The inability to become pregnant can be difficult and impact many aspects of your life.
If you continue to see negative home pregnancy test results when trying to become pregnant, you may not know how to proceed. If you have a partner, one of you may feel more confused or upset than the other and want to discuss it in greater detail. It may also hinder the relationships you have with family and friends, impact the ability to fully concentrate on your job, and so much more.
No matter what you may be experiencing, the stress associated with infertility is very real. Research shows that women who are dealing with infertility have the same level of anxiety and depression as do those with cancer or heart disease.
confidence in your care
Despite all of this, there are many reasons to feel hopeful. It may be surprising to hear, but infertility is common. One of every six couples in the country now experiences infertility and more than two-thirds of all couples treated go on to conceive successfully.
Our technologies are more accurate and innovative than ever before. We regularly diagnose and treat complicated cases. Our fertility laboratory features many of the brightest minds in reproductive medicine - including 30 scientists, PhD’s, embryologists, and lab technicians who focus exclusively on ways to improve embryo development and success rates.
Without a doubt, there are many reasons to feel optimistic if you are experiencing infertility.
We understand that scheduling an appointment with a specialist isn't always the very first thought you have when facing a negative home pregnancy test or have general concerns about your fertility. Sometimes you just need advice.
That's where Rhonda - our Patient Liaison - can help. Rhonda has been with us since 1986 and is a phone call or email away if you need general advice or answers to specific questions.
Don't hesitate to contact Rhonda any time by phone at 888.300.2483 or via email by clicking here.
By the numbers, 35% of all infertility cases reside with the female partner, 35% with the male, 20% with both partners, and 10% are deemed "unexplained".
In other words, infertility affects men and women equally. With that in mind, below you will find a snapshot of what it takes to make a baby and the most common male and female conditions that may hinder conception.
In order to fully understand the causes of infertility, it is helpful to first understand the causes of positive pregnancy. Before we discuss this in greater depth, let’s first review some basic yet crucial roles in the "baby-making" process.
A woman must produce a healthy egg
A male must produce healthy sperm
A woman's Fallopian tubes must be open (and not blocked) to ensure sperm can pass through and reach the egg
Healthy sperm must fertilize a healthy egg to become a healthy embryo
A healthy embryo must implant to the uterus
Female infertility 101
Female-factor infertility can be diagnosed through blood testing, ultrasound, and x-rays such as a hysterosalpingogram (HSG). Some common causes of female infertility include:
- advanced maternal age
- hormonal imbalances
- polycystic ovarian syndrome (PCOS)
- structural abnormalities of the uterus, fallopian tubes, or ovaries
- previous pelvic infection or inflammation
- diminished ovarian reserve
- genetic abnormalities in an embryo
- fallopian tube blockage or damage
male infertility 101
Male-factor infertility is often diagnosed through a semen analysis test. Causes of male infertility include:
- sperm production issues within the testicles: too many abnormally shaped sperm (poor morphology), low sperm count, and decreased sperm movement (poor motility)
- past injury to testicles
- varicocele: dilated veins in the scrotum that may cause low sperm production
- previous infections
- health conditions: high blood pressure, diabetes
- hormonal abnormalities
When it comes to maximizing your fertility success, it’s crucial that you feel confident in the quality of care you are receiving.
If you have received treatment at another center and are considering a change in care, Boston IVF can help.
- we routinely diagnose and treat difficult fertility cases and rare reproductive disorders
- each month our entire team of physicians join together to sit down and review all intricate cases
- this is especially valuable for patients who’ve experienced IVF failure and instances of miscarriage or unexplained fertility while at other fertility centers
- we offer exclusive clinical trials that offer access to new treatments
- we are the only fertility center in the world to offer a needle-free saliva test, which replaces the need for daily blood draws associated with treatment monitoring
- we offer intracytoplasmic sperm injection (ICSI) for patients with male factor infertility or those who previously had low fertilization rates or fertilization failure
- we offer assisted hatching of embryos to increase the chance of implantation in the uterine cavity
Scar tissue that may be located in the abdominal cavity, fallopian tubes, or inside the uterus. Can interfere with the transport of the egg and implantation of the embryo in the uterus.
Lack of menstrual period for 6 months or more.
A physician who performs evaluations of male fertility.
The failure to ovulate. This is the most common cause of female infertility. There are many different causes for the failure to ovulate, including problems with the central nervous system or pituitary gland, and abnormalities within the follicles or ovaries.
ASSISTED HATCHING (AH or AZH)
A micromanipulation procedure in which an opening is made into the hard outer surface of the early embryo with the use of chemicals, mechanical techniques, or lasers to improve implantation after the embryo is transferred into the uterus.
