An upset couple glaring at a negative pregnancy test due to infertility issues.

Couples and Conception: Taking on Infertility Together

By Stephen Overholser, MD

When a couple is ready to start a family, challenges with infertility can be stressful, mortifying, and even embarrassing. As the months or years pass, and nothing is working, the stress can mount. Doubt and frustration set in and a couple can begin to feel as if the situation is hopeless, or that somehow, they are not doing something right, or that they are alone with their struggle to conceive.

In truth, they are not alone. Infertility is rising globally, and most starkly in modernized societies, as broadly our fertility has dropped over the last 50 years. As scientists rush to understand the cause, individual couples struggling to achieve pregnancies face the worst of it. Why is this happening to us? What do we do next?

Why Is This Happening to Us?

The key word here is us. Most causes of infertility are explained by both a male and female factor. Neither person is entirely infertile, but rather both have a condition, often correctable, that makes them individually less fertile, and as a couple unsuccessful with natural pregnancy to date.

For women, this could be an issue at the ovarian, tubular, or uterine level. It could be hormone-related, or endometriosis, or related to previous infections. These issues can contribute partially, or wholly to a couple’s infertility.

For men, sperm health and performance can be affected by a myriad of factors. While a physical exam and genitourinary tract history are important, more often issues arise from the presence of sperm and their quality. Issues including varicoceles, previous infections, hormonal imbalances, environmental exposures, and congenital variants in development can all contribute.

What Do We Do Next?

The urologic field defines a couple as being infertile after they have attempted pregnancy for 12 consecutive months without success. Thus, at first, patience is key. However, during this time, there are steps a couple can take.

Both ovulation and sperm health are optimized by managing stress and optimizing the environment. Our bodies are designed to increase fertility potential naturally when the environment would support childbirth. Getting regular and sufficient sleep, maximizing nutrition, and reducing or eliminating toxins like alcohol, tobacco and other substances is an important first step.  A couple can also limit physical insults to reproductive success, such as the use of lubricants during sexual activity, and the use of heat sources like hot tubs and laptop computers that can damage sperm. Ovulation and spermatogenesis are fragile processes, the former requiring balance over many months, and the latter requiring 76 days of health to come to fruition. Illnesses that generate a fever or require an extended recovery can impact fertility for months. Lastly, better understanding the woman’s ovulation cycle, and timing sexual activity mid-cycle, just prior to ovulation, can help.

Should optimizing these factors fail, the next step should be to meet with a reproductive system expert – for both parties. This would be an OBGYN for her, and a urologist for him. Your doctor will first learn about your trials and tribulations to date and begin an evaluation that will include a physical exam, and possibly lab and imaging studies to help identify the contributing factors. From there, treatment can be prescribed and implemented.

Couples should tackle their infertility challenges with neither dread nor shame. Many evaluations find correctable issues, and many couples find they can conceive naturally after being evaluated and treated. Even if the evaluation recommends considering assisted reproductive technology, such as intrauterine insemination, or in vitro fertilization, having both the urologist and OBGYN team involved from the beginning can make the process easier, safer, and more successful.

Starting a family, or adding to an existing one, can be stressful for those couples facing infertility. Our team at Georgia Urology stands by ready to help. Our knowledge, experience, and cutting-edge techniques are why we are the preeminent urology group of Georgia. But it is our compassion and dedication to those who feel afraid or alone in this process or any other, that drives us to be so much more. Learn more about Georgia Urology’s fertility services or schedule an appointment with one of our experts.