Fertility Issues

Grief is a natural and common reaction to all kinds of loss; this includes the loss of or the threat of losing the chance to have children when diagnosed with infertility. Grief involves several emotional reactions to loss such as negative thoughts, a change in behaviors (e.g., difficulty sleeping), conflicting feelings, and challenging interpersonal experiences such as difficulty attending baby showers or other child-focused activities.

Grief related to infertility affects many areas of a person’s life. Infertility-related grief can include sadness, anger, anxiety, shock, feeling invisible, feeling like no one understands your experience, emotional numbness, loneliness, and/or difficulty engaging in daily life.ⁱ Fertility issues can also impact self-esteem.^ii,iii Although infertility-related grief can sometimes be long-lasting, feelings of grief generally decrease over time.

Infertility is recognized as a medical condition by the World Health Organization (WHO), as well as many other professional societies including the American Medical Association (AMA), the American Society for Reproductive Medicine (ASRM), and the European Society of Human Reproduction and Embryology (ESHRE).^i,ii,iii,iv

Estimates of infertility frequency vary worldwide and even differ depending on the way data is collected. Prevalence is the term used to describe how common a medical condition is in a particular population. According to the U.S. National Survey of Family Growth, the prevalence of infertility in married heterosexual women aged 15 to 49 is approximately 19.4 percent.^v Estimates in the U.K. for a similar population were 12.5 percent.^vi Some studies indicate that the prevalence of male infertility is 10 to 15 percent, but these estimates may not be accurate due to the lack of quality evidence.^vii

Klinefelter syndrome (KS) is a genetic condition in which a male is born with an extra X chromosome. This condition often impacts fertility (potentially in addition to other aspects of health and development), though it does not necessarily mean a person cannot have biological children. By understanding the symptoms, causes, risks, and treatments, individuals with Klinefelter syndrome can better navigate treatment options.

Hypothyroidism can play a role in fertility problems. That means females going through in vitro fertilization (IVF) should be aware of the symptoms of hypothyroidism and possible treatments.

Egg donation is a process by which a fertile female donates her eggs (oocytes) to another individual or couple who want to conceive a baby. There are several steps involved in the decision to use donor eggs, and many more things to consider once the choice has been made. For anyone thinking about using donor eggs, it is important to understand the details around how egg donation works and how to find an egg donor. Being aware of egg donation success rates is also key.

Sperm retrieval procedures are used to remove sperm from the testicles for the purpose of fertilizing an oocyte (egg). They may be used for males who have zero sperm count in their ejaculate (azoospermia) but still produce sperm in the testes.

There are two main techniques for surgical sperm retrieval: aspiration and extraction. Sperm aspiration involves using a needle to aspirate (remove) sperm from the epididymis or the testes. Testicular sperm extraction takes a sample of the tissue, known as a biopsy, to collect the sperm. There are also different variations or subtypes of these procedures, as well as non-surgical approaches for individuals with ejaculation limitations.

Though a vasectomy used to be considered a permanent sterilization procedure, modern developments have made reversal possible. This article will explain various vasectomy reversal procedures and the likelihood of success in restoring fertility. It will also review alternative fertility options.

Embryo implantation is a complex process and a significant step toward achieving a viable pregnancy. Implantation is aided by good-quality embryos (both genetically and structurally normal), a receptive endometrium, and complex communication between the embryo and the uterine lining.ⁱ

The term “implantation failure” describes the lack of a positive pregnancy test — and therefore lack of increased human chorionic gonadotropin (hCG) levels, or the lack of an intrauterine pregnancy seen on ultrasound following in vitro fertilization embryo transfer.ⁱⁱ When implantation failure happens multiple times, it is known as recurrent implantation failure (RIF) or repeated implantation failure. The terms can be used interchangeably.

Turner Syndrome (TS), also known as monosomy X, is a chromosome abnormality that occurs randomly during fertilization and affects only females. It is a genetic condition that, if present in a fetus, causes significantly increased risk for miscarriage and prenatal complications such as heart defects.

After birth, individuals with Turner syndrome have an increased risk for growth issues, learning disabilities, and infertility as adults. Fortunately, with proper early intervention and counseling on reproductive options and risks, females with Turner syndrome may go on to have successful pregnancies.

Pregnancy loss can be devastating under any circumstances, but recurrent pregnancy loss (RPL) — defined as two or more miscarriages — can be particularly difficult. Overall, the risk of pregnancy loss is approximately 25 percent, meaning one in four clinically recognized pregnancies end in loss. The risk of two or three pregnancy losses in a row is about 2.25 percent and 1 percent, respectively. After three consecutive pregnancy losses, the risk of another pregnancy loss rises to around 40 percent.ⁱ

To understand recurrent pregnancy loss, it is important to know the potential causes of recurrent pregnancy loss and what tests and treatments are available to help individuals and couples experiencing the devastating impact of recurrent miscarriage.

In recent years, red light therapy, also known as phototherapy or light-emitting diode (LED) light therapy, has gained attention as a potential tool to enhance fertility in both males and females. This article will explore red light therapy and its impact on reproductive health, including who can benefit from it, the safety of red light therapy, and how it may potentially improve factors such as blood flow and cellular energy.

