Infertility is defined as the inability to become pregnant after one year of trying for women less than 35 years of age or after six months of trying for women over 35. Women who are able to become pregnant but cannot stay pregnant may also be infertile. About 10 percent of women ages 15-44 in the United States have difficulty getting pregnant or staying pregnant, according to the CDC. Approximately 15% of American women of childbearing age receive care for infertility each year.
Both women and men can have problems that cause infertility. About one-third of infertility cases involve problems with the female, one-third are due to problems with the male, and the other cases are due to a mixture of male and female problems or unknown problems.
Ovulation dysfunction is the most common cause of female infertility. Without ovulation (release of an egg from the ovary), there are no eggs to be fertilized. Some indications that a woman may not be ovulating normally include irregular or absent menstruation.
Polycystic ovarian syndrome (PCOS) is a common cause of female infertility. PCOS is a hormone imbalance problem that can interfere with ovulation. Ovarian insufficiency is another cause of ovulation problems. Ovarian insufficiency occurs when a women’s ovaries stop working normally before age 40.
Other causes of female infertility include:
85 to 90 percent of infertility cases are treated with conventional therapies, such as drug treatment or surgical repair of reproductive organs. Although IVF is usually every couple’s best chance for pregnancy, most couples do not need it. The majority of infertile couples who achieve pregnancy do so without employing the most expensive, most “high tech” interventions.
Your provider will thoroughly review your medical, family, and social history. You should bring all pertinent medical records, including any previous reproductive treatment you have received.
Beginning the infertility investigation with a new patient is much like opening a mystery novel.It is most effective to begin with the simple evaluation methods and move to the more complex. Because of the myriad causes of and contributing factors to infertility, it is important to use a process of elimination, determining what the problems are not in order to better understand what they are.
Specific fertility tests will be recommended and may include:
Although there are common approaches to the evaluation of infertility, each woman and her partner are unique in their specific situation and deserve individualized care. We believe that our patients are in partnership with us to seek the most thorough explanation of “why” successful pregnancy has not occurred and to formulate a plan that will have the greatest potential to help them in their quest for a child.
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