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Updated on Apr 1, 2021 by Dr. Fernando Mariz (Gynecologist), Manhattan Women’s Health and Wellness

Infertility affects 2 out of 10 women in the US

Even though around 80% of women who try for pregnancy will become pregnant within 12 months, according to the CDC, 10-20% of women of childbearing age will be diagnosed with infertility or subfertility this year. This can be devastating when planning for pregnancy, especially due to the tumultuousness of life and family planning.


Infertility Workup and EvaluationInfertility is generally defined as 12 months of unprotected intercourse without conception, and actually only six months of unprotected intercourse without conception in women over the age of 35. While these are strict guidelines, it is sometimes useful to begin an assessment of fertility prior to reaching this point, especially if there are known factors that can cause subfertility (difficulty getting pregnant) that can be mitigated early on.
Gynecologist of Manhattan Women’s Health & Wellness offer comprehensive Obstetrics & Gynecology care in New York City for women of all ages. At our obgyn clinic, we provide a full range of gynecology services, from annual check-ups and routine pap smears to initial infertility workup and GYN procedures, surgeries performed in our office or in the hospital. Our state-of-the-art gynecology NYC facility equipped with the latest obgyn equipment.

Causes of Infertility

Causes of infertilityInfertility or subfertility can be caused by a multitude of problems. Your NYC Midtown gynecologist, Dr. Fernando Mariz will always start with taking your medical history to see if there are any clues that might aid in knowing why you have not been able to achieve a pregnancy. After that, the gynecologist will likely investigate each of the major causes of infertility with different tools available to them:

  • Hormonal causes – these are very common and can sometimes be corrected with medications. Clues to hormonal causes of infertility can include not having your period regularly every month, having irregular spotting or bleeding, or having male pattern hair growth, such as hair on your chin, chest, back, or belly. Polycystic ovarian syndrome, PCOS, is a common hormonal abnormality that can lead to difficulty becoming pregnant. When diagnosed with PCOS, it is important to see a gynecologist when planning pregnancies, as they may be able to help increase your fertility.
  • Uterine abnormalities – Anything that has the ability to distort the uterus in a way that would make it difficult for sperm to enter the uterus, or an embryo to implant within the uterus, or even take away blood supply from the uterine lining, can cause difficulty with pregnancy. Some of these issues can include but are not limited to, polyps (small abnormal outpouchings of the inner layer of the uterus, essentially skin tags inside the uterus), fibroids (muscular tumors that can grow in any or multiple layers of the uterus), and septums (pieces of tissue that connect one side of the inner lining of the uterus to the other side, distorting the overall shape of the uterus). Luckily these can be corrected usually with office-based procedures.
Causes of infertility

Other important abnormalities can also include a misshapen uterus, two uteri, or no uterus at all. An ultrasound exam is an important step in diagnosing these abnormalities, and in some cases, you may need a hysteroscopy, that is, a small procedure where a tiny camera is introduced into the uterus in order to diagnose, and potentially treat problems that are seen during the exam.

  • Fallopian tube problems – The fallopian tubes function to carry an egg, once released, from the ovary into the uterus. This is done via rhythmic contractions of the tubes. Abdominal trauma, history of abdominal surgery, ruptured appendix, or even pelvic infections such as pelvic inflammatory disease (PID) can damage the fallopian tubes and even block them off completely. Your Midtown gynecologist may order special imaging such as a Hysterosalpingogram (HSG), a test where dye or fluid is placed into the uterus, and either with ultrasound or X-ray, the tubes are noted to see if they are open and communicate freely with the ovary.
  • Male factor infertility – This relates to any problems that may affect male sperm. Sperm are important factors infertility as one sperm must combine with an egg in order to produce an embryo (early baby). Sperm can have several problems such as low count (not having enough sperm), low motility (not moving correctly), morphology (being misshapen). A sperm analysis can elucidate any of these issues. Ejaculatory problems can also cause infertility, i.e. the sperm not being able to make their way into the vagina and uterus.
  • Other – This includes medications you may be on, a prior medical history that can cause problems with fertility, obesity, or be severely underweight, current treatments you may be undergoing, perimenopause or premature ovarian failure, and even in the frequency of intercourse.


Many forms of infertility can be reversed or fixed

IUDs are generally considered to be an extremely low risk during placement, maintenance, and removal. During placement, the risk of infection, perforation (poking a hole through the uterus and the IUD going inside the abdomen which would require a small surgery to remove), or pain, can all occur. Luckily, these are all very rare, and there are ways your gynecologist can mitigate these risks, such as using ultrasound during the placement of the IUD.

Over one third of infertility is male related

Once you have had a full evaluation, your gynecologist will discuss the next best in treating your infertility or subfertility. There are many ways to aid infertility that can be done in the office such as ovulation induction (making you ovulate more) with medication, timed intercourse, fixing any uterine abnormalities with hysteroscopy, or more sophisticated management such as intrauterine insemination (IUI), or In Vitro Fertilization IVF.

Important Reminder: This information is only intended to provide gynecology guidance, not definitive medical advice. Please consult an OBGYN doctor about your specific condition. Only a trained, experienced gynecologist or certified gynecology specialist can determine an accurate diagnosis and proper treatment.

Have questions about Infertility evaluation? Schedule an appointment with the best OBGYN in Manhattan, NY, Dr. Fernando Mariz by calling our office today.

Dr. Fernando Mariz has either authored or reviewed and approved this content.
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DISCLAIMER: PLEASE READ CAREFULLY The information on this website is to provide general information. The information on this website does NOT reflect definitive medical advice and self diagnoses should not be made based on information obtained online. It is important to consult a physician for a consultation and examination regarding ANY and ALL symptoms or signs you may be having. An accurate diagnosis and treatment plan should only be made by your physician in order to exclude a serious condition.