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Infertility means not being able to get pregnant. You may have fertility problems if you couldn't get pregnant after trying for at least 1 year (or 6 months if you're over 35). It doesn't mean you'll never get pregnant. Some people conceive without help in their second year of trying. Treatments help many people.
Most cases of infertility are caused by a problem with the female or male reproductive system. This can include a problem with the eggs, with the uterus or fallopian tubes, or with sperm. But sometimes no cause can be found.
The main symptom of infertility is being unable to get pregnant after 6 to 12 months of trying, depending on your age.
Doctors can do tests and ask you questions about your past health to check for infertility. Tests may check hormone levels, semen quality, or the uterus, fallopian tubes, and ovaries.
A wide range of treatments may be used for infertility. Depending on the cause, they include:
You may also consider in vitro fertilization (IVF). During IVF, eggs and sperm are mixed in a lab to fertilize the eggs. Then the doctor puts one or more fertilized eggs into the uterus.
Treatment for fertility problems can be stressful and costly. Before you start, think about how far you're willing to go with treatment. You may change your mind later, but it's a good idea to start with a plan.
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Infertility may be caused by:
Rates of infertility and miscarriage increase with age. Female fertility peaks in the late 20s. It slowly starts to decline in the early 30s. A larger drop in fertility and increase in miscarriage risk begins around the mid-30s. This is mainly because of the aging egg supply. Male fertility also decreases with age. But it's a more gradual decline.
Things that increase your risk for infertility include:
Sometimes infertility is related to lifestyle or other health conditions. To help protect your fertility:
If you have been diagnosed with cancer and hope to have children in the future, talk to your doctor about your options to help preserve fertility.
Consult with your doctor if you:
Before seeking medical help with conception, you can increase your chances of becoming pregnant by practicing fertility awareness. This means charting your basal body temperature and using home tests to let you know when you are likely to ovulate and be fertile.
For your first fertility questions and testing, you can see:
For complete fertility testing, see an obstetrician/gynecologist with special training and experience in fertility problems. This doctor may be called a reproductive endocrinologist or fertility specialist. When looking for a specialist, ask what percentage of a doctor's practice is fertility treatment. Also ask if the doctor has training in reproductive endocrinology.
To check for infertility, a doctor can:
Before you have fertility tests, it may help to try fertility awareness. Chart basal body temperature and use home tests to learn when you are likely to ovulate and be fertile. Some people find that they have been missing the most fertile days when trying to conceive.
A wide range of treatments may be used for infertility. Treatment depends on the cause of fertility problems. They can include:
Treatment may include taking medicine, such as:
If your fallopian tubes are blocked, treatment may include tubal surgery.
If mild to moderate endometriosis seems to be the main reason for your infertility, treatment may include laparoscopic surgery to remove endometrial tissue growth. This treatment may not be an option if you have severe endometriosis.
Depending on the cause of the problem, treatment may include medicines, surgery, or insemination. If your doctor recommends insemination, the sperm are collected. Then an increased number of healthy sperm are placed inside the uterus.
If your doctor can't find out why you haven't been able to get pregnant, treatment may include:
Many people who have problems getting pregnant consider assisted reproductive technology (ART). The most common type of ART is in vitro fertilization (IVF). During IVF, eggs are fertilized by sperm in a lab. The fertilized egg or eggs are then placed in the uterus through the cervix. Sometimes a technique called intracytoplasmic sperm injection, or ICSI (say "ICK-see"), is used during IVF. With ICSI, each egg is injected with one sperm in the lab. This can help fertilize the eggs.
Before you start treatment, talk about how far you want to go with treatment. For example, you may want to try medicine but don't want to have surgery. You may change your mind during your treatment. But it's good to start with an idea of what you want your limits to be.
Treatment for fertility can also cost a lot. And provincial and private health plans often don't cover these expenses. If cost is a concern for you, ask how much the medicines and procedures cost. Then find out if your health plan covers any costs.
To decrease the risk of fertility problems and increase the chances of pregnancy, use the following guidelines.
Very strenuous exercise may be a cause of lower sperm counts in some men.
High scrotal temperatures may decrease sperm count and quality.
High fever has been known to have a harmful effect on sperm for 2 to 3 months afterward. (Sperm take this long to grow from germ cells to mature sperm.)
When you have infertility, you may feel alone, confused, or scared. Talking with others about your feelings can help. Here are some places you may find support.
Medicine or hormone treatments are often the first steps in fertility treatment. They're also used for in vitro fertilization (IVF) and other assisted reproductive technologies. Medicines include:
For some people with fertility problems, a structural problem can be treated with surgery. Treatment can increase the chances of natural conception.
When thinking about surgery, ask your doctor questions about the procedure. For example, how many times has the surgeon done the procedure? What are the chances of treatment success? How long will it take to recover?
Surgery may include:
If you have severely blocked fallopian tubes, your doctor may advise you to skip surgery and have in vitro fertilization (IVF). IVF is also often recommended first for women over 34 (regardless of the type of blockage). This is because tubal surgery and natural conception may use up precious time if IVF might be used later.
Complementary medicine may help you stay well and cope with infertility. Complementary medicine for fertility includes:
Talk with your doctor about any complementary health practice that you would like to try or are already using. Your doctor can help you manage your health better if they know about all of your health practices.
Current as of: November 22, 2021
Author: Healthwise StaffMedical Review: Kathleen Romito MD - Family MedicineAdam Husney MD - Family MedicineFemi Olatunbosun MB, FRCSC - Obstetrics and Gynecology
Current as of: November 22, 2021
Author: Healthwise Staff
Medical Review:Kathleen Romito MD - Family Medicine & Adam Husney MD - Family Medicine & Femi Olatunbosun MB, FRCSC - Obstetrics and Gynecology
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