Infertility 101

We sat down with AFMC Medical Director Dr. Vuk Jovanovic to answer the most common questions people have about infertility. Whether you’re experiencing infertility or you would like to know some information to support a loved one, this blog provides the basics of what infertility is all about.


What is infertility?

Dr. Jovanovic: “Generally, infertility is the inability to conceive. If a woman 35 years old is unable to conceive within a year or a woman 40 years old is unable to conceive in six months, fertility physicians would define this as infertility.”


Society tends to associate fertility and fertility issues with women, but is fertility always a women’s issue?

Dr. Jovanovic: “Definitely not.”


So how does infertility impact males and females?

Dr. Jovanovic: “We can, in general say, that about one-third of fertility problems are female-factored, one-third are male-factored, and the remaining one-third is a combined factor between male and female. In terms of male infertility, there are various grades. Infertility impacts men mainly in the way of reduced sperm quantity and quality, as well as increased sperm fragmentation. There are also some males that have a mild impact on their sperm, and others who have a severe impact on their sperm. For females, infertility impacts women naturally as they age, so at some time in each women’s life, she will have fertility issues. Some women have tubal factor infertility, others have problems with their ovaries and fallopian tubes, menstrual cycle, egg quality…so there are many ways for infertility to impact women. However, there are some cases, we are unable to tell the patient exactly what caused the fertility problem, which is called unexplained infertility. Sometimes it’s caused by just waiting too long to conceive.”

If a couple already conceived a child naturally, do they need to worry about infertility?

Dr. Jovanovic: “So if the couple has already conceived a child naturally, some of them do have to worry about infertility occurring. Primary infertility occurs when a couple has never had a pregnancy, but secondary infertility occurs after successfully becoming pregnant with the first or second child. This happens if the couple had a child at a younger age and now is attempting to have another child at a later time. But sometimes, things just naturally change. So yes, it’s definitely possible to experience infertility even among couples who successfully became pregnant with a previous child.”

Infertility is sometimes not spoken about mainstream. Is this because infertility an uncommon medical issue?

Infertility is definitely quite a common issue as it affects 10% – 15% of couples. It’s actually more common than people assume and becoming more common as couples are waiting longer to become pregnant. The problem is, is that many couples are not comfortable bringing up the topic, even to friends and family, and that’s why we don’t hear very much about it.


Being a fertility physician for over 15 years, I’m sure you’ve had a lot of questions and conversational topics come up during patient consultations. What is the most common question asked by patients and what is a frequent myth you hear?

Dr. Jovanovic: “The most common question asked is if there is some sort of magic pill or medication that can make them fertile. Unfortunately, there isn’t a magic pill or medication that can make someone fertile. Usually, it’s a process that involves testing and some sort of treatment that follows. A myth? What is a common myth…This is one I need to think about! Okay, okay. A lot of times people focus on things that won’t affect their fertility situation. Like what positions they’re trying to conceive in, what food to eat, what time of day they’re going to have intercourse. All these things, in most cases, won’t affect the chances to conceive. Some fertility myths are male-focused as well! Myths about how we could improve the sperm, like with certain remedies. In my experience, it could be very hard to improve the sperm and make someone who has poor sperm quality have good sperm quality. It’s extremely rare.”

Infertility seems to be composed of several different factors, but is there a time fertility journeys are the same in some patients?

Definitely not. Every fertility journey is different, and every couple has their own set of circumstances that affect their situation. We have to consider several things. One of our goals here is to take care of each patient, both medically and personally. Testing is always an important thing to consider. But, we always have to consider the emotional well-being of the patient and comfort the patient throughout the fertility treatment. Then we are able to come up with a good plan.”

Speaking of personal care, what is a quote or phrase you use to represent your work as a fertility physician?

Dr. Jovanovic: “Aside from the medical expertise and treatment, I always want to make sure patients feel comfortable and have a pleasant experience.”

And final question. What would you tell people who are always told to keep trying or try harder to conceive by family and friends?

Dr. Jovanovic: “Go find some help. Find a good fertility physician. You don’t have to be alone on your fertility journey.”


Do you have any questions for Dr. Jovanovic? Let us know in the comment section below!


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