In the past, people used to say that adoption was the only ethical solution to infertility problems. However, the biological urge to have children is so strong that many people are willing to exhaust every infertility option before considering adoption, says Dr. Samuel Pang, Medical Director of the Reproductive Science Center (RSC) in New England. Over 5 million babies have been born using assisted reproductive technology since its inception. Fertility treatments are becoming more popular, due to the well-published success rates. “With the appropriate treatment, up to 80% of our patients will conceive,” says RSC Associate Medical Director Dr. Isaac Glatstein. Today there are many myths about infertility and misconceptions about the options available to couples.

One myth about treatments for infertility is that doctors are working to create “designer babies.” From a scientific point-of-view, reports that we will someday be able to pick and choose our baby’s traits are “totally, totally made up,” says Barnard College researcher Sarah Franklin. She says that embryo screening was developed to check for diseases, but no one wants to do it because “complications include contamination, misdiagnosis and risk to the embryo.” While an infertility specialist may be able to select a particular embryo that will go on to develop, they cannot just tinker around and choose their favorite genes or control how these genes replicate and get expressed. Biomedical ethics professor Bonnie Steinbock of the University of Albany explains, “The only thing you can reliably design is the sex of your baby — if you are willing to discard embryos of the wrong sex.”

Debora Spar, author of “The Baby Business” says that one of the myths of fertility treatments is there is a huge reserve of available eggs. No one wants to think about the profit aspect, but “it is egg sales,” says Spar. Whether these eggs deliver “infertility hope” is irrelevant when individual couples are paying egg donors up to $50,000 for their eggs. Egg sellers are usually women in their twenties who are willing to risk their own fertility and health for money. The risk of egg harvesting is ovarian hyper-stimulation syndrome, which causes swelling, shortness of breath and fluid to leak into the stomach and chest. “When women die of IVF, this is what they die from,” explains Sarah Franklin. Risks aside, the process itself involves hours of interviews, screenings, multiple doctor’s visits, hormone injections and invasive procedures that many women would rather not go through.

A third myth is that most fertility treatments involve high-tech petri dish fertilization, frozen embryos and assisted reproductive technology. However, 85-90% of infertility problems are treated with conventional therapies like drug treatment or surgical repair of reproductive organs. Most couples have issues such as: ovulation disorders, poly-cystic ovary syndrome, uterine fibroids, medication side effects, erectile dysfunction, enlarged scrotum veins, illness and hormone deficiencies. Only in cases where women have blocked or damaged fallopian tubes or the men have low sperm counts will the infertility specialist recommend in vitro fertilization, which accounts for less than 5% of all infertility treatments in the U.S.

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Many men and women are in search of anything that would help female infertility in their desperate quest to have children before they become too old. Recent research indicates that women are only directly responsible for 30% of all infertility troubles, and men are just as likely to have physical issues affecting them from spawning a child. In 40% of the cases, the couple is in it together, with factors affecting the pregnancy. Sometimes there are failures in ovulation or sperm production; other times the reproductive organs may be damaged or obstructed. A number of lifestyle factors, medications and environmental components have been known to affect a couple’s ability to have children as well. There are a number of sources for infertility information available online.

Medline Plus is a good place to begin your search for infertility information (at www.nlm.nih.gov/medlineplus/infertility.html). There are a number of helpful links here under the following headings: Overviews, Latest News, Diagnosis/Symptoms, Treatment, Alternative Therapy, Nutrition, Coping, Specific Conditions, Related Issues, Videos, Anatomy/Physiology, Clinical Trials, Genetics, Research, Journal Articles, Directories, Organizations, Law & Policy, Statistics, Men’s Topics and Women’s Topics. This comprehensive website is undoubtedly one of the best sources of free infertility help online.

Another recommended source of information on fertility can be found at the American Society for Reproductive Medicine. According to www.asrm.org, this non-profit organization’s mission is “to be the nationally and internationally recognized leader for multidisciplinary information, education, advocacy and standards in the field of reproductive medicine.” Founded in 1944, the doctors working with ASRM pioneered some of the first methods used to treat infertility, such as donor insemination, in vitro fertilization and ovulation induction. The society publishes the peer-reviewed medical journal, Fertility & Sterility, and is responsible for two newsletters. You can be sure to find the latest information regarding infertility at this respected website.

Lastly, you should talk to your primary practitioner about where to find helpful infertility information. Often doctors have free pamphlets or brochures that can help you make your decision regarding your infertility options. The doctor should be able to run a couple of preliminary tests to see if you have any abnormalities, counsel you regarding how to best achieve pregnancy, and even refer you to a trusted colleague who is an infertility specialist. You should not be afraid to seek treatment because the level of invasiveness is wholly up to you. Treatment may involve changing your technique, your dietary habits, quitting smoking or losing weight. You might consider medication to help you ovulate better. It might require minimally invasive laparoscopic surgery to remove obstacles to reproduction or repair internal injuries. In some cases, the eggs will be fertilized outside the body and implanted into your womb. By gathering all the information and talking about these emotional issues with your spouse first, you will be better prepared to see a health care specialist regarding your desire to have a child.

