Infertility Resources & Support

Polycystic Ovarian Syndrome, or PCOS, is a common disorder that can contribute to infertility and long-term health risks. If you think you may be dealing with symptoms of the disorder, you're certainly not alone. In fact, as many as 12% of women of reproductive age in the U.S. live with PCOS. 

If you have PCOS, you may have many questions about the condition, its treatment, and what it might mean for your chances of getting pregnant. In this article, we'll answer some common questions about PCOS.

What Is PCOS?

PCOS is a multi-system disorder affecting many women of reproductive age. The cause of the disorder is unknown, but people with PCOS commonly exhibit imbalances in certain reproductive hormones, such as androgens. As the name implies, people with PCOS often have large numbers of follicles which are the small egg-containing cysts found in the ovaries. During a normal menstrual cycle, your ovaries mature and release an egg every month. Due to the effects of PCOS, your ovaries may be unable to make or release an egg regularly. This can result in infertility issues.

What Are the Symptoms of PCOS?

PCOS symptoms vary between individuals and can range from mild to severe. Many people may experience irregular periods, erratic ovulation, infertility, oily skin, extra hair on the face or body, hair loss on the scalp, and weight gain. More recently, PCOS has been linked with depression or mood disorders. Some people with PCOS are overweight, although people who are not overweight can have it also. Being overweight can make the signs and symptoms of PCOS worse. 

A common problem in people with PCOS is insulin resistance (more on this below). People with insulin resistance can often find darkening of the skin along creased areas like the groin or neck can occur, as well as the development of skin tags.

Who is at Risk for PCOS? 

The condition affects women of all ethnicities and can develop at any time during reproductive years or any time after puberty. The precise cause of PCOS is unknown. However, you may be at higher risk if you have a family history of the disorder.

As noted above, people with PCOS often have insulin resistance. People with insulin resistance can make insulin, but their cells don't respond to insulin as they should. As a result, insulin levels in the body may increase. This can cause the ovaries to produce higher levels of a group of hormones known as androgens which causes some of the symptoms of PCOS like unwanted hair growth. 

In addition to PCOS, other factors can contribute to insulin resistance such as being overweight, having an unhealthy diet, or a family history of diabetes. These people can see a worsening of their symptoms of PCOS. It's important to take action if you have high insulin or blood sugar levels since this may increase your risk of developing diabetes. 

How Is PCOS Diagnosed? 

Since PCOS is a syndrome with many different signs and symptoms, not all experts agree on the criteria to diagnose PCOS. The three most commonly used criteria are seen here.

As you can see, some criteria rely on blood tests, others rely on ultrasound, and still, others emphasize signs and symptoms. Therefore, your doctor may perform an exam and discuss your medical history to diagnose PCOS. They may perform a pelvic ultrasound to examine your ovaries and do blood tests to determine your hormone levels. These exams and tests will help rule out any other possible causes of your symptoms. 

How Is PCOS Treated?

There is no total cure for PCOS. But fortunately, you can take steps to manage or improve your symptoms. Getting adequate exercise, managing your weight, and eating a healthy diet can all help. You may also be able to take medication to lessen physical symptoms, like hair growth and acne. Making lifestyle changes can lower your long-term risks like type 2 diabetes. 

It's not easy to hear that you may have PCOS, but you can talk to your doctor about how to lessen your symptoms. Some simple lifestyle changes may improve things.

Can You Get Pregnant if You Have PCOS?

It's possible to get pregnant if you have PCOS. While PCOS can cause infertility struggles, there are a few things you can do to increase your chances of pregnancy. 

Having irregular ovulation will make it harder to track the fertile phase of your menstrual cycle. Even so, you could still be able to get pregnant naturally. If this doesn't happen, there are fertility treatment options available. 

Can Fertility Treatments Help You Get Pregnant With PCOS?

Absolutely! If you're having trouble getting pregnant, one possible option is in vitro fertilization (IVF). During this advanced fertility treatment, a doctor extracts your eggs, fertilizes them in a laboratory with collected sperm, and transfers the fertilized egg into your uterus. IVF bypasses the fallopian tubes, enabling a fertilized egg to be placed directly into your uterus, where it can implant. IVF can be an effective choice for many people, including those with PCOS, endometriosis, or damaged fallopian tubes.

However, many patients don't require IVF to get pregnant. 

Reducing insulin resistance by lifestyle changes or medication can often result in more regular ovulation and pregnancy. Another alternative is ovulation induction with intercourse or intrauterine insemination (IUI). For this procedure, you take fertility drugs to induce ovulation before having intercourse or undergoing artificial insemination so that your eggs can become fertilized.