ASSISTED REPRODUCTIVE TECHNOLOGY (ART)
A group of treatment methods used to improve fertility, which involves collecting the eggs and putting them in direct contact with sperm. Including IVF, ICSI, Assisted Hatching, egg freezing, and more.
Semen that contains no sperm, either because the testicles can’t make sperm or because the man’s reproductive tract is blocked.
BASAL BODY TEMPERATURE (BBT)
The body temperature when taken at its lowest point, usually in the morning before getting out of bed. Charting a woman’s BBT is used to document ovulation. If the BBT pattern rises about a half degree during the latter half of the menstrual cycle, it suggests that ovulation has taken place.
BETA hCG TEST (BhCG)
A blood test used to detect very early pregnancies and to evaluate the development of the embryo. The test measures hCG, which is secreted by the placenta after implantation.
A stage of embryonic development that occurs about 5 days after fertilization, when the embryo consists of two different cell types (those that will form the placenta and those that will form the fetus) and a central cavity.
Placing blastocysts into the uterus during IVF.
BLIGHTED OVUM (EGG)
Rarely-used term for an embryo that attaches itself to the uterine wall but the embryo does not develop. The amniotic sac may only contain fluid and no fetal tissue when the miscarriage occurs.
BROMOCRIPTINE (Parlodel, Dostinex)
These fertility drugs are used to reduce the prolactin secreted from the pituitary in those women with high prolactin levels.
The sticky, thick mucus produced by glands in the cervical canal that plugs the opening of the cervix. Most of the time this thick mucus plug prevents sperm and bacteria from entering the womb unless ovulation is about to take place. At this time, under the influence of estrogen, the mucus becomes thin, watery, and stretchy so that sperm can pass into the womb.
The opening into the uterus.
A pregnancy verified by lab tests but which results in an early miscarriage before a gestational sac is seen on an ultrasound.
A cyst in the ovary that is filled with blood. It is known medically as an “endometrioma.” The term chocolate cyst is used because it resembles melted chocolate. A chocolate cyst forms when endometriosis implants invade the ovary and bleed.
CLOMIPHENE (Clomid, Serophene)
Often a first line of treatment to stimulate and induce ovulation. Clomid binds to estrogen receptors in the hypothalamus. When their sites are occupied, the hypothalamus responds by telling the pituitary to release more FSH.
The fertilization of an egg by sperm that leads to the creation of a baby.
Conditions present from birth, either hereditary or environmental.
A yellow-colored cyst that forms from the ovarian follicle after it releases an egg. Once formed, the cyst produces estrogen and progesterone to prepare and support the uterine lining for implantation.
The process of freezing tissues or cells and then storing them in liquid nitrogen at very low temperatures. This process is used to store sperm, embryos, and unfertilized eggs. They are stored in small vials or straws that can last for decades.
DONOR INSEMINATION (DI)
A type of artificial insemination using sperm not from a male partner.
Semen specimens donated and used in an ART procedure.
Also called a tubal pregnancy, this is a condition in which the embryo implants outside of the uterus, usually in the fallopian tube, although it can also occur in the ovary or abdominal cavity. If such a pregnancy is allowed to continue, it may eventually rupture the fallopian tube and cause life-threatening hemorrhage. Such a pregnancy can never be sustained and often leads to decreased or complete loss of function in the affected tube.
Process in which eggs from a fertile woman are donated to an infertile woman for use in an ART procedure.
A procedure used to collect eggs from a woman’s follicles for use in IVF, usually performed with ultrasound-directed needle aspiration during IVF.
A term that describes the time from fertilization of the egg until the first few weeks of pregnancy.
Placing an embryo into a woman’s uterus or into the fallopian tube after IVF
A removal of a small piece of the uterine lining for microscopic study.
A chronic condition in which some of the normal cells that line the internal cavity (endometrial tissue) are found outside the uterus – most often in the pelvic area involving the ovaries. Endometriosis may interfere with ovulation and with the implantation of the embryo.
A coiled, tubular organ attached to and lying on the testicle that stores the sperm before ejaculation.
A natural estrogen produced by the ovary and released through reproductive life. It supports the development of the uterine lining and is important to breast and other female organ development
Hollow ducts through which eggs travel to the uterus once released from the follicle.
A program of fertility specialists offering a range of fertility services, usually including ART.
A group of drugs given to women to improve fertility. Fertility drugs are also used to treat some men with male factor infertility. See Fertility Drug Glossary.
A doctor who specializes in the diagnosis and treatment of infertility.
Penetration of the egg by the sperm cell.
