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Why can't I get pregnant?

A closer look at what causes infertility

Couples struggling with infertility can feel lonely, especially when it seems like every other couple they know is expecting a baby.

NASCAR power couple Samantha and Kyle Busch can relate. The couple had tried for two years to get pregnant. The Busches certainly weren’t alone in their struggle. Infertility affects 15 percent of couples of childbearing age.

What is infertility?

“Infertility is when a couple cannot successfully get pregnant after trying for one year,” said Dr. JoAnne Gutliph of Novant Health UVA Health System Prince William OB-GYN in Manassas, Virginia. “It can be caused by several factors and it’s not something that just affects women. Men can have issues with infertility as well.”

After many months of trying to get pregnant, Samantha and Kyle Busch learned they each had reproductive issues after being referred to the REACH fertility clinic in Charlotte, North Carolina.

“Infertility can stem from a collection of things,” Gutliph said. “There are different factors, like behavioral and lifestyle factors, environmental factors and physical factors.”

What causes infertility?

Behavioral and lifestyle factors for both men and women include excessive alcohol and tobacco use, as well as vitamin deficiencies. Women can be affected by increased caffeine consumption, obesity and a sedentary lifestyle, as well as being underweight and excessively exercising. Men can be affected by emotional, psychological or relational stress that can decrease sperm production.

Even environmental factors, such as exposure to pesticides and lead, can disrupt ovulation and normal hormone function.

“Age is definitely a factor,” Gutliph said. “A woman’s chances of getting pregnant start to decline around age 32. For men, it’s around age 35.”

Sperm shape and movement, as well as sperm count, contribute to a man’s fertility or infertility.

For women, infertility can be caused by inflammation and scarring of the fallopian tubes and the uterus. Hormone imbalances can also cause polycystic ovary syndrome (PCOS), the most common cause of female infertility. Samantha Busch learned PCOS was a component of her and Kyle’s struggle to conceive.

Female fertility can also be affected by various medications and medical conditions, such as thyroid dysfunction, kidney disease, cancer, early menopause and more.

What can couples do?

However, there is hope in the face of infertility, as the Busches can attest. “There are several options for couples who struggle with infertility,” Gutliph said. “These options can be anything from lifestyle changes and medication to surgery and assisted reproductive technology.”

Since Samantha Busch has PCOS, she was prescribed Clomid, a drug that helps level out hormones. After they were each tested and learned they would need a little help conceiving, the couple chose to tap into assisted reproductive technology with in vitro fertilization (IVF). So far, it’s been a successful journey – they are expecting a baby boy in May.

Along the way, Samantha Busch had documented her family’s experience with infertility on her blog, where she highlighted the various medications and procedures they tried in an effort to support other couples in similar situations.

“We decided to share our journey publicly on my blog because we didn’t know anyone who had gone through it,” Samantha Busch said. “I felt anxious and overwhelmed at times (after we decided to go through) the whole IVF process, and thought I could be a comfort to other women as they began their journey.”

She advised other couples to be proactive to help identify potential fertility issues early.

“If possible, ask your doctor early on to do a blood panel to check your hormone levels and an ultrasound to check your ovaries,” Samantha Busch said. “It’s also a good idea to have your husband’s sperm count checked. People try to reassure you that there really isn’t anything to fret about until after six months to a year of trying, but it could have saved us a lot of frustration if we had done these things early on.”

Published: 3/18/2015