Does Having PCOS Increase Your Risk of Pregnancy Complications? 

If you have PCOS, there can be some increased risk of certain complications like gestational diabetes and preeclampsia during pregnancy. However, this does not always happen, and you can reduce your risks by maintaining a healthy weight and making sure your blood sugar levels are normal before trying to become pregnant. 

No matter your situation, the team of caring professionals is here to support you on your fertility journey. We would be glad to answer any questions you may have about PCOS, infertility, and fertility treatment options. Explore our website or schedule a consultation with our experts today if you'd like more information.

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Who Faces Fertility Issues?

More than 48 million couples struggle with infertility worldwide. In the U.S., one in eight couples faces fertility issues.

Who Is Using Fertility Services?

Fully one-third of Americans have either used fertility services themselves or know someone else who has.

How Long Does it Take to Get Pregnant with Fertility Treatment?

With treatment, 85% of couples will succeed in getting pregnant within the first year and 7% during the second year.

What’s the Average Age to Have a Baby with Fertility Treatment?

The odds of conceiving depend on various factors, including underlying causes and treatment types. For IVF, the age range with the greatest success is age 30 to 33.

Need help? Contact us today.

Those experiencing fertility challenges while trying to build their family may have many questions about fertility. One common question is about fertility testing and the evaluation process. Without the correct information, couples or individuals may delay consulting an infertility specialist for a fertility evaluation. We compiled specific details in this guide to help you make the proper decisions and get started with a fertility evaluation. You will learn more about the fertility evaluation process, what to expect, and the tests involved.

What is Fertility Evaluation?

A fertility evaluation assesses fertility health and involves reviewing medical history, a physical examination, and diagnostic testing. The fertility evaluation process differs for men and women. Through a fertility evaluation, are productive medicine physician can diagnose possible causes of infertility and aid decision-making. After assessing your needs, your fertility physician will recommend the most appropriate treatment plan to reach your family-building goals.

When Do You Need a Fertility Evaluation?

The reasons to seek a fertility evaluation can differ from person to person. The presence and or persistence of these symptoms are typically an indication for a fertility evaluation.

For women, here are some signs you may need a fertility evaluation:

• If you’ve been actively trying to conceive without success for one year (or six months if you’re over 35)
• history of uterine or tubal disease
• irregular periods or no menstrual periods
• endometriosis
• history of pelvic inflammatory disease
• history of having had cancer treatment(chemotherapy or radiation treatment, especially if directed to the abdomen andpelvis)
• history of multiple miscarriages
• If you’re 37 or older and want to get pregnant
• history of genetic diseases that run in your families

Here are some indications for fertility evaluation in men:

• a history of testicular trauma
• history of surgery for an undescended testicle or hernia
• treatment with chemotherapy drugs
• history of infertility with a previous partner
• if you’ve been actively trying to conceive without success for one year (6 months if your partner is over age 34)

What to Expect From a Fertility Evaluation?

During your first visit to a fertility clinic, the fertility physician will start with a detailed clinical history to collect your personal health information and identify your unique health needs. The fertility physician may ask you (and your partner) the following:

• history of medical illnesses, including STDs and past pelvic surgery
• medication uses
• sexual history
• duration of infertility
• use of tobacco, alcohol, and illicit drugs

 For women, the doctor will typically ask about:

• your last menstrual period
• menstrual cycle length and frequency
• birth control methods
• past pregnancies and their outcomes.

While for men, here are some questions the fertility physicians may ask:

• history of childhood trauma to the testis
• history of infections such as orchitis or mumps
• prior childhood disorders like cryptorchidism
• history of infertility

After the clinical history, your fertility doctor will perform a physical examination.Clinical history details help direct the physician to examine particular organs. For example, males with testicular symptoms may require further urologic examination.

To aid the accuracy of clinical diagnosis, your doctor may recommend a series of diagnostic tests.

What is Fertility Testing?

A fertility specialist uses your medical history obtained when consulting with you to help choose the most suitable diagnostic tests that fit your personal situation. Hence, consulting with a fertility specialist early in the process may save you time and money and keep you from having any unnecessary testing.

Fertility testing involves a combination of laboratory tests and imaging studies to try to identify an explanation for your struggles to conceive. The results of these tests often point to a cause of your infertility, though it is important to know that at least 20% of the time, there is no explanation identified becauseall of the tests come back normal. The testing results will help your fertility provider know what treatments are available to you and will also help them know what treatment they would recommend as the most appropriate.

