Trying to conceive month after month? You are not alone. Infertility in MEN and women is more common than most people think. Host Myrna Young welcomes fertility specialist Gabriela Rosa to explore the top causes of infertility in women and the often-overlooked role of male fertility.
They discuss factors affecting egg and sperm quality, the impact of lifestyle and environmental elements, and the importance of comprehensive diagnosis in overcoming infertility.
Gabriela shares insights from her Fertility Breakthrough program, emphasizing personalized treatment and holistic approaches to enhancing reproductive health. Gain valuable information about improving fertility and the collaborative journey couples undertake to successfully achieve parenthood.
What Does “Struggling to Conceive” Really Mean?
An infertile woman is defined medically as being unable to conceive a child after one year of regular, unprotected sex (or six months if over age 35). It is a treatable condition, often caused by ovulatory issues (like PCOS), blocked fallopian tubes, or uterine conditions. Infertility is not always permanent, and many go on to conceive.
Infertility is common, affecting approximately 1 in 6 people (17.5% of the adult population) worldwide, according to the World Health Organization. In the United States, about 9% of men and 11% of women of reproductive age have experienced fertility problems, with roughly 10%-15% of couples struggling with conception.
Key Infertility Statistics
- About 17.5% of adults globally experience infertility, with similar rates in both high- and low-income countries.
- US Prevalence: Around 6% to 13% of women in the U.S. ages 15-49 have experienced impaired fecundity (difficulty getting or staying pregnant).
- Infertility is not solely a female issue; roughly one-third of cases are due to female factors, one-third to male factors, and the remainder due to combined or unknown factors.
- Age Factor: While infertility affects younger individuals, it becomes much more common as women reach their late 30s and early 40s.
Infertility is common, affecting approximately 1 in 6 couples globally and roughly 10% to 15% of couples in the United States. It is defined as the inability to conceive after one year of unprotected intercourse, impacting millions of people regardless of gender.
The Truth About Fertility: It’s Not Just Her
Break the myth: fertility is a shared responsibility
The persistent, outdated myth that fertility issues are solely a “woman’s problem” is medically inaccurate and emotionally damaging. In reality, fertility is a shared journey and a joint responsibility between partners.
The Myth: Infertility is a woman’s issue.
The Reality: Fertility challenges are split almost equally between male factors, female factors, and combined or unknown causes
Transition: let’s look at both sides.
Infertility in Men and Women: Breaking the Myth with Facts
- The 50/50 Split: Studies show that 40-50% of infertility cases involve male factors, such as low sperm count, poor motility, or structural issues.
- Both Partners Need Evaluation: Because infertility is a couple’s journey, early diagnosis should involve both partners simultaneously to identify the root cause and avoid unnecessary delays or stress.
- Male Fertility is Vulnerable: Male fertility can be significantly affected by age, lifestyle choices (diet, smoking, alcohol), and environmental factors, debunking the idea that only female fertility declines or is affected by health.
- Shared Responsibility = Better Outcomes: When both partners participate in the journey-seeking testing, optimizing health, and managing stress-treatment success rates improve, and the emotional burden on the woman is reduced.
Female fertility issues often stem from ovulation disorders (like PCOS), blocked fallopian tubes, uterine conditions (fibroids, endometriosis), or age-related decline in egg quality. Other major factors include lifestyle choices (smoking, alcohol, weight), infections (PID), and hormonal imbalances. Specialized care can address these causes.
Common Causes of Female Fertility Issues
- Ovulation Disorders: The most common cause, responsible for 40% of cases, preventing the release of eggs.
- Polycystic Ovary Syndrome (PCOS): A hormonal imbalance, which is the leading cause.
- Primary Ovarian Insufficiency (POI): Ovaries cease to function normally before age 40.
- Hypothalamic dysfunction: Interference with FSH and LH hormone production.
- Age: Fertility declines significantly around age 37, due to a lower number of eggs and higher rates of chromosomal abnormalities.
