Infertility is defined as the inability to conceive after one year of unprotected intercourse. It affects an estimated 15% of couples globally. Infertility rates can vary significantly based on gender due to differences in reproductive biology. Understanding how infertility rates differ between men and women is important for identifying causes and potential treatments.
Key Facts About Infertility Rates By Gender
Here are some key facts about infertility rates in men versus women:
- It is estimated that infertility affects about 8-12% of reproductive-aged couples worldwide.
- For about 40% of infertile couples, the primary cause is due to female factors. For another 40%, the primary cause is due to male factors.
- In the remaining 20% of infertile couples, infertility is caused by a combination of male and female factors or is unexplained.
- Women’s fertility starts declining gradually in the early 30s, more rapidly after age 35, and significantly after 40. Male fertility also declines with age but not as abruptly.
- The most common causes of female infertility include ovulatory disorders, uterine or fallopian tube damage, endometriosis, and age-related egg quality decline.
- The most common causes of male infertility include low sperm count, poor sperm motility or morphology, anatomical defects, and genetic issues.
While infertility can affect both men and women, there are some key gender differences in infertility rates and causes. The following sections explore this in more detail.
Female Infertility Rates and Causes
It’s estimated that 1 in 8 couples (or about 12% of) trying to conceive will face female factor infertility. Here are some key statistics on infertility in women:
- Approximately 10% of women ages 15-44 in the U.S. have difficulty getting pregnant or carrying a pregnancy to term.
- For women 35-39 years old, 17% experience infertility. This rises to 26% for women 40-44 years old.
- Ovulation disorders, often related to problems with ovulation regulation by the pituitary gland and hypothalamus, account for 25% of female infertility cases.
- Damage to the fallopian tubes, often due to pelvic inflammatory disease, accounts for another 25% of female infertility cases.
- Endometriosis, a disorder where tissue that normally lines the uterus grows outside of it, accounts for 15% of female infertility cases.
- Uterine or cervical abnormalities such as fibroids or scarring account for 10% of cases.
- Unexplained infertility accounts for approximately 15% of cases.
In summary, the most common causes of infertility in women are ovulatory disorders, fallopian tube damage, endometriosis, uterine abnormalities, and age-related decline in egg quantity and quality. Infertility rates rise steadily with age as egg quantity and quality diminish.
Male Infertility Rates and Causes
It’s estimated that about 1 in 8 couples (or 12%) experiencing infertility face male factor infertility. Here are some statistics on infertility rates in men:
- Approximately 7% of all men ages 15-44 in the U.S. experience fertility problems.
- Male factor infertility contributes to about 30-50% of all infertility cases.
- Low sperm count (oligospermia) affects 10-15% of men and accounts for 20-25% of male infertility.
- Poor sperm motility (asthenozoospermia) affects 10-15% of men and accounts for 20-25% of male infertility.
- Abnormal sperm shape and size (teratozoospermia) affects 10-15% of men and accounts for 10-15% of male infertility.
- Combinations of low count, poor motility, and abnormal morphology cause about 50% of male infertility.
- Obstructions like varicocele affect about 40% of infertile men.
- Unexplained male infertility accounts for about 10% of cases.
In summary, the most common causes of male infertility are low sperm count, poor sperm motility and morphology, anatomical defects, and unexplained factors. Unlike female fertility, male fertility does not seem to decline sharply with age.
Comparison of Infertility Rates Between Genders
Both men and women can face infertility challenges fairly equally. However, some research suggests infertility rates may be slightly higher in men than women:
- A study in the journal Human Reproduction found infertility rates of 33.8% in men vs 28.1% in women in couples actively trying to conceive.
- An older study found that across couples actively trying to conceive, infertility was attributable solely to the male in about 20% of cases vs 10% attributable solely to the female.
- However, female age is one of the strongest predictors of infertility. 60% of infertile couples include a female partner older than 35.
Here is a summary table comparing infertility rates and causes by gender:
| Gender | Estimated Infertility Rate | Common Causes |
|---|---|---|
| Female | 10-15% | Ovulatory disorders (25%), Tube damage (25%), Endometriosis (15%), Uterine abnormalities (10%), Age-related egg factors (10%), Unexplained (15%) |
| Male | 7-12% | Low sperm count (20-25%), Poor sperm motility (20-25%), Abnormal sperm (10-15%), Obstructions (40%), Unexplained (10%) |
Based on the research, it appears that male factor infertility may play a role in a slight majority of couples struggling with infertility. However, female age also significantly impacts fertility, so infertility rates tend to be higher in couples where the woman is over 35.