Fertility testing procedures are obviously different for men and women and best requested by fertility physicians.

Fertility Testing for Women

Female fertility testing entails using specific tests and radiological procedures to assess the ovarian function of your fallopian tubes and the integrity of the uterine cavity. Here are specific tests often performed in a complete fertility evaluation:

Assessment of Ovarian Function and Reserve

Ovulation— the release of a mature egg from the ovaries occurs at a specific time point in the monthly menstrual cycle. Ovulation testing helps to determine if a female is ovulating or not. It involves hormone testing on specific days in the menstrual cycle.

Ovarian reserve testing— women, lose the ability to get pregnant as they get older due to a decline in their ovaries and egg quality. Testing of your ovarian reserve is performed using a combination of blood testing of reproductive hormones and ultrasounds assessing what is referred to as your follicle count. 

Follicles are fluid sacs with an egg, which are visible on ultrasound early in your cycle. The number of follicles you have represents the number of eggs available to your body for ovulation that month. Typically, women start with a relatively large number of follicles, even if they ovulate only one egg at a time.

Hormone testing is another important part of evaluating ovarian function. These blood tests assess the level of hormones such as follicle stimulating hormones( FSH), antimullerian hormone (AMH), and estrogen levels in the blood.

Most of these ultrasounds and hormonal blood tests must be performed on a particular day of your menstrual cycle. AMH testing, however, can be done at any time in the menstrual cycle.Your fertility physician interprets the results from these hormone tests and determines if the ovarian function and reserve are within normal range.

Assessment of the Uterine Cavity

There are different methods for assessing the uterus. Typically, fertility experts use imaging tools to inspect the uterine cavity for abnormalities such as congenital uterine defects and adhesions. In addition, fertility doctors typically use a hysteroscope (a long lighted, flexible tube) to visualize the interior layers of the uterus. The procedure is called hysteroscopy. 

There is also a specialized ultrasound that is performed at the same time saline is instilled into your uterus to better determine if there is anything abnormal that may be keeping you from getting pregnant.This is known as a saline sonohysterogram.  Your physician will determine which of these tests is/are most appropriate.

Assessment of the Fallopian Tubes

Fallopian tubes are typically assessed in the clinic with a procedure known as a hysterosalpingogram or HSG. This fertility test aims to inspect the fallopian tubes for occlusions or blockages.The fallopian tubes can become blocked due to prior pelvic infections, endometriosis, or prior pelvic surgeries.  

An HSG involves using X-rays and X-ray contrast to outline the fallopian tubes and uterus. This test is typically done in the week or so after your period ends but before ovulation occurs so that there is no chance you are pregnant when you have it performed.

Laparoscopy (an actual surgery) is another method your fertility physician may decide to use to assess the fallopian tubes. However, it is invasive and not often the first choice.

Fertility Testing for Men

Semen analysis is the primary method of male fertility testing. The andrologist analyzes the semen for various characteristics such as the quality and quantity of sperm cells. Before the test, you or your partner will be counseled to abstain from sexual activity for 2-5 days. Your fertility doctor interprets the semen analysis result to determine the impact.

Here are the specific components of a semen analysis test.

Sperm Count

What most people refer to as a “sperm count” is technically a measure of the concentration of sperm in the ejaculate. It is reported as the sample's number of sperm cells per milliliter. According to the World Health Organization (WHO), the normal sperm cell count should beat least 15 million cells per milliliter. If the sperm cell count is below this level, the fertility doctor will typically assess the possible causes and recommend the most suitable therapeutic intervention.

SpermMotility

Sperm motility evaluates the movement pattern of sperm cells in the ejaculated semen.A sperm sample should have at least 40% progressive sperm motility, which does mean that it can be normal if over half of the sperm in the sample is “dead.”

Unlike conventional laboratory evaluation of sperm motility, computer-assisted semen analysis (CASA) uses digital technology to provide an in-depth kinetic analysis of sperm cells. CASA provides details on the sperm head motion patterns and a quantitative overview of the sperm cell kinetics.

Sperm Morphology

The word morphology means the shape, and so when your sperm is assessed as part of the analysis, we take a look to see what percentage of your sperm looks normal in every respect. Here the concept is that it is only normally shaped sperm that are capable of fertilizing an egg. 

Any defects or abnormalities in the sperm head, neck, body, or tail typically affect sperm quality and increase the risk of male infertility. A normal semen analysis should have at least 4% sperm cells with a normal shape.

