BETTER UNDERSTANDING
INFERTILITY

Between 8 and 15% of couples have difficulty conceiving a child. Although this rate has not changed for several decades in industrialized countries, the number of couples resorting to medically assisted procreation has increased significantly. Today, fertility problems are recognized and many treatment options exist.

Man embracing woman in gentle hug

What factors can affect fertility? 

Many factors can influence your chances of conceiving a child: age, ovulatory disorders, sperm problems and more. Some patients already know the reason for their infertility when they first come to us, while others have not yet received a diagnosis.

By consulting our fertility specialists and going through various diagnostic tests, you will be able to better understand your own situation.

Here are some of the most common causes of fertility problems.

Age

A woman's fertility declines with age, especially from the mid-30s and even more significantly in the late 30s. Before that, a woman's ovaries contain a greater number of eggs. They are also more likely to be fertilized and implant in the uterus, and they respond better to medications that stimulate ovulation. There is also the risk of miscarriage and chromosomal abnormalities in babies that increases with age.

Amenorrhea

Amenorrhea means the absence of menstrual periods. There are two types of amenorrhea: primary and secondary. Primary amenorrhea is often diagnosed when a woman does not have a period before the age of 16. Secondary amenorrhea can occur when a woman has had a period before, but it stops for 3 to 6 months or more.

Endometriosis

Endometriosis is a common problem that occurs when the endometrium, which lines the inside of the uterus, becomes outside the uterus. This displaced tissue can implant and grow anywhere in the body, most commonly in the abdominal area.

Endometriosis can affect fertility by causing scar tissue or adhesions that attach the ovaries, fallopian tubes, and intestine together. These adhesions can make it difficult for the ovaries to release eggs or for eggs to travel through the fallopian tubes, reducing the chances of pregnancy.

Ovulatory disorders

Each month, the production of an egg that can be fertilized goes through a series of complex steps. If just one of these steps doesn't go as planned, your fertility will be affected. A number of health conditions can slow or prevent ovulation, including:

  • Symptoms of Polycystic Ovary Syndrome (PCOS)

  • Thyroid gland problems

  • Hyperprolactinemia, a disorder related to a hormone that stimulates milk production and suppresses ovulation

  • Low levels of fertility hormones (FSH and LH)

  • Premature ovarian failure

  • Extreme weight loss or gain

  • Excessive physical activity

  • Eating disorders

A reduction in the quantity and quality of eggs makes it difficult for a woman to conceive a child. Some women experience ovarian dysfunction well before menopause. Premature ovarian failure (POF), or early menopause, occurs when a woman under the age of 40 stops producing eggs that can be fertilized. On average, natural menopause occurs at about age 51, but in women with POF, menopause begins much earlier.

Ovulatory disorders are the most common cause of infertility in women. The good news is that many of these problems can be treated.


Polycystic ovarian syndrome

Polycystic ovarian syndrome (PCOS) and polycystic ovarian disease (PCOD) are endocrine disorders and one of the main hormonal factors that can affect a woman's fertility. The egg production of women with PCOS and COPD is affected by an imbalance in their hormone levels. This affects their menstrual cycles: some experience irregular ovulation (often fewer than eight cycles per year), while others may have several long periods of bleeding per month.

Repeated miscarriages

A miscarriage is a pregnancy loss that occurs during the first 20 weeks of gestation. It occurs in 15 to 20% of pregnancies, most often in the first trimester. The risk of miscarriage increases with age, reaching 50% for women over 45.  

When a woman has more than one miscarriage, it is called recurrent pregnancy loss. There are many causes, but the most common is a chromosomal abnormality in the embryo. Recurrent pregnancy loss can also be caused by uterine fibroids or abnormalities in their shape, genetic abnormalities, hormonal disorders, infections or immunological factors.

Sperm problems

Sperm problems are the cause of fertility problems in about 40% of cases. The observed spectrum varies from azoospermia (absence of sperm in the ejaculate) in varying degrees to the combination of oligo-astheno-teratospermia (low sperm concentration, reduced motility and abnormal shape). Sperm health, motility and quantity can be affected by nutrition, exercise and lifestyle habits such as alcohol, tobacco and recreational drug use. Long-term use of testosterone for bodybuilding can also lead to azoospermia.

Infertility associated with fallopian tubes

The fallopian tubes play a key role in the fertilization process and pregnancy. Up to 25% of cases of infertility in women are related to damage to the fallopian tubes. However, there are now advanced techniques that allow women with blocked or damaged tubes to have a healthy pregnancy.

Unexplained infertility

Unexplained infertility is defined as a period of infertility of more than three years during which, according to the results of laparoscopy, with or without hysterosalpingography (HSG), semen analysis, ovulation by basal body temperature measurement or serum progesterone measurement, and fallopian tubes and pelvic cavity are normal. Individuals with normal results who have been infertile for less than three years have a 60% chance of conceiving a child naturally within the next 18 months. However, after three years, the chance of conceiving a child naturally decreases to 30% or less depending on the woman's age and the duration of infertility, or about 3% per month.

In cases of unexplained infertility or failure of usual treatments, advanced infertility treatments, such ashyperstimulation/IUI and IVF/ICSI, could be recommended to you. 

When to consult a fertility specialist?

Understanding the factors that affect your fertility allows you to adopt the best methods and get the support you need to increase your chances of starting or expanding your family. That's why we recommend consulting a fertility specialist if you find yourself in one of the following situations:

  • You are under 35 and have been trying to get pregnant for at least 12 months.

  • You are over 35 and have been trying to get pregnant for at least 6 months.

  • You have irregular periods, meaning your menstrual cycle does not usually last between 26 and 34 days.

  • You have already had a pelvic infection.

  • You have been diagnosed with endometriosis, polycystic ovarian syndrome (PCOS) or polycystic ovarian disease (PCOD).

  • You have experienced more than two pregnancy losses. 

  • Your family has a history of early menopause or you are at risk for early menopause.

  • You have been diagnosed with a sperm problem, had testicular surgery, or suffered from an infection, injury, or other problem related to the testicles (for example, mumps).

  • You or your partner have a health condition that may impact fertility (for example, diabetes, high blood pressure, or a history of cancer treated with chemotherapy or radiation therapy).

The fertility journey is a unique and complex experience that differs from person to person. When you feel ready to chart your own course, our dedicated team of fertility specialists will welcome you to develop a personalized treatment plan with you and help you realize your dream of starting a family.

How much do treatments cost and what is covered? RAMQ?

We answer your questions.


Expected costs


Consult our prices


Discover

Find out how our specialists work with you to develop a treatment plan specifically tailored to your needs.