Getting pregnant can be challenging for some. There’s a 25 to 30 percent chance per cycle that a woman will get pregnant if she’s in her 20s or 30s. And for both women and men, the chances of conception naturally decrease with age.

If you and your partner are struggling with fertility, it’s important to know some of the basics about treatment so you can make the most out of your appointment with your doctor. Use the following questions as a guide to take with you. Your doctor will give you the best advice based on your individual circumstances.

What’s the first-line treatment for infertility?

Medications are usually the first-line treatment if your doctor diagnoses you with infertility. These medications are designed to help increase the likelihood of conception and pregnancy. They can come in the form hormone replacements to stimulate ovulation in women, or medications to treat erectile dysfunction in men. Your doctor may also recommend lifestyle changes, such as eating a healthy diet or stopping smoking.

Do I need to be in good health for fertility treatments? What about my partner?

Fertility can diminish with age, but some of this has to do with health conditions that may develop as you get older. For example, thyroid conditions in women can affect fertility. Infections, cancer, and poor nutrition can affect both male and female reproductive chances. Also, alcohol consumption, smoking, and certain medications can interfere with fertility.

Ideally, you and your partner will want to be in good health before conception. This not only helps increase the chances of pregnancy, but parental health also directly affects the baby’s health. Your doctor will make specific recommendations to help you get into the best health possible at your medical examination.

What’s the difference between male and female fertility treatments?

Your doctor will determine whether male or female infertility (or both) is keeping you from getting pregnant. Low sperm count or an inability to get or maintain an erection during intercourse can impact fertility in men. In some cases, erectile dysfunction medications may help.

Female fertility is often affected by ovulation difficulties. These may be treated with in vitro fertilization (IVF). This process involves fertilizing sperm with an egg in a laboratory. Once the fertilization process is complete, the egg(s) are transferred to your uterus during ovulation.

Your doctor may also prescribe high-dose hormones, such as estrogen, to help induce ovulation. Other more potent medications come in the form of injections, a process referred to as controlled ovarian hyperstimulation (COH).

What is assisted reproductive technology, and how does it work?

Assisted reproductive technology (ART) is the name for fertility treatments that involve more advanced procedures and techniques. This includes IVF. ART also includes intrauterine insemination (IUI), a type of procedure where sperm is injected directly into the uterus to help fertilize eggs. Third party-assisted ART is another option where couples might opt to have egg, embryo, or sperm donations.

The main difference between ART and COH is that conception occurs with the help of a laboratory with ART. COH allows for conception in the body without the need to go to the doctor’s office.

Is surgery involved during fertility treatments?

Your doctor may need to perform surgery if they find issues with your reproductive organs. In women, surgery is sometimes used to fix torn or blocked fallopian tubes so that an egg can be successfully released and fertilized. Female fertility surgeries may also help treat:

  • scars in the reproductive tract
  • uterine fibroids
  • endometriosis
  • polyps

In men, surgical options may be used to repair varicose veins in the testicles that may be causing problems with erections. Surgery is also sometimes used to help open tubes that transfer sperm to the penis.

Are there any risks involved with treatments for infertility?

Surgery can involve risks, such as infection. Fallopian surgery in women can also increase the risk for ectopic pregnancy, which is a serious condition where an egg and subsequent fetus grows on the outside of your uterus.

Other risks may be posed to the baby, where a low birth weight is possible. There’s also a higher chance of premature birth when ART is used for fertility. Premature birth occurs when your baby is born earlier than 37 weeks’ gestation. The risk is even higher if you’re carrying multiple babies.

Do fertility treatments mean we’ll have multiple babies at once?

ART treatments may produce multiple pregnancies at once. While such cases are on the decline, researchers estimate by 2011 about 35 percent of twin births and 75 percent of triplet or higher-order births in the United States resulted from conception assisted by fertility treatments. Doctors can now reduce this by limiting the number of embryos transferred to the uterus at one time.

What is the overall success rate of fertility treatments?

According to some estimates, between 85 and 90 percent of infertility cases are treatable. This is welcome news to the many families who struggle with infertility in America. But aside from age and health, the success rate also depends on the treatment type you select.

For example, IUI can have a 20 percent success rate compared to a 50 percent success rate from an embryo donation. Your doctor can help give you a better idea of your individual chances of success based on different treatments.

How long do fertility treatments take to work?

Unfortunately, there’s no straightforward answer here. The process of fertility treatments can be long and tiring, which can increase stress if you’ve been trying to get pregnant. To choose the best treatment options possible, your doctor will review your health history and look for any potential reproductive problems in both you and your partner.

COH may be tried before ART, depending on the outcomes of your doctor’s investigation. Even if ART is attempted, it can take multiple tries before a pregnancy occurs. On top of that, these are done once a month, as a female ovulates only once in a 28-day period on average.

Opting for fertility treatments is no easy task, but your doctor can help you determine the right course for the most successful outcome possible.