Other features assessed in a semen analysis include:

• pH:Normal range is 7.0-8.0
• ‍Volume:Normal should be at least 2 mls per ejaculated semen‍
• White blood cells: White blood cells are typically absent in semen. The presence of white cells indicates an infection.‍
• Sperm viability: Some of the sperm ejaculated are simply dead. The viability assay helps determine if there is too high of a percentage of sperm that are dead when ejaculated.

Do You Need a Fertility Evaluation?

Fertility evaluation involves a review of your medical history, a physical examination, and specialized diagnostic tests. This process helps a fertility physician to evaluate your fertility status and offer solutions to any fertility problems.

Getting a fertility evaluation starts with consulting a fertility expert and choosing a fertility clinic with a team of professional fertility experts with a proven track record of helping couples or individuals start and expand their families. The proper fertility evaluation is essential to move you towards achieving your dream of starting or growing your family.

The first step in your fertility journey to parenthood is an initial consultation with one of our fertility specialists at Advanced Fertility Care. We have dedicated fertility professionals who assess our patients using the most recent reproductive technology solutions. We provide personalized fertility evaluations and testing that fits your unique health needs. Schedule your initial consultation today to get started on realizing your dreams of parenthood. We serve at several locations. Connect today!

Starting and expanding a family is a dream come true for many couples. Unfortunately, infertility impacts one in eight couples in the U.S. and many who desire to start a family or expand their family size may face challenges in conception. Male factor infertility is responsible for about 20-30% of infertility cases. Genetic and acquired medical conditions that affect the reproductive tract in males are responsible for male infertility.In this article, we discuss the common causes and diagnosis of male infertility as well as the therapeutic interventions available.

What is Male Infertility?

Male infertility occurs when male reproductive factors cause an inability to conceive. Inherited or acquired defects in the male reproductive tract can cause male infertility. Abnormalities may occur at various sites in the male reproductive tract and affect the chances of achieving conception. For instance, male infertility occurs when medical conditions destroy sperm-producing cells in the testis or hinder sperm transport.The clinical symptoms and therapeutic interventions in male infertility differ based on the underlying causes. For example, the therapy for individuals with a primary disorder in the testis is different from those with sperm transport disorder. Resolving male infertility starts with an accurate diagnosis of the cause.

Causes of Male Infertility

There are various causes of male infertility, but unfortunately, in a large percentage of patients, we are unable to identify the exact cause. Fertility experts classify these causes into groups for clinical management purposes. Here is a classification of the common causes that we can identify.

Genetic Causes

Genetic disorders account for 15-30% of male infertility cases. Genetic disorders could result from alterations that disrupt the structure and number of chromosomes (the cellular structure that contain the genes for sperm production). Males with a genetic or sex chromosomal defect are prone to male infertility.These genetic disorders affect the hormonal regulation and quality of sperm produced in the testis. An example of this would be a "microdeletion" of a part of the Y chromosome responsible for sperm production that can lead to very low or even absent sperm numbers. Males with genetic causes of infertility may also have a collection of other co-existing medical disorders. This is called a medical syndrome. Examples are Klinefelter syndrome, Young syndrome, Kallmann syndrome, etc.

Hormonal Causes

Hormones from the pituitary gland and testosterone influence sperm production in the testicles. Medical conditions that alter the blood concentration and balance of testosterone and pituitary hormones cause male infertility. Oftentimes, when these medical issues are addressed, sperm production normalizes.Examples of such conditions are iron overload syndrome, head trauma, intracranial radiation, hyperthyroidism, etc. Included in this category would be problems in sperm production caused by men taking testosterone supplementation. If men take regular testosterone injections or use testosterone gels or creams, sperm production often ceases completely. We, therefore, recommend any man interested in getting pregnant with his partner should not be taking testosterone or other steroids.

Undescended Testis

Typically, during fetal development, the testes descend from the abdomen into the scrotal sac. However, in some individuals, one or two testicles do not fully descend into the scrotum. Males with undescended testes are more prone to infertility, especially if the undescended testicle is not brought down into the scrotum surgically at a very young age.

Blockage in Sperm Transport Tubules

The testicles have tubules that transport sperm after production in the testis. When these tubules are blocked, it leads to infertility. One situation that everyone knows about that fits into this category is having had a vasectomy. Sperm cells are still produced but are unable to enter the ejaculate because the vas deferens (the tube that connects the testicle to the penis) have been interrupted.There can be genetic reasons for this too. Some men who are carriers of Cystic Fibrosis are actually born without vas deferens leading to infertility. Common risk factors of acquired blockages are physical trauma, prior pelvic surgeries, and infections. Chronic infections cause prolonged inflammatory changes that damage men's health and may produce car tissues that block these tubules.Poorly treated sexually transmitted diseases are one of the most common causes of blockage in sperm transport tubules. Thus, if you suspect you could have a sexually transmitted disease, consult your doctor for prompt treatment.