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The desire to have children is very strong for some people. There is no greater job than bringing a life into this world. The profound joy of feeding, clothing, teaching and caring for a child cannot be described or replicated in any way. Unfortunately, there are many obstacles in both men and women that may prevent this natural process from taking place. Infertility in men may occur due to inadequate sperm count, past surgery or hormonal malfunctions. Female infertility may occur because of fallopian tube failure, improper egg release or endometriosis. Sometimes the reasons are wholly unknown, but the good news is that there is infertility help and treatments to consider before merely giving up on the dream of having a child.

Infertility treatments for men may focus on general sex problems, hormone failure or the lack of sperm. There are many drugs out there that treat sexual dysfunction like impotence or premature ejaculation. Often treating these problems with medication or behavioral therapy will improve fertility. Other behavioral factors may contribute to the reasons for infertility in men, including smoking, prolonged use of recreational drugs, chronic alcohol abuse, anabolic steroid use, overly intense exercise, inadequate vitamins (particularly C and zinc), tight underwear, exposure to environmental toxins (pesticides, paint, radiation, mercury, benzene, boron, heavy metals), malnutrition, anemia and stress.

Often this can be corrected behaviorally, but sometimes surgery may be required to remove blockages in the ejaculatory duct. Sometimes the sperm gets ejaculated into the bladder, rather than out through the penis, in a condition known as “retrograde ejaculation,” in which case doctors can remove sperm directly from the testicles or recover them from the bladder and inject them into the woman’s egg in the laboratory to later implant the fertilized embryo into her womb. In rare cases, the man may need to take additional hormones, either in pill or shot form, which will stimulate the pituitary and the hypothalamus to disseminate sperm.

The most common infertility help and treatments for women center on drugs like Clomid or Serophene, which help the body produce and release eggs (ovulate). In some cases, however, women may ovulate prematurely and have irregular cycles, in which case a gonadotropin-releasing hormone (GnRH) is administered to help. For women with irregular ovulation cycles due to elevated levels of prolactin, bromocriptine (Parlodel) is prescribed. Though not widely prescribed, some drugs used to treat other conditions also offer some hope to treat infertility. For instance, the aromatase inhibitor medications (Femara, Arimidex) not only treats breast cancer, but also aids in ovulation for women who don’t respond to clomiphene citrate. Metformin (Glucophage) is an oral drug used to treat type II diabetes but also inadvertently boosts ovulation.

Complications of infertility help and treatments may include bleeding, infection, low birth weight or even birth defects. Any type of invasive procedure such as a surgery or implanted embryo brings a certain risk of internal bleeding and infection. Another high risk factor is low birth weight, which increases the odds of infant morbidity. Some studies speculate that 7% of all babies born with low birth weight may be attributable to assisted reproductive technology. While more research is needed to link birth defects with ART, the CDC recently reported that “septal heart defects, cleft palate and two GI defects are two to four times more likely.” Given these perils, it’s important that couples carefully evaluate whether taking advantage of infertility services are really worth the risk.

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Infertility occurs when a couple actively tries to conceive a child for six months to a year, yet have no success. Reasons for infertility may include the man (30%), the woman (30%) or both (40%). Sometimes the causes for male infertility are diseases or undiagnosed medical conditions that exhibit no signs or symptoms. Other times there may be an untreated disease, side effect from a medication or they were born with certain abnormalities. In this article, we’ll discuss some of the possible causes for infertility in men — all which require different approaches to treating the problem.

There are many possible causes or reasons for male infertility. Varicocele (enlarged scrotum veins) is found in 40% of all male infertility cases. The enlarged veins cause the scrotum temperature to increase, thereby affecting sperm production and quality. Cryptorchidism (the failure of the testicles to descend) is a common side effect of premature births, which may require corrective surgery. Retrograde ejaculation occurs when the nerves or bladder muscles malfunction, causing the sperm to seep into the bladder instead of moving down through the penis. Diseases like cystic fibrosis, cancer or autoimmune diseases seriously impair a man’s ability to father children as well.

Sometimes the infertility doctor will find an obstruction in the male reproductive system, such as a urinary tract infection, scarring from STDs, a tumor, an injury, a vasectomy or another anatomical defect. Occasionally, accidents or injuries damage male reproductive organs or hormone deficiencies interrupt sperm production. Certain medications taken for fungal infections, hypertension, cancer, gout, inflammatory bowel disease, ulcers, depression and psychosis cause sexual dysfunction as a side effect.

Medical conditions are often the causes for male infertility. For example, sometimes doctors notice nerve damage caused by diabetic neuropathy, which causes problems with erections and ejaculations. Extreme obesity can cause hypothyroidism and hormonal imbalances, interfering with sperm production. As well, a man may be unable to produce sperm if he has hypogonadism (undeveloped testes), testicular torsion (impaired blood supply to one of the testicles) or undescended testicles or varicocele (a group of enlarged veins inside the scrotum). Inherited conditions like Down syndrome or Klinefelter’s syndrome may also impair the ability to produce sperm.

Despite the mystery surrounding many of the causes for male infertility, as 25 to 50% seem to occur as genetic defects during embryonic development, there are many approaches to male infertility treatments. In some cases, a specialist will just take a sperm sample and fertilize the egg in a laboratory to implant into the female’s womb. Other times, the man may require a small surgical procedure to clear impedances or repair damaged organs. For more information about male infertility, visit www.nlm.nih.gov/medlineplus/infertility.html.

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