A technique that reduces the number of fetuses in a multifetal pregnancy to reduce the risks of multiple pregnancy.
A term used to describe human in utero development, from the period of time when the embryo is fully formed at around 8 weeks, until birth.
Benign tumors of the uterine muscle and connective tissue.
Fingerlike projections at the end of the fallopian tube nearest the ovary. When stimulated by the fluid released from the follicles during ovulation, the fingerlike ends grasp the egg and sweep it into the tube.
FOLLICLE STIMULATING HORMONE (FSH)
A reproductive hormone that stimulates sperm production in a man; in a woman, FSH stimulates the growth of the ovarian follicle and the production of eggs.
The portion of a woman’s cycle before ovulation during which a follicle grows and high levels of estrogen cause the lining of the uterus to grow.
A fluid-filled sac in the ovary that contains the eggs.
FSH FOLLICLE STIMULATING HORMONES
Fertility medications like Bravelle, Follistim, Gonal-F stimulate follicle growth.
Term for either a sperm or egg.
GAMETE INTRA-FALLOPIAN TUBE TRANSFER (GIFT)
A technique in which the egg and the sperm are brought together by retrieving the eggs, placing them with sperm into a catheter, and immediately delivering them into the fallopian tube for fertilization using laparoscopy.
The medical term for pregnancy.
A type of surrogacy in which a surrogate mother is implanted with the genetic offspring of another couple and then turns the baby over to them at birth.
Gn-RH AGONIST (Lupron, Synarel)
These drugs inhibit premature ovulation.
Gn-RH ANTAGONIST (Cetrotide, Ganirelix)
These drugs inhibit premature ovulation.
The hormones that stimulate the growth of the follicle, i.e. FSH and LH.
The gender-neutral term for the ovaries and testicles.
A physician whose specialty is health care for women, especially the treatment of the female reproductive organs.
A chemical substance that travels via the bloodstream and carries a signal from one part of the body to another.
HUMAN CHORIONIC GONADOTROPIN
Medication (Ovidrel, Novaryl, Pregnyl) used to trigger ovulation.
HUMAN MENOPAUSAL GONADOTROPIN
Fertility medications (Menopur, Repronex, Luvens) that stimulate follicle growth.
A part of the brain that regulates hormones, located next to the pituitary gland at the base of the brain.
A surgical procedure involving the removal of the uterus, and which usually removes the cervix but not necessarily the ovaries and fallopian tubes.
HYSTEROSALPINGOGRAM (HSG, HYSTEROGRAM, TUBOGRAM)
An X-ray of the pelvic organs while a radio-opaque dye is injected through the cervix into the uterus and fallopian tubes. This test is used to check for malformations of the uterus or blocked fallopian tubes in suspected infertility.
A surgical procedure to check for abnormalities within the uterus. It is performed by placing a small, thin telescope-like instrument through the cervical canal to inspect the inside of the uterus. The procedure can be used both to diagnose and treat problems, since minor surgical repairs also can be done during operative hysteroscopy.
The process of attachment of the embryo to the maternal uterine wall.
The inability to conceive after a year of unprotected, well-timed intercourse, or the inability to carry a pregnancy to term.
INTRACYTOPLASMIC SPERM INJECTION (ICSI)
A lab procedure in which a single sperm is injected through the outer shell of the egg to enable fertilization.
INTRAUTERINE INSEMINATION (IUI)
An Assisted Reproduction Technique which deposits washed sperm directly into the uterus, bypassing the cervix, and allowing the sperm to enter the fallopian tubes (where fertilization normally occurs).
IN VITRO FERTILIZATION (IVF)
Literally meaning “in glass,” the term refers to fertilization that takes place outside the body in a small glass dish. This procedure involves stimulating the ovaries, retrieving eggs, fertilizing the eggs and then implanting the embryos in the woman’s uterus.
A minimally invasive surgical procedure in which a telescope-like instrument called a laparoscope in inserted through a small incision in the abdominal wall to view the inner organs in order to diagnose and sometimes treat suspected reproductive problems.
LEUPROLIDE ACETATE (LUPRON)
A fertility drug containing a Gonadotropin-releasing hormone analog that, following an initial stimulation, suppresses premature ovulation.
A sudden large release of Luteinizing Hormone from the pituitary gland that culminates in the release of a mature egg from the follicle about 36 hours after the surge begins.
The second half of the menstrual cycle that occurs between the release of an egg and the menstrual period.
LUTEINIZING HORMONE (LH)
A pituitary hormone that stimulates the ovaries or testicles.
The monthly series of physiologic reproductive changes in the uterus and other female organs that averages about 28 days, measured from the one menstrual flow to the next.