Medical Disorders

Apart from infections, some health conditions cause male infertility. For example, swelling in the veins located in the testis. These are known as "varicoceles." These swollen veins alter the blood supply to your testes. Consequently, impaired blood flow affects sperm production and the quality transported in the tubules. In addition, some immunological disorders and tumors may damage the regulatory hormone-producing glands. Examples are tumors in the testis and pituitary glands.

Medications

Some medications, such as chemotherapy drugs or steroids, affect sperm formation and increase male infertility risk. Discuss therapeutic options with your doctor if your medications adversely affect your fertility.

Exposure to Environmental Toxins

Persistent exposure to Industrial chemicals and radiation disrupts sperm formation in the testis. This results in a reduction in sperm count if unchecked. Periodic health screening in a fertility clinic is beneficial if your profession exposes you to heavy metals and radiation.

Unhealthy Lifestyle and Habits

Self-care is critical to your reproductive health. Stay active, eat healthily and avoid unhealthy habits such as alcohol and tobacco intake. We also recommend that you not smoke or use marijuana frequently if you are attempting pregnancy with your partner. Neglecting these self-care practices raises your risk of male infertility. An unhealthy lifestyle may affect the formation and quality of sperm produced.

Symptoms of Male Infertility

Although the male infertility symptoms vary depending on the cause. Much of the time, there are no symptoms that you would be able to notice. However, here are some signs you may notice:

• Sexual dysfunction such as difficulty obtaining or maintaining an erection.
• Reduced fluid volume ejaculated.
• Pain or swelling in your testis.
• Abnormal breast growth.
• Decreased facial or body hair.

If you notice any of the symptoms above, consult your doctor for further clinical evaluation.

Diagnosis of Male Infertility

Your doctor typically starts with a thorough clinical history and physical examination before conducting further investigations for diagnosis. During the clinical history, your doctor will take an exhaustive history to understand your unique health needs. Your doctor will ask questions related to your family history, sexual history, social history, and medical history to identify possible risk factors. During the physical examination, your doctor inspects your body for visible signs of defects or features that suggest hormonal imbalance. Also, your doctor may examine your genital for any abnormalities.

Tests You Can Expect for Male Infertility

Semen analysis is the major test for diagnosing male infertility. For your doctor to get the best results, here are some tips:

• Observe between two and five days of sexual abstinence.
• Submit semen samples within 30 minutes of collecting the semen.

Sometimes, your physician or laboratory may request you submit two semen samples at an interval of no sooner than one month. Your semen is analyzed for the following:

• volume
• pH
• presence of white blood cells.
• "Sperm count" or concentration
• Sperm motility
• Sperm morphology (shape)

In addition to semen analysis, the clinical findings from history taking and physical examination guide your doctor on the type of investigations to conduct. For example, suppose there is a history of multiple sexual partners with signs of a sexually transmitted infection (S.T.I.). In that case, your doctor may request blood and urine tests for S.T.I diagnosis.If your semen analysis results are significantly abnormal, or if your medical history indicates that you need more intensive assessment, you may be referred to a male infertility urology specialist.Other possible investigations are:

• Scrotal ultrasound scan
• Testicular biopsy
• Hormonal profile.

Your Options for Male Fertility Treatments

The specific treatment for male infertility depends on the underlying cause. If you have an unhealthy lifestyle, your doctor may recommend adjustments such as weight loss, physical activity, stoppage of alcohol and tobacco smoking, and intake of supplements. Here are some male fertility treatments that could put you on the path to parenthood.

Hormonal Therapy

This is the therapeutic option for males with hormonal causes of infertility. Your doctor may prescribe these medications to normalize the blood concentration of hormones that affect sperm production. Examples of these medications are aromatase inhibitors or Clomid.

Surgical Intervention

There are various types of surgical interventions. For instance, males with varicocele (distended veins in the testis) may benefit from a surgical repair. Also, individuals with obstruction along the transport tubules in the male reproductive tract are sometimes candidates for surgical correction.

Antimicrobial Therapy

These are medications for treating infections caused by microbes. Males with underlying sexually transmitted infections will benefit from antimicrobial therapy.

