• Dealing With Fertility Problems

    If you have been trying to get pregnant for a year or more (six months or more if you are 35 or older), you may want to visit your doctor to discuss your fertility. Getting pregnant requires a complex chain of events to fall in place. If one piece of that chain is not occurring properly, there are many fertility treatments that can help you to become pregnant.
    While a few women easily get pregnant soon after they start trying, many women face fertility problems. Infertility affects more than six million Americans, or 10% of the reproductive-age population.
    You should schedule a visit with your doctor to discuss your fertility if you:
    • Are under age 35 and have not been able to get pregnant after a year of frequent sex without birth control
    • Are age 35 or older and have not been able to get pregnant after six months of frequent sex without birth control
    • Have reason to believe you or your partner may have fertility problems, even before trying to get pregnant
    There are a number of factors that affect infertility. In women, advancing age, uterine fibroids , endometriosis , pelvic inflammatory disease , polycystic ovarian syndrome (PCOS) , premature ovarian failure (POF), luteal phase defect (LPD), smoking, alcohol use, extreme underweight or overweight, strenuous exercise, eating disorders, and sexually transmitted diseases (STDs) are examples of factors that can affect fertility. In men, advancing age, alcohol, drugs, STDs, diabetes, prostate surgery , and testicle injuries or problems are factors that can lead to infertility.
    Advancing age is associated with declining fertility, especially in women after age 35. Men often remain fertile into their 60s and 70s, although advancing age can be linked to problems with the shape and movement of sperm.
    If your doctor performs fertility testing on you and/or your partner and finds a problem with fertility, there are a number of treatment options that can help you get pregnant. The table below lists some of the most common fertility treatments.
    Treatment Description
    Medications There are a variety of medicines that can be used to treat infertility. Many of these medicines can be used to treat women with ovulation problems. Your doctor will explain the medicine options that will be of most benefit to you.
    Surgery Often, surgery can be performed to treat male or female infertility, especially if it is due to a structural problem (e.g., damage to the ovaries, fallopian tubes, or uterus).
    Intrauterine insemination (IUI) Intrauterine insemination, or artificial insemination, involves injecting a woman with sperm from her husband or sperm donor. IUI is often used with medicines to encourage ovulation.
    In vitro fertilization (IVF) In IVF, medicines are used to encourage the ovaries to produce multiple eggs. The eggs are removed when they are mature. They are cultured in a dish with sperm. Fertilized eggs are placed into the woman’s uterus or fallopian tubes.
    Donated gametes (reproductive cells) or embryos A woman or man may have problems producing eggs or sperm or may have genetic problems that could be passed on to offspring. Donated eggs, sperm, or embryos, along with IVF, can be used to achieve a pregnancy.
    Surrogacy If a woman is unable to carry a pregnancy or cannot safely carry a pregnancy, a surrogate carrier may be used. In surrogacy, an embryo is placed in the surrogate, who carries the pregnancy until birth and then gives the baby to the parents.

    RESOURCES

    National Women’s Health Information Center http://www.womenshealth.gov/

    National Infertility Association http://www.resolve.org

    CANADIAN RESOURCES

    The Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org

    Women's Health Matters http://www.womenshealthmatters.ca/

    References

    Evaluating infertility. American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq136.pdf?dmc=1&ts=20121226T0618408458 . Accessed December 26, 2012.

    Infertility. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/infertility/ . Accessed December 26, 2012.

    Treating infertility. American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq137.pdf?dmc=1&ts=20121226T0617520655 . Accessed December 26, 2012.

    What is infertility? The National Infertility Association website. Available at: http://www.resolve.org/infertility-overview/what-is-infertility/ . Accessed December 26, 2012

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