McFarland Clinic

Finding the Cause of Your Infertility

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June 17, 2011

When a couple is ready to get pregnant and start a family, any delay in these plans can be nerve-wracking, and the longer it takes to get pregnant, the more fertility problems become a consideration.

Clinically, a couple is said to be experiencing infertility if they have been unable to get pregnant after a full year of unprotected sex, or six months if the woman is over the age of 35. Once a couple reaches this point, it is recommended they visit with their obstetrician to discuss the need for fertility testing.
“Once the couple is diagnosed with infertility, it is important to establish the underlying cause, which will in turn determine the course of treatment,” says McFarland Clinic Obstetrician and Gynecologist Afshin Malaki, MD. “Further testing is often necessary to pinpoint the cause of infertility.”
McFarland Clinic offers some infertility testing and treatment options, although, depending on the nature of the infertility, some couples will be referred to a reproductive specialist if further testing and treatment is necessary. According to Jan Ziebell, manager of the McFarland Clinic Obstetrics & Gynecology Department, a typical infertility work-up at the clinic may include BBT (basal body temperature) charting, blood tests, an ultrasound, a hysterosalpingogram (HSG), semen analysis and sometimes diagnostic laparoscopy.
Treatment options available at the clinic include the prescription of certain fertility drugs (Clomid, HCG, Femara) and some surgical options, including a tubalplasty – surgery to clear a blocked fallopian tube – and a tubal reversal.
Common Causes of Infertility
According to an article on McFarland Clinic’s online library, Healthwise, in cases of infertility, the cause of the fertility problem is linked to the woman’s reproductive system 50 percent of the time and to the man’s reproductive system 35 percent of the time. In 10 out of every 100 cases of infertility, no known cause is discovered despite testing.
There are a wide variety of causes of infertility in both men and women, which is why working with your physician on the appropriate infertility testing is so important. Some of the more common causes include the following:
For Women
  • Fallopian tube blockage: If one or both fallopian tubes are blocked, a woman’s egg cannot travel to meet the man’s sperm, making pregnancy impossible. Blocked fallopian tubes are often the result of a history of pelvic inflammatory disease, abdominal surgery, or uterine infection.
  • Endometriosis: Endometriosis is a disorder where the tissue that normally lines your uterus also grows in other places, like your ovaries, inhibiting your chances of getting pregnant.
  • Premature ovarian failure: Premature ovarian failure is a condition where women experience a loss of ovarian function before the age of 40, often resulting in few to no eggs produced by the ovaries.
  • PCOS: Polycystic Ovary Syndrome is a hormone imbalance that often results in a lack of ovulation, meaning the woman’s body will fail to produce a mature egg for implantation. Other types of ovulation disorders due to hormone imbalances can cause infertility as well, but PCOS is the most common.
For Men
  • Low sperm count: Low sperm count is the primary cause of infertility in men and can be the result of a variety of biological and environmental factors.
  • Impaired shape and/or movement of sperm: There can also be problems with sperm morphology and motility, caused by a variety of underlying conditions, which can limit the sperm’s ability to reach and penetrate the egg.
  • Blockage of ducts: Blocked ejaculatory ducts, which a man would be born with, impair the emission of semen, making it unlikely sperm will be present to fertilize the woman’s egg.    
Regardless of the cause of a couple’s infertility – or if a cause can even be determined – it’s important for the couple to work with their physician on a plan for managing the infertility problem and seeking appropriate treatment. Treatment options depend on the underlying cause for infertility.
 “It is important to follow instructions from your OB closely to increase your chances of conceiving in a timely fashion. This will save you and your partner a great deal of anxiety and frustration,” says Dr. Malaki. “It will also allow for a timely referral to a reproductive endocrinologist for more advanced forms of assisted reproductive technology (ART), including in-vitro fertilization (IVF), if needed based on the test results and response to basic infertility treatments.”
Boosting Your Own Fertility
While treatment is often necessary when there is a diagnosed cause of infertility, couples can typically enhance their chances of getting pregnant through their own lifestyle choices. Coupled with the treatment recommended by your physician, or sometimes even on its own depending on the cause of infertility, the following lifestyle recommendations may make pregnancy more likely to occur:
  • Maintaining a healthy weight:Women who are overweight or underweight when trying to conceive will generally take longer to get pregnant, with underweight women’s fertility especially impacted by their weight. Achieving and maintaining a healthy weight is a great way for women to increase their own fertility. 
  • Getting enough sleep and exercise:The right amount of sleep and exercise are both components to a healthy lifestyle and can impact your fertility for a variety of reasons. Along with maintaining a healthy diet to stay in a healthy weight range, getting enough sleep at night and exercising – without overdoing it – will ensure your body is in peak form for getting pregnant.
  • Managing your existing health conditions:There are several chronic health conditions, such as diabetes and hypertension, that can negatively impact your fertility if not appropriately managed. Work with your primary care doctor on keeping all of your health conditions under control to keep them from impacting your fertility.   
  • Avoid certain vices:Cigarettes and alcohol can have an impact on both men and women’s fertility, so having both partners limit or altogether eliminate these vices can increase your odds of getting pregnant. Some studies have also shown that excessive amounts of caffeine can negatively impact a woman’s fertility.  
  • Prenatal vitamins: Women should take prenatal vitaminswith a minimum of 400 micrograms of folic acid.
  • For men: avoid tight underwear and pants
For More Information
Learn more about the McFarland Clinic Obstetrics & Gynecology Department, which has physicians at our Medical Arts Building in Ames, IA, or contact the office directly at 515-239-4414. Obstetric services are also available through McFarland Clinic at the following McFarland Clinic offices:
To learn more about infertility, including specific causes and testing, check out the following resources on our online health library:
General Infertility Articles:
Infertility Testing Articles:
Specific Infertility Causes Articles:
Infertility Treatment Articles:


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