Risk Factors For Infertility
In addition to gender, there are various risk factors that can increase the chances of infertility:
Female Risk Factors
- Age over 35
- History of irregular periods, PCOS, or amenorrhea
- Endometriosis
- Pelvic inflammatory disease
- Uterine fibroids
- Eating disorders
- Thyroid disorders like hypothyroidism
- Cigarette smoking
- Excess alcohol use
- Obesity
- Anorexia
- Chemotherapy or radiation treatment
Male Risk Factors
- Varicocele
- Testicular trauma or infection
- Chromosome defects
- Cancer treatment
- Pituitary disorders
- Congenital defects
- Cigarette smoking
- Excess alcohol use
- Anabolic steroid abuse
- Obesity
- Diabetes
- Abnormal heat exposure
Being aware of these risk factors can help identify potential causes of infertility and allow early interventions to improve fertility outcomes.
Evaluating Infertility in Men vs Women
When an infertility workup is conducted on a couple, tests will be done to evaluate both male and female fertility factors. Here is an overview of how infertility is evaluated in each gender:
Female Infertility Evaluation
- Medical history – Menstrual cycle regularity, prior pregnancies/miscarriages, pelvic issues, medications, etc.
- Physical exam – Pelvic exam to check for anatomical abnormalities.
- Ovulation testing – BBT charts, urine LH tests, or blood tests to confirm ovulation.
- Hormone testing – Blood tests to check hormones like FSH, estrogen, TSH, prolactin.
- Imaging tests – Pelvic ultrasounds or hysterosalpingograms to examine uterus and fallopian tubes.
- Laparoscopy – A surgical procedure to view the pelvic organs.
- Ovarian reserve testing – Blood tests like AMH levels to estimate egg supply.
Male Infertility Evaluation
- Medical history – Prior fertility, sexual function, medications, medical conditions.
- Physical exam – To examine the genitals and look for varicocele, etc.
- Semen analysis – Examines semen volume, sperm count, motility, and morphology.
- Hormone testing – Testosterone, LH, FSH levels.
- Genetic testing – Karyotype and cystic fibrosis screening.
- Imaging – Scrotal ultrasound to examine epididymis, testicles, and ducts.
- Testicular biopsy – Extracting testicular tissue to examine under a microscope.
This thorough medical detective work is needed to identify the potential causes impacting fertility in both partners. Treatment can then be tailored after the root causes are discovered.
Treatments For Infertility
Depending on the cause of infertility, various treatments may be recommended. Some options include:
Female Infertility Treatments
- Ovulation induction medications like Clomid, gonadotropins.
- Intrauterine insemination (IUI) – Inserting sperm directly into the uterus.
- Surgery – laparoscopic surgery to remove endometriosis, fibroids, clear blocked tubes.
- Assisted reproductive technology (ART) – In vitro fertilization (IVF) using the woman’s own eggs.
- Donor eggs – Using another woman’s eggs during IVF.
- Gestational carrier – Using another woman’s uterus to carry the pregnancy.
Male Infertility Treatments
- Medications – Clomid, gonadotropins, or testosterone gel to improve sperm production.
- Surgery – Varicocele repair, removal of blockages.
- Intrauterine insemination (IUI) – Inserting sperm directly into uterus.
- Assisted reproductive technology (ART) – In vitro fertilization (IVF) using the man’s sperm.
- Donor sperm – Using another man’s sperm during IVF or IUI.
The right treatment depends on factors like age, specific diagnosis, duration of infertility, and personal preferences. ART like IVF has the highest success rates but is also very expensive. IUI with fertility drugs is less invasive and costly but also has lower success rates per cycle.
Coping With Infertility
Battling infertility can take an emotional toll on both partners. Here are some tips for coping:
- Seek support – Talk to your partner, friends, family, and support groups.
- Explore different treatment options – IVF, IUI, surrogacy, or adoption.
- Practice self-care – Make time for activities you enjoy, eat healthy, exercise.
- Consider counseling – Mental health support can help manage stress and grief.
- Communicate with your partner – Share your feelings and remember you are in it together.
- Be patient and stay hopeful – Recognize progress however small.
Dealing with infertility challenges is difficult. However, various medical solutions and alternative paths to parenthood exist today. With time, support, and perseverance, most couples can ultimately become parents in some form despite infertility.
Conclusion
Infertility is a common condition affecting millions globally. Although infertility rates may be slightly higher in men, both genders contribute equally in about 1/3 of infertile couples. Female age is also a strong infertility risk factor. Ovulatory disorders, sperm abnormalities, reproductive tract blockages, endometriosis, and age-related decline are leading causes. Infertility evaluation examines hormone levels, ovarian reserve, semen analysis, reproductive anatomy, and genetic factors. Treatment options range from fertility drugs to IVF to surrogacy and adoption. With support and perseverance, most couples can attain parenthood despite an infertility diagnosis using one of the many paths available today.