1750 South Harbor Way, Suite 200

Barriers to Pregnancy

There are many reasons why a woman can’t get pregnant, and not all of them are medical. Stress and emotional health can impact fertility. For others, there are financial hurdles that keep a couple from seeking help.

Dr. Stoelk is sensitive to these very real problems. He spends considerable time helping his patients identify and resolve even non-medical issues that separate them from their dream of having a child. When necessary, Dr. Stoelk will recommend other resources, such as counseling.

For most people, the problems fall into one or more of the seven barriers to pregnancy.

When  you come into our office for a consultation or treatment, we will focus on your unique needs. From the very beginning, we partner with you on reaching success. Every step fo the way – your hopes, your fears, and your personal philosophy will guide us.

Dr. Stoelk’s Philosophy

The causes for infertility can usually be identified in one or several of the Seven Barriers to Pregnancy.

Sperm survival

Even with normal count, poor survival in the women’s cervical mucous may prevent pregnancy.

Sperm factors

Low count, lazy swimmers, poor shape and immune (“allergy”) problems will decrease pregnancy success rates.

Tubal blockage

Full blockage of the Fallopian tubes may be from previous infections, ectopic pregnancy, or tubal ligations. Less severe problems can be from adhesions (scar tissue) around the ovaries or tubes.

Ovulation problems

Many women are not good ovulators for various reasons. Some never ovulate; others ovulate, then have low hormone levels that making the implantation site inadequate for pregnancy, and this may lead to frequent miscarriages. Polycystic ovarian syndrome (PCOS) is a very common special category and very treatable, but often needs additional medications and modifications.


This is where tissues from inside the uterus are implanted outside the uterus on the pelvic surfaces and ovaries. This leads to inflammation, and the sperm cannot fertilize the egg. This problem is quite common but very often overlooked or not regarded as a “real” cause of infertility. Even when surgery is performed, most physicians who are not specialists in endometriosis will only get a partial cure and pregnancy still does not occur.

Age-related issues

The single best predictor of fertility success is the women’s age. Natural pregnancy rates and treatment success rates clearly correlate with age, declining from the early 30’s on, worse from 35-40, and very poor thereafter. Any fertility treatment game plan must be tailored to female age. Contrary to common opinion, the “biological clock” does not care about general health or how good of shape you are in, your nutrition, or your previous pregnancies.

Unusual factors

Uterine fibroids or polyps, female or male serious health problems, impotency or ejaculation problems are examples of unusual factors. Also, work and travel that often separates the couple will clearly slow them down. Increasingly, we are seeing men on testosterone therapy, sometimes for very marginal reasons, and they unknowingly cause their own decreased fertility.

When we have sorted out these factors, we can set up a logical treatment plan. Other factors such as finances/social/ emotional/ethical issues and the sense of urgency will impact how fast the couple proceeds. As stated before, the woman’s age is critical and delay may not be wise if she is older. There is almost always a way to parenthood for every situation, but not every couple will choose to pursue these options. We fully respect their choice at every step.