Understanding Infertility

Age and Infertility Explained

Age is your biggest barrier to success with fertility treatments. If you’re under 35 years old and trying to get pregnant for twelve months or more without success, you should schedule an appointment with a reproductive endocrinologist to talk about your fertility. If you’re over 35 years old, and trying without success for six months or more, it’s time to talk with a specialist, now.

Unfortunately, women are born with all the eggs or oocytes they’ll ever have in their lifetime. By the time a woman reaches her early 30’s her quantity of eggs has dropped from over 1-million to 100,000 or less. Age also impacts quality of eggs: by the time a woman is in her late thirties, over 40% of her embryos will be low-quality due to genetic imbalances or other issues related to maternal age. For men, the issues of sperm quantity and quality are also impacted by age and decline with advanced age.

What is Premature Ovarian Failure?

Premature Ovarian Failure (POF) can be plainly described as early menopause. Usually happening in women in their mid-to-late 40’s, POF is a condition in which menopause occurs before the age of 40 and where women have little to no eggs. Like a lot about infertility, POF is still not well understood. However, genetics and hereditary factors, autoimmune diseases like rheumatoid arthritis can be linked, and medical treatments like chemotherapy can be linked to POF.

What is Recurrent Miscarriage?

Often patients who can get pregnant but can’t stay pregnant don’t think of themselves as infertility patents. But they should. The tools and resources to overcome pregnancy loss and miscarriage have advanced dramatically in just the last several years giving us all reason for hope at STL Fertility.

According to the American College of Obstetricians and Gynecologists (ACOG), miscarriage is defined as three or more consecutive, spontaneous pregnancy losses. Approximately 20% of pregnancies end in miscarriage (loss before 20 weeks). Most miscarriages occur within the first several weeks of gestation. While there are many factors behind multiple miscarriages including uterine malformations, one of the biggest drivers are genetic abnormalities like chromosomal imbalances.

New genetic tests like PGT-A, or preimplantation genetic testing for aneuploidy, can be performed at the embryonic level during IVF cycle to gain information about embryos’ genetic health and improve the chance of a healthy pregnancy and delivery.

What is Polycystic Ovary Syndrome?

Polycystic Ovary Syndrome (PCOS) is very common in women and caused by hormonal imbalances – typically too much androgen which inhibits normal ovulation. Patients with PCOS often have low levels of FSH or follicle stimulating hormone and too much LH or luteinizing hormone.

FSH is one of the most important hormones responsible for stimulating follicular or egg growth in the ovaries. Too little FSH and the immature follicles in your ovaries develop into small cysts – or what can be seen on an ultrasound image commonly known as a “string of pearls.”

Too much FSH generates too much estrogen and androgens (male hormones) also impairing proper fertility. Endometrial tissue is also affected by high androgen levels causing it to get thick, lead often irregular periods. Acne and/or hair on your face, or hair loss are symptoms of PCOS.

What about Infertility & Men?

Like women, the factors behind male infertility are based on largely on issues of quality and quantity. Unlike women however, the vast majority of issues are related to one thing: sperm. Azoospermia or lack of sperm, poor morphology (shape and size), varicocele which is an enlargement of veins in the testicles), and the presence or prevalence of anti-sperm antibodies, cover most of the reasons for infertility in men.

During a routine infertility work-up and examination, male partners will be asked to provide a semen sample or semen analysis (SA) to look at sperm count, motility, and morphology. At STL Fertility, we can perform a semen analysis on site or happy to receive results from a referring Urologist.

Infertility Testing and Work-Up

At STL Fertility, we look at everything because everything matters when you’re dealing with infertility.

Maybe your OB/GYN did some testing a year ago and said keep trying on your own. Or maybe it’s been 6-12 months without success and time to get a formal fertility work-up with a reproductive endocrinologist.

On your first consult at STL Fertility we’ll review your health history information, we’ll do bloodwork and physical examination to get as many of the answers we need as quickly as possible. We’ll check FSH and AMH levels and all the other acronyms of infertility.

We’re looking for clues in hormonal imbalances, genetic information, or infectious disease history – all of which can impact getting and staying pregnant. An infertility work-up can usually be completed within 30-days of your first consultation, so you won’t have to wait too long to get started with your first treatment cycle.

Infertility Hormones 101

Hormones are the “software” or the “code” often impacting your fertility. Understanding which ones do what and when they’re activated is critical to overcoming infertility.