperm count of 20 million/ml or above is considered normal.

Sperm Morphology
The evaluation of the size and shape of sperm in a semen sample.

Sperm Motility
The ability of sperm to swim.

Sperm Wash
A technique used to separate sperm cells from the seminal fluid, resulting in a small volume of highly concentrated sperm used for IUI treatments.

Sterility
A condition that results in the absolute inability to reproduce.

Swim-Up Test
A useful diagnostic procedure that also can be used to remove sperm from the semen. It has some advantages to sperm washing because the live sperm will swim up to the culture media leaving behind most of the debris.

Testicles
Also known as testes, testicles are the male sex glands located in the scrotum. Testicles store and produce sperm and are the main source for the secretion of the male hormone testosterone.

Testicular Biopsy
A surgical procedure in which a small sample of testicular tissue is removed for microscopic examination to see if sperm is present and able to be retrieved.

Testosterone
The primary male hormone is responsible for secondary sex characteristics and for supporting the sex drive. Testosterone is also necessary for sperm production.

Tubal Ligation
Female sterilization. The fallopian tubes are blocked to prevent the egg from meeting sperm. Commonly known as “having the tubes tied”.

Ultrasound
Use of high-frequency sound waves that are reflected off solid tissues to give an image of internal body structures. This device is used to detect and count follicle growth in many fertility treatments and to detect and monitor pregnancy.

Uterus
Part of the female reproductive system that contains and nourishes a fetus prior to birth.

Zygote
An embryo in the early stages of development.