What is infertility?
Infertility is defined as a couple's inability to become pregnant after 1 year of sex without using birth control. When considering whether you may have an infertility problem, however, bear in mind that "normal fertility" is defined as the ability to naturally conceive within 2 years' time. Sometimes it's a matter of determining when you are most fertile. If you are not sure when you ovulate, use this interactive tool to calculate your peak fertility.
Of all couples who have not conceived after 1 year, about half will go on to conceive naturally in the following year. 1 If you are a younger couple, this is encouraging news. However, if you are 35 or older, another year may be too long to wait before seeking testing and treatment.
A woman's fertility declines from her mid-30s into her 40s, as her egg supply ages. At the same time, her risk of miscarriage increases. Although a man's sperm count decreases with age, male fertility is not known to be greatly affected by age. 2
What causes infertility?
Infertility can be caused by problems with either the man's or woman's reproductive system, or both. Some conditions are hormonal in nature, and others are structural problems in the reproductive organs that require surgical repair.
Half of all couples tested for a cause of infertility are affected by a problem with the woman's fallopian tubes or uterus or her ability to ovulate. About one-third find that their infertility is caused by problems in the male reproductive tract. Some couples find that both partners have problems that are contributing to their infertility. 1 See illustrations of the female reproductive system and the male reproductive system.
In 10% of infertile couples, no cause is found despite thorough testing. 1
Should I be tested?
Experts usually recommend that fertility testing begin at home. By using fertility awareness and basal body temperature readings, a woman can identify her fertile period. Some couples find that they simply have been missing their most fertile days when trying to conceive.
Consider medical testing for a cause of infertility if you:
* Have noticed a physical problem (such as an absence of ejaculation or ovulation, or menstruation irregularities) or have a history of repeat miscarriages or pelvic inflammatory disease.
* Are in your mid-30s or older and have been unable to conceive after 6 months of regular sex.
* Are in your 20s to early 30s and have been unable to conceive after a year or more of regular sex.
Initial testing for a couple's cause of infertility evaluates both partners' lifestyle habits and health. Among other general health factors, your health professional will focus on sperm and egg production, checking sperm counts and ability to ovulate. If no cause is found, you can decide whether to proceed with further testing.
What kind of treatment is available?
Infertility treatment ranges from simple home treatment to specialized surgical, hormonal, and assisted reproductive technology treatments. Some of these can have high financial, physical, and emotional costs.
Before trying treatment for infertility, discuss your financial and emotional limits ahead of time and start out with a sense of how far you are willing to go with testing and treatment.
Learning about infertility:
* What causes infertility?
* Does it take longer to get pregnant after stopping hormonal birth control?
* Are there symptoms of infertility?
* What increases our risk of infertility?
* When should we see a doctor?
* Who is affected by infertility?
Being diagnosed:
* How do we identify the best days to conceive?
* Do we need to see a specialist?
* How will our doctor diagnose a cause of infertility?
* What should we consider when setting limits on infertility testing?
* Should I have infertility testing?
* Should I consider adoption as an alternative to infertility treatment?
Getting treatment:
* How is infertility treated?
* What should we consider when setting limits on infertility treatment?
* What kinds of medications are used to treat infertility?
* What questions should we consider about medication or hormone treatment?
* What kinds of surgeries are used to treat infertility?
* What questions should we consider about surgery to treat infertility?
* What is assisted reproductive technology?
* What questions should we consider about assisted reproductive technology?
* What are the odds of conceiving a multiple pregnancy with infertility treatment? What are the risks?
* Is pregnancy possible after cancer treatment?
* Should I have infertility treatment?
* Should I have a tubal procedure or in vitro fertilization for tubal infertility?
Personal considerations:
* What emotional and social issues are related to infertility?
* What ethical and legal issues are related to infertility?
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