- Tubal Blockage or Damage: Often caused by Pelvic Inflammatory Disease (PID), STIs (chlamydia/gonorrhea), or past surgery.
- Endometriosis: Tissue from the uterine lining grows outside the uterus, affecting the fallopian tubes or ovaries.
Uterine or Cervical Issues:
- Uterine Fibroids/Polyps: Noncancerous growths that can interfere with implantation or block tubes.
- Uterine Anomalies: Congenital issues with the shape of the uterus.
Lifestyle and Environmental Factors:
- Weight Issues: Being significantly underweight or overweight can interrupt ovulation.
- Substance Use: Smoking, heavy alcohol consumption, and drug misuse.
- Chronic Stress: High stress levels can affect hormone production.
Medical Conditions & Treatments:
- Thyroid Disorders: Overactive or underactive thyroid.
- Cancer Treatments: Chemotherapy and radiation can harm ovarian function.
- Autoimmune Disorders: Conditions like lupus or rheumatoid arthritis.
Ovulation disorders (PCOS, hormonal imbalance)
Blocked fallopian tubes
Endometriosis
Age-related fertility decline
Lifestyle factors (stress, weight, nutrition)
Common Causes of Male Fertility Issues
Male fertility issues commonly stem from sperm production problems, blockages preventing sperm delivery, chronic health conditions, or lifestyle factors like obesity and heat exposure. The most common cause is varicoceles, which are enlarged, heat-producing veins in the scrotum. Other factors include infections, hormonal imbalances, and genetic issues.
- Varicoceles: Enlarged, swollen veins in the scrotum that increase testicular temperature, hindering sperm production.
- Sperm Production Issues: Low sperm count, poor sperm motility (movement), or abnormal morphology (shape).
- Infections: Sexually transmitted infections (e.g., chlamydia, gonorrhea) or chronic infections like tuberculosis can cause scarring and blockages.
Lifestyle Factors:
- Obesity: High BMI is linked to reduced fertility.
- Smoking/Alcohol: Tobacco, marijuana, and heavy alcohol use impact sperm quality.
- Overheating: Frequent use of hot tubs, saunas, or keeping a laptop on the lap for extended periods.
- Hormonal Imbalances: Dysfunction in the hypothalamus, pituitary, or thyroid glands, as well as low testosterone (hypogonadism).
- Ejaculatory/Anatomical Disorders: Retrograde ejaculation (sperm enters the bladder) or blockages of the tubes transporting sperm.
- Environmental/Occupational Toxins: Exposure to pesticides, heavy metals, radiation, or industrial chemicals.
- Genetic Conditions: Disorders such as Klinefelter syndrome, Kallmann syndrome, or cystic fibrosis.
- Medications: Testosterone supplements, steroids, and certain medications for chronic conditions can reduce fertility.
- Age: Fertility can begin to decline after age 35, and significantly after 40, according to Cleveland Clinic
Low sperm count
Poor sperm motility or shape
Hormonal imbalances
Lifestyle factors (smoking, alcohol, heat, stress)
Underlying medical conditions
Signs You Might Be Facing Fertility Issues
Signs of potential fertility issues include failing to conceive after 12 months (6 months if over 35), irregular or absent menstrual cycles, severe pelvic pain, and multiple miscarriages. Other indicators include hormonal imbalances (acne, hair growth), pain during sex, and known conditions like endometriosis or PCOS.
Fertility Warning Signs in Women
- Irregular or Absent Periods: Cycles that vary significantly in length or missing periods entirely suggest irregular ovulation.
- Extremely Painful Periods: Pain that causes vomiting or interrupts daily life, or heavy bleeding, may indicate endometriosis.
- Hormonal Imbalance Symptoms: Unexplained weight gain, chronic acne, or excess hair growth (hirsutism) on the face/chin.
- Multiple Miscarriages: Losing two or more pregnancies suggests a need for evaluation.
- History of Health Issues: Prior pelvic inflammatory disease (PID) or sexually transmitted infections (STIs).
