If getting pregnant has been a challenge for you and your partner, you're not alone. Ten to 15 percent of couples in the United States are infertile. Infertility is defined as not being able to get pregnant despite having frequent, unprotected sex for at least a year for most people and six months in certain circumstances.
Infertility may be due to a single cause in either you or your partner, or a combination of factors that may prevent a pregnancy from occurring or continuing. Fortunately, there are many safe and effective therapies for overcoming infertility. These treatments significantly improve the chances of becoming pregnant.
Most couples achieve pregnancy within the first six months of trying. Overall, after 12 months of frequent unprotected intercourse, about 90 percent of couples will become pregnant. The majority of couples will eventually conceive, with or without treatment.
The main sign of infertility is the inability for a couple to get pregnant. There may be no other obvious symptoms.
In some cases, an infertile woman may have irregular or absent menstrual periods. Rarely, an infertile man may have some signs of hormonal problems, such as changes in hair growth or sexual function.
When to see a doctor
If you're a man, talk with your doctor if you have:
To become pregnant, the complex processes of ovulation and fertilization need to work just right. For some couples, infertility problems can be present from birth (congenital) or something can go wrong along the way that results in infertility.
The reasons for infertility can involve one or both partners. In general:
Causes of male infertility
Causes of female infertility
Other causes in women include:
During each menstrual cycle, an egg is released by one of the ovaries (ovulation). The egg travels into the fallopian tube. If fertilization is to occur, sperm ejaculated into the vagina must swim up ...
Many of the risk factors for both male and female infertility are the same. They include:
Preparing for your appointment
Depending on your age and personal health history, your doctor may recommend a medical evaluation. A woman's gynecologist or a man's urologist or a family doctor can help determine whether there's a problem that requires a specialist or clinic that treats infertility problems. Both you and your partner will likely have a comprehensive infertility evaluation.
What you can do
For infertility, some basic questions to ask your doctor include:
Don't hesitate to ask your doctor to repeat information or to ask follow-up questions.
What to expect from your doctor
Questions for the couple
Questions for the man
Questions for the woman
Tests and diagnosis
Before having infertility testing, be aware of the commitment that's required. Your doctor or clinic will need to determine what your sexual habits are and may make recommendations about changing them. Tests and treatment trial periods may extend over several months. In some infertile couples, no specific cause is found (unexplained infertility).
Evaluation can be expensive and in some cases involves uncomfortable procedures. Many medical plans may not reimburse the cost of fertility treatment. Finally, there's no guarantee — even after all the testing and counseling — that conception will occur.
Tests for men
You may have a general physical exam. This includes an examination of your genitals. Specific fertility tests may include:
Tests for women
You may have a general physical exam. This includes a regular gynecological exam. Specific fertility tests may include:
Depending on your situation, rarely your testing may include:
Not everyone needs to have all, or even many, of these tests before the cause of infertility is found. Which tests are used and their sequence depend on discussion and agreement between you and your doctor.
Treatments and drugs
Treatment of infertility depends on the cause, how long you've been infertile, your age and your partner's age, and many personal preferences. Some causes of infertility can't be corrected. However, a woman may still become pregnant with assisted reproductive technology. Infertility treatment involves significant financial, physical, psychological and time commitment.
Treatment for men
Treatment for women
Assisted reproductive technology
In vitro fertilization (IVF) is the most common ART technique. IVF involves stimulating and retrieving multiple mature eggs from a woman, fertilizing them with a man's sperm in a dish in a lab, and implanting the embryos in the uterus three to five days after fertilization.
Each year thousands of babies are born in the United States as a result of ART. The success rate of ART is lower after age 35.
Other techniques are sometimes used in an IVF cycle, such as:
Complications of treatment
In vitro fertilization
With in vitro fertilization, the doctor uses a needle to remove eggs from the ovary (A). The eggs and sperm are combined in a petri dish (B) and placed in an incubator (C). If fertilization occurs, ...
Coping and support
Coping with infertility can be extremely difficult. It's an issue of the unknown — you can't predict how long it will last or what the outcome will be. The emotional burden on a couple is considerable. Taking these steps can help you cope:
Managing emotional stress during treatment
Managing emotional effects of the outcome
Some types of infertility aren't preventable. But several strategies may increase your chances of pregnancy.
Last Updated: 2013-07-19
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