What Causes Infertility?

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Dr. Jaime Knopman, Reproductive Endocrinologist at CCRM New York

Dr. Jaime M. Knopman is a board-certified Reproductive Endocrinologist with years of experience treating couples and individuals with infertility. She serves as the Director of Fertility Preservation for CCRM New York. During her fellowship training, Dr. Knopman pursued several areas of research, including fertility preservation for medical and elective indications. She’s written several papers devoted to the topic of fertility preservation, specifically egg freezing for cancer patients.

She is also the Medical Director of Chick Mission, a non-profit organization dedicated to the critical issues unique to young adult cancer patients with a focus on fertility challenges as a result of chemotherapy, surgery, radiation and/or drug treatment.

Dr. Knopman understands that entering the world of fertility treatment can sometimes be confusing and frightening. To help address these concerns, she Co-Founded Truly, MD, a website designed to help patients navigate the complexities of fertility treatment and reproductive health. We are so appreciative of the work Dr. Knopman is doing to destigmatize fertility and women’s health issues. Her mission closely aligns with our Beyond Mother’s Day.  and as part of the campaign, she answered our question What Causes Infertility? Read her answer below!

Finding out that you have infertility is no piece of cake. It can rock you in a way like nothing else has. Why me? What did I do? How did this happen? The questions are endless. And while your fertility doctor may not be able to give you individual answers (at least not until we meet you!), we can tell you what is most likely (in percentages and rates) to be hampering your efforts.

Infertility and its various causes (ex. low ovarian reserve, ovulatory dysfunction, tubal damage, uterine issues, sperm abnormalities) are often depicted in medical literature and medical textbooks as a pie chart. And a pie chart, for all of you who have been away from math and statistics for some time, is a circular statistical graph that is divided into slices—each slice represents a different piece of the overall pie (aka the problem you are analyzing). Therefore, the bigger the piece, the bigger its contribution to the issue at hand.

Whether you prefer apple or blueberry, close your eyes and picture a pie. Now substitute infertility for whatever fruit you are envisioning and let’s cut it up.

~35% of infertility is “female” related

~ 25% of infertility is “male” related

~ 10% of infertility is unexplained

~30% of infertility is due to both female and male pathologies (aka combined)

 

Keep in mind that percentages are like pieces of pie; cutting is not an exact science. Depending on the study or the reporting agency, numbers can be slightly higher or lower.

Now it’s pretty rare that you go to a party and there is only one dessert (or pie) option. Same goes for infertility pie graphs—there is usually one that represents the percentages for all causes of infertility, one that represents the percentages for all FEMALE causes of infertility, and one that represents the percentages for all MALE causes of infertility. Take a bite out of these numbers.

 

For causes of female infertility the numbers are as follows:

~ 40% of female infertility is due to ovulatory disorder (includes ovulatory dysfunction AND diminished ovarian reserve/failure)

~ 30% of female infertility is due to tubal/peritoneal disease

~ 15% of female infertility is due to endometriosis

~ 10% of female infertility is unexplained

~ 5% of female infertility is due to uterine disease/cervical disease

 

For causes of male infertility the numbers are as follows:

~ 35% of male infertility is unexplained

~ 15% of male infertility is due to varicocele(s)

~ 10% of male infertility is due to hypogonadism (low testosterone)

~ 10% of male infertility is due to urogenital infection

~ 8% of male infertility is due to an undescended testes

~ 5% of male infertility is due to sexual dysfunction

~ 15% of male infertility is due to other causes (immune dysfunction, systemic disease, etc.)

 

And while you may be able to guess what slice of the infertility pie is yours, a visit to a fertility specialist will solidify the diagnosis. With this information, an appropriate treatment “recipe” can be created. I recommend finding a clinic, like CCRM, that will develop a personalized treatment plan that will help ensure you achieve success, because no matter the slice of pie you’ve been served, people who want to have a baby should be given the very best chance to do so.

Dr. Jaime M. Knopman