Fertility Warning Signs in Men:
- Changes in Sexual Function: Low libido or difficulty with erections.
- Testicular Changes: Pain, swelling, or lumps in the testicles.
- Hormonal Issues: Loss of muscle mass or abnormal hair growth.
- Ejaculation Changes: Reduced volume of semen or changes in semen color/consistency.
Key Infertility signs For Women:
- Irregular periods
- Painful cycles
- Hormonal symptoms
For Men::
- Low libido
- Testosterone issues (Often no obvious symptoms)
Hidden Factors That Affect Both Partners
The multifaceted nature of fertility challenges demands a comprehensive and informed approach. Gabriela Rosa’s insights illuminate the complexity surrounding infertility, urging couples to consider both partners’ roles while recognizing the influence of their environment and lifestyle. Her treatment methodology demonstrates the effectiveness of personalized care in achieving desired outcomes.
By expanding the dialogue around fertility and emphasizing shared responsibility, couples can better navigate their path toward parenthood. The journey is marked by understanding, collaboration, and strategic action, offering hope and clarity in the often-daunting landscape of fertility challenges.
- Stress and emotional health
- Poor diet and nutrient deficiencies
- Sleep and hormone disruption
- Environmental toxins
When Should You Seek Help?
Seek professional help when you experience severe, persistent symptoms lasting two weeks or more, such as deep sadness, anxiety, daily dysfunction, or substance abuse. Immediate emergency care (call 911) is necessary for chest pain, difficulty breathing, sudden confusion, severe injuries, or thoughts of suicide.
When to Seek Mental Health Support
- Daily Dysfunction: Difficulty performing normal daily tasks, concentrating, or completing work.
- Persistent Mood Changes: Intense sadness, worry, anxiety, or irritability lasting for weeks.
- Social Withdrawal: Avoiding friends, family, or activities you used to enjoy.
- Unhealthy Coping: Increased alcohol or drug use.
- Physical Changes: Persistent sleep issues (insomnia/hypersomnia), major appetite/weight changes, or chronic fatigue.
- Self-Harm: Thoughts of suicide, death, or harming others.
When to Seek Immediate Medical Help (Emergency Room)
- Cardiovascular/Respiratory Distress: Chest pain/pressure lasting 2+ minutes, difficulty breathing, or shortness of breath at rest.
- Neurological Emergencies: Sudden weakness, numbness (especially on one side), trouble speaking, or sudden confusion.
- Severe Physical Symptoms: Uncontrolled bleeding, fainting, sudden high fever, or severe, unexplained pain.
What You Can Do to Improve Fertility Naturally
Achieving successful pregnancy outcomes often requires a methodological, personalized approach. Gabriela Rosa emphasizes a tailored strategy in assessing fertility issues. She describes her methodology as “understanding and diagnosing the problem effectively is halfway through to a solution, really.” By focusing on individual cases, Rosa ensures that treatment aligns with the unique needs and challenges faced by each couple.
Crucial to her strategy is the notion of acting pregnant before conceiving, as Rosa explains, “Act pregnant now to get pregnant later. That is the key to success.” This mindset supports couples in preparing their bodies for conception, optimizing conditions for both egg and sperm health. Her approach enables couples to make informed decisions, aligning their actions with the ultimate goal of bringing a healthy baby into their family.
Nutrition (Fertility-Supporting Foods)
Key Fertility-Supporting Foods
- Leafy Greens: Spinach, kale, and romaine are rich in folate and iron, essential for ovulation and DNA synthesis.
- Fatty Fish: Salmon, mackerel, and sardines provide omega-3 fatty acids, which boost blood flow to reproductive organs and help hormone production.
- Healthy Fats & Nuts: Avocados, olive oil, walnuts, and almonds support hormonal health and provide Vitamin E.
- Beans and Lentils: Excellent sources of iron and plant-based protein, which can reduce the risk of ovulatory infertility.