The use of high magnification and special instruments to manipulate sperm, eggs, and embryos during IVF.
The spontaneous loss of an embryo or fetus before the 20th week of pregnancy. Most miscarriages occur during the first 14 weeks of pregnancy.
The surgical removal of fibroid tumors from the uterus.
An irregular menstrual cycle that occurs in intervals longer than 35 days. This condition is usually caused by irregular coordination between the hypothalamus, the pituitary gland and the ovaries.
The term for a low sperm count in the ejaculate.
The biological term for an egg.
A fluid-filled sac within or on the surface of the ovary. The majority of ovarian cysts are not related to any disease and disappear without treatment within a few months.
A condition involving a loss of normal ovarian function in which the ovaries don't produce eggs, so estrogen levels drop and follicle-stimulating hormone levels rise.
OVARIAN HYPERSTIMULATION SYNDROME (OHSS)
A complication occasionally seen in women who take certain fertility medications that stimulate egg production. Ovarian hyperstimulation can cause ovarian enlargement and discomfort and fluid can leak into the abdominal area. Most cases are mild.
The release of a mature egg from a follicle.
Drug treatment that stimulates the development and release of one or more mature eggs from the ovaries.
A microscopic examination of cells scraped from the cervix to detect cancerous or precancerous conditions of the cervix.
PELVIC INFLAMMATORY DISEASE (PID)
A general term for infection of the female reproductive organs.
The small gland found at the bone of the brain that secretes many hormones, including FSH and LH.
POLYCYSTIC OVARIAN SYNDROME (PCOS)
A metabolic condition associated with irregular ovulation. The condition may include obesity, infertility and excess hair growth.
PREIMPLANTATION GENETIC TESTING (PGT-A and PGT-M)
With the help of PGT-A, we can identify the cause of recurrent pregnancy losses or unsuccessful fertility cycles, select the very the best embryos prior to implantation, and increase your IVF success rate. With the help of PGT-M, we can establish whether you and your partner are at risk of having a baby with a specific genetic disease and eliminate the chance of passing it on to your children.
An important ovarian hormone that is normally secreted after ovulation and during pregnancy. Progesterone triggers thickening of the lining of the uterus so it can accept implantation of a fertilized egg.
The pituitary hormone that stimulates the production of milk in breast-feeding women. It also circulates in low levels in the bloodstream of non-pregnant women. High levels of prolactin in non-pregnant women can cause anovulation.
The gland encircling the urethra in men that produces a third of the fluid in the ejaculate.
High white blood cell count in the sperm.
An obstetrician-gynecologist who has completed additional training in reproductive endocrinology. Reproductive endocrinologists are qualified to manage imbalances in the complex hormonal reproductive system, including infertility and recurrent pregnancy loss.
Surgical removal of one or more fallopian tubes. Salpingectomy is usually performed if the tube has become infected or to treat an ectopic pregnancy.
Inflammation of the fallopian tube.
Fluid of the male reproductive tract, containing sperm and a number of other substances such as water, simple sugars, alkaline chemicals, and prostaglandins.
SEMEN ANALYSIS (SA)
A laboratory test used to assess the amount and quality of a man's sperm and semen.
A service that maintains frozen sperm samples.
The number of sperm in the ejaculate, also called sperm concentration and given as the number of sperm per milliliter. A low sperm count is called oligospermia. A sperm count of 20 million/ml or above is considered normal.
The evaluation of the size and shape of sperm in a semen sample.
The ability of sperm to swim.
A technique used to separate sperm cells from the seminal fluid, resulting in a small volume of highly concentrated sperm used for IUI treatments.
A condition that results in the absolute inability to reproduce.
A useful diagnostic procedure that also can be used to remove sperm from semen. It has some advantages to sperm washing because the live sperm will swim up to the culture media leaving behind most of the debris.
Also known as testes, testicles are the male sex glands located in the scrotum. Testicles store and produce sperm and are the main source for the secretion of the male hormone testosterone.
A surgical procedure in which a small sample of testicular tissue is removed for microscopic examination to see if sperm are present and able to be retrieved.
The primary male hormone responsible for secondary sex characteristics and for supporting the sex drive. Testosterone is also necessary for sperm production.
Female sterilization. The fallopian tubes are blocked to prevent the egg from meeting sperm. Commonly known as “having the tubes tied”.
Use of high-frequency sound waves that are reflected off solid tissues to give an image of internal body structures. This device is used to detect and count follicle growth in many fertility treatments and to detect and monitor pregnancy.
Part of the female reproductive system that contains and nourishes a fetus prior to birth.
An embryo in the early stages of development.