Infertility is a problem for an estimated 6.1 million people—roughly
10 percent of US couples. Though two people may be physically capable
of having children, they are considered infertile if they have not
achieved pregnancy after six months to a year of unprotected sex.
Fortunately, many couples who are treated for fertility problems
are able to conceive after therapy.
Infertility may be due to factors related to the female partner,
the male partner, or a combination of both. In some cases, the cause
of infertility is never identified.
Increasing age, improper ovulation (release of eggs from the ovaries),
abnormal anatomy, or scarring or blockages in the fallopian tubes
are the main causes of infertility in women. Gynecologic conditions,
such as polycystic ovary syndrome, endometriosis, and fibroids,
can also make it difficult for a woman to conceive.
Male fertility also declines with age, but at a slower rate. Infertility
in men usually involves problems with the sperm. Sexually transmitted
diseases (STDs) or an injury to the testicles, such as overheating
(from spending too much time in a hot tub, for example) or a reaction
to medication, can lead to short term infertility in men.
If you are having trouble getting pregnant, see your ob-gyn. Your
doctor may order a group of tests to understand what is causing
the problem. You may be referred to a reproductive endocrinologist—a
doctor who specializes in infertility—or other counselors and
specialists.
Standard fertility
testing for women includes a physical exam and a health history
that focuses on menstrual function and a woman’s history of
pregnancy, STDs, and birth control use. Blood and urine samples
may be analyzed to confirm that normal ovulation is taking place.
X-rays or ultrasounds may be used to view and inspect the reproductive
organs for any abnormalities. To test for male fertility, a semen
sample will be checked for the number, shape, and movement of a
man’s sperm and for signs of infection.
Infertility can be treated in a variety of ways depending on the
cause. If you are overweight or obese, losing weight may improve
your chances of getting pregnant. Medications that stimulate the
ovaries or regulate blood insulin levels (which can interfere with
ovulation) may be pre-scribed. Your doctor can also help you decide
if surgery or assisted reproductive therapies, such as in vitro
fertilization, are right for you.
For more information, the ACOG Patient Education Pamphlet “Evaluating
Infertility” is available in English and Spanish at www.acog.org/publications/patient_education/.
The American Society for Reproductive Medicine also provides resources
for patients at www.asrm.org/patients/mainpati.html.