Intracytoplasmic Sperm Injection (ICSI)

This is a procedure in which sperm cells are injected into the egg for fertilization outside the body. This occurs in conjunction with an IVF (in vitro fertilization) treatment with your partner. The American Society for Reproductive Medicine recommends intracytoplasmic sperm injection for couples with male factor infertility. Intracytoplasmic sperm injection is safe and effective and can often overcome even the most significant male factor.

Assisted Reproduction Technology

The American Center for Disease Control (C.D.C.) defines assisted reproduction technology as fertility-based treatments in which the eggs or embryos are manipulated to aid conception. This is what is commonly known as IVF. Here are the stages of an assisted reproduction technology procedure:

• Stimulation: This involves using medications to boost egg production in the female.
• Egg retrieval: Here, the fertility doctor conducts a minimally invasive procedure to retrieve eggs in the female.
• Insemination and fertilization: This step involves placing sperm cells and selected eggs under favorable conditions for fertilization.
• Embryo culture: After successful fertilization, the fertilized egg undergoes cellular divisions in a regulated environment to become an embryo from the 5th day.
• Embryo transfer: The doctor retrieves the embryo and transfers it into the uterus for implantation.

Do You Need Help Starting a Family?

Male infertility occurs due to various factors such as genetic or acquired causes such as untreated sexually transmitted diseases, physical trauma, or the use of some medications. If you notice symptoms such as erectile dysfunction, painful swelling in your testis, or abnormal breast growth, see your doctor.As part of men's health awareness, regular clinical screening and checks will aid the early diagnosis of medical conditions that may cause infertility.Your doctor will typically diagnose male infertility after conducting a clinical history, examination, and semen analysis. A fertility expert decides the most effective therapeutic option based on clinical findings and test results.

At Advanced Fertility Care, we want to help you start a family. Our fertility experts use evidence-based best practices combined with innovative technology, which increases your chances of conceiving and fulfilling your dreams of being a parent. To join other happy parents who have used our services, take one step today by contacting us.

Whether you are trying to conceive (TTC) or pursuing in-vitro fertilization (IVF), infertility can become a serious strain on your mental health and emotional well-being. In this article, we look at the reality of the strain of infertility and ways to cope during this time.  

Infertility: A Common Challenge

If you are having difficulty conceiving, you are far from alone. With over 6 million pregnancy-challenged couples in the U.S., this is a well-traveled -- if sometimes bumpy -- road.

Fortunately, medical advancements and practices have made it possible for many people to overcome infertility and achieve the family of their dreams. Assisted reproductive technology has moved light-years forward in the past few decades, delivering the miracle of life to over 10 million babies. Also, mainstream awareness of infertility as a commonmedical challenge has improved dramatically.Despite these progressions, one study suggests that the psychological impact of an infertility diagnosis is comparable to a diagnosis of cancer. It is typical – and perfectly normal -- for anyone to have a difficult emotional reaction to infertility.

The Challenge of Waiting and Uncertainty

Battling infertility can bring physical challenges, such as pregnancy losses, failed cycles, medications, and medical procedures. There may be a gauntlet of tests, calendars, doctors, and pills.Yet most people feel that it is really the uncertainty of infertility that presents the greatest challenge. Infertility can involve long periods of waiting combined with the ultimate fear of not being able to build your family or provide for your partner. You may have to sit with this discomfort for long and indefinite periods of time. It is common for those struggling with infertility to grapple with depression and anxiety.

Mental Health and Infertility

Infertility and Depression

One U.K. study found that 90% of people facing infertility reported experiencing depression.You may be experiencing  clinical depression (also known as major depression) if you exhibit at least five of the following symptoms for more than two weeks:1. Depressed mood2. Loss of interest/pleasure in everyday things3. Weight loss or gain4. Insomnia or hypersomnia5. Psychomotor agitation or retardation6. Fatigue7. Feeling worthless or excessive/inappropriate guilt8. Decreased concentration9. Thoughts of death/suicideDepression can be a painful condition in which your perception changes. You may begin to feel helpless and have a harder time seeing the possibility of ever conceiving. Infertility may seem like a life sentence rather than a temporary challenge.Depression also leads to changes in behavior. These can negatively impact your self-care, relationships, work, outlets, and other areas of life.

When to Contact Your Doctor

The onset of depression is not a medical emergency. In the U.S., over 10% of the population will experience major depression in a given year. 1 out of 6 Americans will experience depression at some time in their life. Depression brought about by life circumstances (like infertility) tends to resolve itself with time.If you have experienced five of the DSM-V symptoms listed above, you should mention this to your doctor. They can walk you through your options to find support and help monitor any worsening of your condition.If you are thinking about hurting yourself or suicide, you can call the National Suicide Prevention Lifeline to speak to someone who can help.

