Common Infertility Questions Answered

Do you know the answer to these frequently asked infertility questions?

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It can be very emotional when the decision to start a family or not is out of your control. If you've been trying to get pregnant for a long time and haven't been successful, infertility may be an issue. Here are some answers to common infertility questions.

When Should a Couple Become Concerned About Not Becoming Pregnant?

When a couple has failed to conceive after one year of well-timed intercourse, they should seek expert care.

In cases where the woman is older than age 35, treatment should be sought after six months of well-timed intercourse. If a woman knows that she has endometriosis or polycystic ovarian disease, the couple should move immediately to expert care. If the husband has known male factor infertility, meaning he has low or no sperm count, poor morphology or motility, the couple should move immediately to expert care. If a woman has had two consecutive pregnancy losses, the couple should move to expert care.

Are There Any Symptoms That Might Indicate an Inability to Conceive?

Women who have extreme pain associated with ovulation or menstruation may be at risk for endometriosis and should seek expert care. Women who do not ovulate or who have very irregular periods may be at risk for polycystic ovarian disease and should seek expert care. Unmanaged, these diseases can cause serious barriers to fertility.

However, early treatment and expert management can preserve a woman's fertility.

What Are the Most Common Causes of Infertility?

Some of the more common causes of infertility are diminished ovarian reserve (older women or women with premature ovarian failure), blocked fallopian tubes (sometimes because of endometriosis, pelvic inflammatory disease and STDs), endometriosis and polycystic ovarian disease.

Low sperm count, poor sperm morphology (the shape of the sperm) and poor motility (the ability of the sperm to swim in the right direction) are also major contributors to a couple's infertility. The estimates are that overall fertility problems are 50 percent female and 50 percent male.

What are Some Less Common Causes of Infertility?

Although still considered "uncommon" by many practitioners, evidence is mounting that many cases of "unexplained" infertility are actually the result of an immune system malfunction. There are many variances of immune problems, ranging from antisperm antibodies to an outright rejection of a developing fetus. The good news is that there is greatly improved testing now available to screen for these problems, and new treatment protocols are netting unprecedented success rates.

How is Diagnosis Made?

Hormone tests are one way to help diagnose infertility. Additional tests for women include a transvaginal ultrasound to confirm follicle development and release, a hysterosalpingogram to determine that the uterus is normal and fallopian tubes are clear and open and possibly a laparoscopy in cases where endometriosis is suspected. For men, a full sperm workup is essential before any treatment protocol is initiated for the woman.

In cases of recurrent pregnancy loss or known implantation failure (after two unsuccessful in vitro fertilization attempts), the couple should have a complete immune workup, which includes about 30 specific tests available at only a few labs in the U.S.

How Can Fertility Problems Be Prevented?

Sexually transmitted diseases can be a major cause of future infertility, so young women should always have protected sex. Also, women should consult with their doctor if they have irregular menstrual cycles or have painful periods or ovulation.

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