With couples waiting to have children later in life,¹ difficulty getting pregnant and infertility issues are becoming more common—perhaps even more common than you may think. According to recent data, 15% of couples experience trouble conceiving.² And, though issues with conceiving can stem from both partners, women may feel like the root cause, driving feelings of isolation and shame.³ One way we can lessen the burden of this issue, and reduce the stigma often associated with infertility issues, is by talking about them openly. Let’s start the conversation by digging into some of the causes for infertility, potential testing and treatment options, and how you can find support if you or a loved one is struggling with these issues.

What Causes Infertility?

Infertility is defined as the inability to get pregnant after one year of trying,⁴ though some couples may struggle much longer before seeking help. Although all couples have different circumstances, some common causes for infertility in women include ovulation disorders, like hormonal and thyroid disorders,⁵ or uterine or cervical abnormalities such as fibroids or polyps. ⁵ Additionally, conditions like endometriosis, primary ovarian sufficiency (which occurs near menopause), and fallopian tube blockage may affect fertility. ⁵ In less common scenarios, conditions like cancer, diabetes or Celiac disease may also play a role in infertility. ⁵

Infertility affects both men and women and often puts strain on couples on their journey to conceive. Causes also vary in men, but common contributing factors include varicocele, or the swelling of the vein that drains the testicle, antibodies that attack the sperm, hormonal imbalances, problems with sexual intercourse, tubule defects that prevent movement of the sperm, and more.⁶

Some risk factors can exist in the absence of these conditions – such as older age, extreme or fluctuating weight, alcohol and drug use, stress, diet, or sexually transmitted infections.⁴

Recent studies suggest that fertility issues may be more prominent in the Black community, noting “Black women may be twice as likely as white women to have fertility problems but are far less likely to seek or receive infertility treatment.”³ For some, the fertility care space is felt to be “overwhelmingly white” ³ and may even exacerbate what is considered to be “an already isolating experience” for non-white couples. ³ Non-white patients have also delayed seeking treatment for fertility, for reasons including the cost of infertility treatments, the stigma associated with infertility, or lack of access to culturally competent care from practitioners.⁷ Women of color, particularly Black women, need to be represented in more clinical studies about infertility to drive a better understanding of their fertility issues as well as how women within these communities can gain access to available treatments. Currently, some ways in which doctors are looking to support women across the board with fertility issues include “lobbying for increased insurance coverage for infertility services and having clinics offer some free services to lower-income couples, enrolling more women of color in infertility studies, and diversifying the infertility workforce to include more physicians, nurses, and lab employees who are people of color.”³

Testing and Treatment

With all these possible causes of infertility, couples might consider talking with an OBGYN or fertility specialist about tests to help identify which underlying condition is contributing to their fertility challenges. Types of tests include hysteroscopy, laparoscopy, and genetic testing.⁵ Fertility treatment options vary depending upon a couple’s circumstances, and in some cases, women may have to go through several rounds of varying treatment before finding success. Treatments include ovulation stimulants, intrauterine insemination, or surgery to restore fertility.⁵ In addition to treatments, couples may also consider looking into assisted reproductive technologies like in vitro fertilization (IVF) should their situation allow. Women suffering from fibroids should ask their doctor about uterine sparing treatment options for fibroid removal, like the MyoSure™ procedure.

Finding Support

Infertility can be stressful and at times isolating for couples, so finding support is critical. If you or a loved one has experienced fertility issues, consider talking to a support group in your community to connect with other people going through the same thing. Hearing the stories of others who have been in similar situations can be comforting and a reminder that you’re not alone.

Important Safety Information

MyoSure tissue removal system is intended to remove unwanted tissue from the uterus. During a MyoSure procedure, a trained gynecologist inserts the MyoSure device through your vagina and then removes the unwanted tissue from inside the uterus. Use of the MyoSure system is not appropriate for patients who are or may be pregnant or have signs or symptoms of a pelvic infection, cervical cancer, or previously diagnosed uterine cancer. As with any surgical procedure, there are potential risks including but not limited to internal injury, excessive bleeding, and complications related to anesthesia. Temporary side effects may include cramping, bleeding, fever, and nausea. This information is not medical advice. Please discuss the risks and benefits with your doctor to find out if the MyoSure procedure may be right for you.

Works Cited:

1. Stahl, A. (2020, May 1). New Study: Millennial Women Are Delaying Having Children Due To Their Careers. Forbes. https://www.forbes.com/sites/ashleystahl/2020/05/01/new-study-millennial-women-are-delaying-having-children-due-to-their-careers/?sh=57b8b7e0276a
2. Infertility. UCLA Health. September 9, 2021, from https://www.uclahealth.org/obgyn/infertility
3. McFarling, U.L. (2020, October 14). For Black women, the isolation of infertility is compounded by barriers to treatment. STAT News. https://www.statnews.com/2020/10/14/for-black-women-isolation-of-infertility-compounded-by-barriers-to-treatment/
4. Office on Women’s Health. U.S. Department of Health and Human Services. Infertility. Accessed February 5, 2019. https://www.womenshealth.gov/a-z-topics/infertility.
5. Mayo Clinic. Infertility. Accessed February 5, 2019. https://www.mayoclinic.org/diseases-conditions/infertility/symptoms-causes/syc-20354317.
6. Mayo Clinic. Male Infertility. Accessed February 5, 2019. https://www.mayoclinic.org/diseases-conditions/male-infertility/symptoms-causes/syc-20374773.
7. Missmer S.A., Seifer D.B., and Jain T. (2011). Cultural factors contributing to health care disparities among patients with infertility in Midwestern United States. Fertil Steril, 95, 143-149. https://doi.org/10.1016/j.fertnstert.2011.02.039