Infertility and Anxiety

Anxiety is another common source of discomfort when trying to conceive. Anxiety and depression occur together so commonly that clinicians call them “two sides of the same coin.”A common complaint among those struggling to grow their family is that their thoughts become dominated by infertility to the point of becoming overwhelming. This type of fixation and these intrusive, troubling thoughts can cause both depression and anxiety.

The Problem of Stigma

Infertility is not limited to women: male factor infertility accounts for about one-third of infertility cases. This is most often due to low sperm count.   Regardless of gender, everyone faces the challenge of stigma – both perceived and actual – because of fertility issues.Perceived stigma may be internalized from a young age. For women, entrenched, historically-based stereotypes suggest that they are primarily valued for their child-rearing ability. There may also be a complex about sexual inadequacy.Actual stigma only exacerbates these existing insecurities. A loved one that always asks, “When are you having children?” can make a family holiday a source of dread and fear.Stigma can lead to low self-esteem, guilt and shame. Even though both are patently untrue, those struggling with infertility may begin to think that there is something “wrong” with them or it is “their fault.”Another pervasive effect of stigma is for people to self-isolate and suffer insilence. Many fear being judged, invalidated, or embarrassed and are less likely to share what they are going through.

Does Depression Reduce Fertility?

The short answer is “no.”  While individuals may experience depression in relation to their infertility, several studies have concluded that depression and anxiety do not significantly impact the success of assisted reproduction.However, depression can have secondary effects on one’s behavior that could influence pregnancy attempts. Feeling helpless or shameful can discourage someone – perhaps even subconsciously- from pursuing all available fertility options. For those TTC, the tendency to isolate may reduce physical intimacy.Depression and anxiety can also bring about lifestyle changes, like overeating, missed sleep, or difficulty in being productive or active. These can all contribute to a cumulative deterioration of health and overall well-being. If you are not feeling physically healthy, it may be harder to find the courage and resilience to help you get through the trials of assisted reproduction.

Side Effects of Fertility Medications

Though far less serious than the aforementioned concerns, you may also experience some side effects if you are taking fertility medication. The most common are:·   breast tenderness·   hot flashes·   headache·   upset stomach·   bloating·   mood swingsFertility drugs may also involve health risks, most notably:·   Multiple pregnancies·   Ovarian hyperstimulation syndrome (OHSS)These effects will vary significantly by the drug taken, the dosage, and the individual. Your doctor can walk you through medication considerations.All of these potential side effects and health risks are not welcome news to anyone already managing anxiety and other infertility-related health concerns. However, these medications are all FDA-approved and have a proven track record of successfully helping achieve pregnancy. The benefits are considered to outweigh far the potential side effects and risks of these medications.On the other hand, fertility medications may offer a subtle boost to your mental well-being: they can provide peace of mind that you are doing everything possible to achieve conception.

Finding Infertility Support

Research has shown that participation in counseling that teaches coping tools for managing infertility-related stress is associated with significantly reduced emotional distress and even increased pregnancy rates in response to fertility treatment.  

Finding Personal Support

Professional one-on-one counseling can help you become more aware of your mental state and develop strategies for dealing with difficult emotions. A counselor with experience and specialized training in helping with fertility challenges is the ideal type of therapist to help, though many different types of therapeutic professionals can help. These include psychiatrists, psychologists, social workers, nurses, and life coaches. One-on-one therapists are particularly useful when you feel withdrawn or are having trouble communicating what you are feeling.

Group Support

Connecting with others is the best way to beat the stigma, secrecy, and isolation that so often make infertility painful.Research has consistently shown that group therapy – sharing your experience in a safe, non-judgmental forum – is one of the most effective forms of therapy available. Some groups may be led by professionals, while others are organized by members. In a cohort of people with the same fertility struggles, participants are typically eager to share their experiences and pool together information, including how they have coped with various infertility-related challenges. Within these support groups, powerful, lasting relationships are often formed.