Polycystic ovary syndrome, or PCOS, is a condition that is often associated with having a negative impact on a female’s ability to conceive. It is characterized by a range of symptoms, from unwanted hair growth to irregular menstrual cycles, and can be difficult to diagnose and treat.

A miscarriage is defined as the loss of a clinically confirmed pregnancy. For individuals hoping to conceive, it is important to have accurate information regarding pregnancy loss including prevalence, common causes, warning signs, and management options. It can also be highly beneficial to understand what to expect after miscarriage and what physical and emotional factors should be considered before trying to conceive again.

Menopause is a natural process all females will eventually go through as they reach middle age. During menopause, the ovaries stop releasing eggs, menstrual periods become less frequent and eventually cease, and hormones such as estrogen and progesterone decrease. While menopause marks the end of fertility, there is still a chance to get pregnant during menopause — either naturally or through fertility treatments.

Individuals who are transgender or transitioning face unique issues regarding fertility, family building, and fertility preservation. Still, transgender parenthood is fairly common. Of the respondents to the U.S. Transgender Population Health Survey, 19 percent of trans individuals were parents.ⁱ Below, learn about options for creating a family as a transgender person, fertility considerations for individuals undergoing gender transition, as well as pregnancy, the delivery process, and aspects of postpartum life for trans individuals.

Note: Some transgender individuals prefer to be identified only as men/male or women/female, dropping the term transgender. Others prefer the terms trans man or trans woman. This article will use trans or transgender terminology for clarity, while recognizing the differences in preferred language.

Endometrial receptivity analysis (ERA, previously known as endometrial receptivity array) is a diagnostic tool intended to determine how “receptive” the maternal uterine lining (also called the endometrium) is to implantation of a transferred embryo.^i,ii ERA specifically evaluates the expression of genes involved in endometrial receptivity during a period of time called the window of implantation (WOI). The results are then used to determine whether a patient should have a frozen embryo transfer with standard timing, or if the timing needs to be adjusted to account for an atypical, or “displaced,” window of implantation — a process known as personalized embryo transfer (pET).

Diminished ovarian reserve (DOR) is a condition in which the quantity of oocytes left in a female’s ovaries is low, as determined by ovarian reserve testing. This low number might result in infertility for some individuals. In addition, females with DOR going through fertility treatments are at risk of having a poor response to fertility drugs.

DHEA, or dehydroepiandrosterone, is a chemical naturally occurring in the body that is frequently suggested as a supplement for female fertility patients. DHEA is important for producing androgen hormones, specifically testosteroneDHEA, or dehydroepiandrosterone, is a chemical that naturally occurs in the body. It is important for producing androgen hormones, specifically testosterone, which is critical for female fertility. There is evidence supporting DHEA supplementation for female fertility patients because it may improve egg quality and/or production due to its roles in follicular development., which is critical for female fertility. There is evidence supporting DHEA supplementation may improve egg quality and/or production due to its role in follicular development.

A dilation and curettage (D&C) is a surgical procedure that removes tissue from the uterus. While it is used for a variety of reasons including diagnostic purposes, it is typically performed following a miscarriage, or for elective termination of a pregnancy. An understanding of what to expect before, during, and after a D&C is beneficial for navigating this procedure, as well as to learn about potential risks and alternative treatments.

Sexually transmitted infections (STIs) can potentially damage reproductive organs and lead to infertility. It is crucial for sexually active individuals, regardless of age, gender, or sexual orientation, to undergo regular STI testing to take charge of their sexual health. Early diagnosis and management of STIs are essential for avoiding long-term harm to reproductive organs and for maintaining fertility. Read on to discover what STIs are, how they may impact fertility, and options for their prevention and treatment.

Asherman’s syndrome is a rare condition in which scar tissue is present in the uterine cavity. It is not a genetic condition; therefore, it can affect any female. In most cases, it develops in individuals who have undergone uterine surgeries. If someone has received an Asherman’s syndrome diagnosis and is concerned about its impact on their fertility, it is beneficial to understand the symptoms, causes, and range of potential reproductive outcomes.

Acupuncture is a type of complementary medicine involving the insertion of small needles into specific acupuncture points in the body. It is believed to work by stimulating the nervous system, which can then affect muscles and glands. Fertility acupuncture gained popularity in North American around 2009. Since then, it has been estimated that over 30 percent of females undergoing fertility treatment will access an alternative medical approach such as acupuncture during their treatment.ⁱ

Research of varying quality has been conducted to assess the role of acupuncture in both male and female fertility. Its effectiveness in helping improve fertility, especially with respect to IVF success rates, remains unclear.

Social media has transformed how many people access information about everything from current events to health conditions. This can be a positive thing, such as allowing users to share their experiences and connect with others, and it can remove barriers to accessing information.ⁱ However, social media platforms have also become a haven for the spread of misinformation, whether intentionally or unintentionally spread. This in turn can have profoundly negative consequences for people seeking advice or information.ⁱⁱ Misleading or inaccurate information may lead people to waste time and money when undergoing fertility treatment and consulting evidence-based sources that can be trusted is important.