What is Infertility?

Infertility is a disease of the reproductive system that prevents the conception of children. Conception is a process that depends on many factors: The production of healthy sperm by the man and healthy eggs by the woman; unblocked fallopian tubes that allow the sperm to reach the egg; the sperm's ability to fertilize the egg when they meet; the ability of the fertilized egg (embryo) to become implanted in the woman's uterus; and sufficient embryo quality.

Finally, for the pregnancy to continue to full term, the embryo must be healthy and the woman's hormonal environment adequate for its development. When just one of these factors is impaired, infertility can result.

What Causes Infertility?

Nobody can be blamed for infertility, any more than someone is to blame for diabetes or leukemia. In rough terms, about one-third of infertility cases can be attributed to male factors, and about one-third to factors that affect women. For the remaining one-third of infertile couples, infertility is caused by a combination of problems in both partners or, in about 20 percent of cases, is unexplained.

The most common male infertility factors include azoospermia (no sperm cells are produced) and oligospermia (few sperm cells are produced). Sometimes, sperm cells are malformed or they die before they can reach the egg. In rare cases, infertility in men is caused by a genetic disease such as cystic fibrosis or a chromosomal abnormality.

The most common female infertility factor is an ovulation disorder. Other causes of female infertility include blocked fallopian tubes, which can occur when a woman has had pelvic inflammatory disease or endometriosis (a condition causing adhesions and cysts which is sometimes painful). Congenital anomalies (birth defects) involving the structure of the uterus and uterine fibroids are associated with repeated miscarriages.

How is Infertility Diagnosed?

Couples are generally advised to seek medical help if they are unable to achieve pregnancy after a year of unprotected intercourse. The doctor will conduct a physical examination of both partners to determine their general state of health and to evaluate physical disorders that may be causing infertility. Usually both partners are interviewed about their sexual habits in order to determine whether intercourse is taking place properly for conception.

If no cause can be determined at this point, more specific tests may be recommended. For women, these include an analysis of body temperature and ovulation, x-ray of the fallopian tubes and uterus, and laparoscopy. For men, initial tests focus on semen analysis.

How is Infertility Treated?

Most infertility cases -- 85 to 90 percent -- are treated with conventional therapies, such as drug treatment or surgical repair of reproductive organs.

What is In Vitro Fertilization?

Infertile couples where women have blocked or absent fallopian tubes, or where men have low sperm counts, in vitro fertilization (IVF) offers a chance at parenthood to couples who until recently would have had no hope of having a "biologically related" child.

In IVF, eggs are surgically removed from the ovary and mixed with sperm outside the body in a Petri dish (in vitro is Latin for in glass). After about 40 hours, the eggs are examined to see if they have become fertilized by the sperm and are dividing into cells. These fertilized eggs (embryos) are then placed in the women's uteus, thus bypassing the fallopian tubes.

Is In Vitro Fertilization Expensive?

In 1993, the average cost of an IVF cycles was $6,233 in the United States. Like other extremely delicate medical procedures, IVF involves highly-trained professionals with sophisticated laboratories and equipment, and the cycle may need to be repeated to be successful. While IVF and other assisted reproductive technologies are not inexpensive, they account for only three hundredths of one percent (0.03%) of U.S. health care costs.

Does In Vitro Fertilization Work?

Yes. Since 1981, when IVF was introduced in the U.S., more than 27,000 American babies have been born from IVF and over 45,000 from all assisted reproductive technologies. The average live delivery rate for IVF in 1994 was 18.6 percent, only slightly less than the 20 percent chance in any given month that a reproductively healthy couple has of achieving pregnancy and carrying it to term.

Do Insurance Plans Cover Infertility Treatment?

Partially. For residents of six states in the U.S. (Arkansas, Hawaii, Illinois, Maryland, Massachusetts, and Rhode Island), insurance companies are required by law to cover IVF. In New York, they are mandated to cover infertility services but not IVF. In Texas and Connecticut, insurance companies are required to offer to cover IVF services, whereas in California they must offer to cover infertility treatment, but exclude IVF.

---

Dr. Jill Flood

Endometrial Biopsy Hysterosalpingogram Semen Analysis Ovulation Predictor Kits Ureaplasma Urealyticum

Endometriosis Laparoscopy Hysteroscopy Tubal Factor Infertility

In Vitro Fertilization 3rd Party Reproduction T.D.I.

Questions Local Hotels Medical Costs

---

Please e-mail Dr. Jill T. Flood any questions, comments or suggestions.
This site is still under construction. Any suggestions are appreciated.

Site Design by Allen McGrath Copyright^©1996
The Beach Center For Infertility, Endocrinology and IVF.

---