Joan Bengtson, M.D., is assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and a member of the Department of Obstetrics, Gynecology & Reproduction at Brigham and Women's Hospital.
What kind of tests will help me find out why I am having trouble getting pregnant?
Infertility affects about 15% of couples attempting pregnancy. The cause is found in the male about 20% of the time and in the female about 40% of the time. Factors involving both partners are present about one third of the time. No specific cause is found in about 15% of couples.
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A lot of us don't realize that some sexually transmitted diseases (STDs) can cause no symptoms, meaning you could have an STD and not know it. And some STDs can lead to infertility, ectopic pregnancy, or chronic pelvic pain.
Chlamydia is one of those diseases. The Centers for Disease Control and Prevention (CDC) estimates that more than 2.8 million people are infected each year.
Chlamydia is most common in sexually active young adults. More than half of all infections involve people ages 18 to 24. You can get chlamydia during oral, vaginal or anal sexual contact with an infected partner. The disease can cause penile discharge in men and infertility in women. It can also cause serious health problems in newborn babies of infected mothers.
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Pelvic inflammatory disease (PID) is caused by bacteria, often the same type of bacteria that is responsible for several sexually transmitted diseases, such as gonorrhea and chlamydia. In some cases, PID develops from bacteria that has traveled through the vagina and the cervix by way of an intrauterine device (IUD).
PID can affect the uterus, fallopian tubes, and/or the ovaries. It can lead to pelvic adhesions and scar tissue that develops between internal organs, causing ongoing pelvic pain and the possibility of an ectopic pregnancy (the fertilized egg becomes implanted outside the uterus). Left untreated, infertility can develop. In fact, one in 10 women with PID becomes infertile. If left untreated, PID can also lead to chronic infection. In addition, if PID is not diagnosed early enough, peritonitis and inflammation of the walls of the abdominal and pelvic cavity may develop.
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Infertility is defined by the American Society for Reproductive Medicine (ASRM) as a disease of the reproductive system that impairs the body's ability to perform the basic function of reproduction. Although conceiving a child may seem to be simple and natural, the physiological process is quite complicated and depends on the proper function of many factors, including the following, as listed by the ASRM:
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Production of healthy sperm by the man
Production of healthy eggs by the woman
Unblocked fallopian tubes that allow the sperm to reach the egg
The sperm's ability to fertilize the egg
The ability of the fertilized egg to become implanted in the uterus
Adequate embryo quality