Causes of Infertility
Health Issues (weight loss, cancer, genetic disorders)
Weight issues can contribute to difficulty getting pregnant. Both underweight and overweight couples may be affected by their weight.BMI is a measure of body fat based on height and weight. Normal BMI is between 19-24, less than 19 is considered underweight and over 30 is considered obese. Most women who struggle with their weight will have no problem getting pregnant, but some will have trouble conceiving, often due to ovulation problems. Underweight patients, indicated by a BMI of 18.5 or less, may have irregular menstrual cycles which may cause ovulation to stop. Issues related to obesity may affect ovulation and your chances of becoming pregnant. Disorders such as thyroid disease, diabetes and insulin resistance may also affect your ability to conceive. It is important to talk with your physician about any of these concerns before beginning your pregnancy journey. Additional issues with obesity include lower rates of success with IVF, increased miscarriage rates, higher risk of developing pregnancy induced (gestational) diabetes and pre-eclampsia, identified by high blood pressure. There is in increased rate of delivery by cesarean section for obese women and children may have higher birth weights and have a higher chance of birth defects. Overweight and obese men can be affected by lower sperm counts and less motility than average weight men. Both men and women that are overweight should consult their physician for recommendations before considering if you should lose weight prior to becoming pregnant. Our reproductive endocrinology experts will consider all factors, including your age, infertility factors and health before recommending you lose weight.
Cancer treatments can have harmful effects that can lead to infertility. Over 800,000 men and women in the US, of child-bearing age, have been diagnosed with cancer. There are options for both men and women to preserve fertility prior to undergoing treatment for cancer. Cryopreservation or freezing of eggs, embryos, or sperm can help you to have children after your cancer treatment. Learn more about your options here:
Recurrent Pregnancy Loss
Recurrent pregnancy loss (RPL) is a term used when women have two or more miscarriages. It is extremely emotional when couples experience this loss, but many times they will go on to have a normal healthy pregnancy, even without treatment. In some instances we are able to recommend procedures to help reduce the risk of miscarriage.
There are many potential causes of recurrent pregnancy loss. Anatomic abnormalities such as an incompletely developed uterus, and fibroid tumors can cause RPL. Some extreme endocrinologic problems such as uncontrolled diabetes or thyroid problems, irregular menses can also be a cause of RPL. Some clotting disorders as well as some infections also have been associated with RPL.
In about 5% of patients with RPL there is a genetic translocation or rearrangement of the chromosomes in one of the partners. When there is a chromosome imbalance in the fetus, there is a higher chance of miscarriage. A blood test can determine if there is a translocation in the parent and if present, genetic counseling may be recommended to determine the best course of action. Many couples eventually achieve a healthy pregnancy naturally, but IVF may be considered. Once the egg is fertilized in the laboratory, but before implantation in the uterus, the embryo can be tested using Pre-Implantation Genetic Testing (PGT). Embryos without translocation can be selected for an increased chance of a healthy pregnancy.
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