- Full-Fat Dairy: Greek yogurt or whole milk can improve fertility compared to low-fat options.
- Berries and Citrus: High in antioxidants and Vitamin C, which protect eggs and sperm from oxidative stress.
- Whole Grains: Oats, quinoa, and brown rice help regulate insulin.
- Eggs: Provide high-quality protein and choline.
Exercise (balance, not extremes)
Reduce stress (mind-body connection)
Supplements (general guidance)
Timing and tracking ovulation
Infertility in Men and Women: The Emotional Toll of Trying to Conceive
Trying to conceive (TTC) often causes profound emotional distress, including anxiety, depression, guilt, and grief, especially when facing infertility. The journey can feel like a “treadmill” of chronic stress, leading to strained relationships, social isolation, and diminished self-worth, with distress levels often compared to those with cancer.
Key Emotional Impacts:
- Anxiety and Depression: The cycle of hoping for a pregnancy and experiencing disappointment leads to significant mental health challenges.
- Mental Load and Burnout: Constant tracking of ovulation, medical appointments, and waiting for results can feel all-consuming and lead to exhaustion.
- Infertility-Specific Distress: Feelings of failure, shame, and jealousy (often triggered by social media or public announcements) are common.
- Strained Relationships: Infertility affects couples differently, with men often experiencing performance anxiety and women bearing more of the pressure related to medical interventions.
Physical and Mental Connection:
High stress can create a vicious cycle where cortisol lowers reproductive hormones and, in some cases, inhibits ovulation.
Coping Strategies:
- Seek Support: Therapy, support groups, or counseling can help manage the emotional burden. Acknowledge your grief, but don't isolate.
- Set Boundaries: Taking breaks from social media or stepping back from baby-related events can help reduce stress.
- Open Communication: Discussing feelings with a partner or trusted friend reduces isolation. Remember it is not about blame.
Hope and Next Steps for Infertility in Men and Women
Many couples go on to conceive with medical options.
Medical options for infertility include IVF-retrieving eggs for laboratory fertilization-and alternatives like ovarian stimulation drugs, ovulation induction, and intrauterine insemination (IUI). IVF types include standard, mild stimulation, and natural cycle IVF. Treatments often target conditions like endometriosis or PCOS, sometimes using hormone supplements (e.g., progesterone) to aid pregnancy.
- Standard IVF: Involves ovarian stimulation with daily injections for roughly 5-10 days to produce multiple eggs, followed by egg retrieval and fertilization in a lab.
- Mild/Natural IVF: Uses fewer or no drugs, reducing the risk of ovarian hyperstimulation syndrome (OHSS), suited for those sensitive to medication or preferring less medical intervention.
Treatments:
- Ovulation Induction: Medication taken to stimulate regular ovulation, often used for PCOS.
- Intrauterine Insemination (IUI): A less invasive method where sperm is placed directly into the uterus during ovulation.
- IVM (In Vitro Maturation): Eggs are removed immaturely and matured in a laboratory, requiring fewer or no fertility drugs.
- Components: Procedures involve ultrasound monitoring, hormone shots (FSH/LH) to manage egg growth, and progesterone supplementation for uterine lining support.
Conclusion
The multifaceted nature of fertility challenges demands a comprehensive and informed approach. Gabriela Rosa’s insights illuminate the complexity surrounding infertility, urging couples to consider both partners’ roles while recognizing the influence of their environment and lifestyle. Her treatment methodology demonstrates the effectiveness of personalized care in achieving desired outcomes.
By expanding the dialogue around fertility and emphasizing shared responsibility, couples can better navigate their path toward parenthood. The journey is marked by understanding, collaboration, and strategic action, offering hope and clarity in the often-daunting landscape of fertility challenges.
Additional Resources
- Gabriela Rosa's Instagram: Gabriela Rosa Fertility
- Gabriela Rosa's Website: Fertility Breakthrough
- Talk Sex with Gabriela Rosa Podcast
- Transforming Unexplained Infertility into Motherhood
