Infertility occurs in about 15 to 20% of American couples. The causes are multiple. Perhaps the most common cause for infertility is male factor. Many couples don't realize that. Approximately 40% of the cases of infertility are due to abnormalities in the sperm, either in the movement of the sperm or the shape of the sperm or even in the sperm concentration. Other very common causes include Fallopian tube disease, which can often occur in women either post-surgically or can occur as a result of Chlamydia infection or other sexually transmitted infections.
Ovulation disorder is also very common. One of the most common causes that we see is what's called polycystic ovary syndrome, where a woman has poor communication between her brain and ovaries, such that she does not ovulate on a regular basis. Other causes include uterine factors including fibroid tumors or uterine scar tissue that can affect implantation. In major metropolitan centers, we find that age is perhaps the biggest factor that we see. As a woman ages, she has a lower number of eggs and also a lower quality of eggs. It's very important that woman who are in their mid 30's, who have not conceived yet, should see their fertility specialist as soon as possible.
Those are the causes of infertility. Again, sperm factors, uterine factors, problems in ovulation, problems in the eggs themselves and in the sperm. Those are the basic causes. There are some other additional causes, which occur in very small numbers, like problems in the cervical mucus or autoimmune factors. In general, the factors that I mentioned are the most important and the ones that are most important to evaluate as quickly as possible as a woman ages.