Partner Support

If you are in a relationship with a significant other,  support from your partner is critical throughout this process. Depression and infertility-related stress can result in distancing and reduced communication. Couples therapy is a healthy way to improve communication in a constructive, mediated space.Some are surprised to find that their partner may be feeling helpless, worried, or upset – yet doesn’t feel like they should keep this to themselves so they can be “strong” for you. Even more of a surprise may be that your partner wants to better support you -- but doesn’t always know how. Therapists can help identify the best ways for partners to support one another.When someone we care about is experiencing difficult emotions, our first instinct may be to try to “fix” the situation. But often, what most people need most in these times is empathy - to be heard, without judgment, by someone who cares.A therapist can help you practice empathic listening. This can help partners validate one another’s feelings without trying to change them. Simply listening to your partner can be the best medicine of all.

Web Resources

A good starting point to learn more about support options is this fact sheet from the American Society for Reproductive Medicine.The National Infertility Association offers a wealth of coping techniques and practical tips, such as scripts that can help you prepare for – and no longer fear – conversations with family members about future children.

Especially when a person or couple is trying to conceive, efforts to be as healthy and fertile as possible are often made into consistent habits. Things like eating healthy, making sure exercise is a priority, and staying away from alcohol and smoking are often lifestyle changes and precautions that are taken early on, to help maintain optimal health throughout the pregnancy process.

However, as around 13% of couples find out, conceiving a baby can often be much more difficult than previously thought. For some of these individuals and couples facing fertility challenges, this could be due to issues (or previous issues) with sexually transmitted diseases. For many, these are often unknown to the individuals and, unbeknownst to them, can carry consequences far after an STD was passed on to them. 

So, what are some things that you need to know about sexually transmitted pillole ritardanti infections and you (or your partner’s) fertility? 

There are not always symptoms:

Especially when it comes to STDs like chlamydia and gonorrhea, symptoms are not always obvious or present at all. In fact, these particular STDs are two of the leading causes of infertility in the United States, often because the diseases went undetected. In cases like these, the disease can spread to the uterus and fallopian tubes, causing other issues like Pelvic Inflammatory Disease, and making it difficult to get pregnant in the long run.

While both of these are easily treatable with antibiotics, it’s when they’re left untreated or undetected that the majority of problems come into play, and can lead to infertility.

When symptoms are present, they’re important to recognize:

In general, it’s important to monitor your sexual health so that you’re in-the-know when it comes to your own body. With this in mind, it’s just as imperative to get the opinion of a doctor if you feel something could be amiss. If you’re sexually active and have any of the following symptoms, it’s probably time to get checked out by a physician:  

1. Sores or bumps on genitals or rectal area
2. Pain during sex
3. Unusual discharge from the penis or vagina
4. Pain in the lower abdomen
5. Unusual vaginal bleeding 
6. Painful urination
7. Rash on the hands, feet or trunk

At the end of the day, remember— It’s better to be safe than sorry.

STDs are Preventable:

Although fertility can certainly be affected by sexually transmitted diseases, the good news is, they’re definitely preventable. Although the only way to be 100% sure is the abstain from sex in the first place, there are a number of precautions that you can take, before you’re looking to conceive a child, in an effort to maintain your sexual health. These can include: 

1. Condoms
2. Frequent testing
3. Getting vaccinated for eligible diseases (such as HPV) 

Ensuring you wash thoroughly before and after intercourse.

STD infertility can affect men, as well as women:

Although when the subject of infertility is brought up, it’s often women’s issues that come to mind, conception issues caused by STDs can affect men directly as well. In fact, when it comes to chlamydia and gonorrhea, for example, men can suffer repricutious similar to women. In males, these diseases can even result in something called epididymitis, or a painful swelling and inflammation of the tubes attached to the testicles. When untreated, this can lead to sexual health issues, as well as infertility in extreme cases.

Testing is Imperative:

Even if you’re not actively trying to conceive a child, chances are, you may at least want the option in the future. This makes it absolutely essential that, if you’re sexually active, you get tested often and regularly. Not only can this help to catch diseases before they become more serious, but it can also help you to identify any issues that may not be producing any symptoms. This can help to protect your fertility in the long run, as well as prevent you from spreading an STD that you may not know you have.

Staying in close communication with your doctor is essential:

According to the CDC, there are about 20 million new STD infections every year. Especially if you do get diagnosed with an STD at some point, it’s important to maintain clear and open communication with your doctor. When it comes to fertility, you’ll want to ensure that you know any and all repercussions, risks, and options that you have for the future. 

Conceiving a child, especially when fertility is proving itself to be an issue, can drum up a number of emotions. However, what’s important is to stay educated on the things that could potentially affect your fertility, know signs and symptoms to look out for, and stay in close communication with your doctor. Not only can this help you to get past any obstacles you may be facing, but it can also help you to make the right decisions for you and/or your partner moving forward.