My husband and I spent so much time and energy trying not to get pregnant, we didn’t realize how difficult it could be when we decided to start a family.
Infertility is a medical condition that affects millions of couples in the United States. It affects both men and women of all races and ethnicities equally.
Here’s what you need to know if you are trying to get pregnant and experiencing infertility.
How Common Is Infertility?
The average 30-year-old woman has only a 20 percent chance of conception each month, according to the American Society for Reproductive Medicine (ASRM). By age 40, that number declines to a 5 percent chance each month.
That said, most “healthy” couples will conceive within a year of trying to get pregnant.
If a woman under the age of 35 isn’t pregnant within a year, she should see a fertility expert. But doctors recommend that a woman over the age of 35 see a specialist if she isn’t pregnant within six months. This will give her the best chance of pregnancy with treatment.
If you know that you have a problem that affects your fertility, you should see your doctor much sooner.
What Causes Infertility?
Infertility can happen to anyone for a number of reasons. Here are four issues that doctors look out for.
Female Factor Infertility
Your doctor will look for abnormalities of the ovaries, eggs, fallopian tubes, and uterus. The most common causes of female factor infertility are irregular or absent ovulation.
A woman can also have blocked fallopian tubes or structural problems with her uterus. These conditions can prevent sperm from meeting an egg, or a fertilized egg from implanting in the uterus. There can also be hormonal or genetic abnormalities that cause infertility or recurrent miscarriages.
Male Factor Infertility
Male factor infertility is diagnosed when there is a problem with sperm cells. Doctors will measure the number, mobility, and percentage of normal sperm cells that a man produces.
An abnormal value of any of these factors can cause infertility. This can range from a mildly decreased sperm count to a total lack of sperm production.
The causes for male factor infertility vary, but they can be structural, hormonal, genetic, or even behavioral (such as from drug use).
Approximately 5 to 10 percent of couples suffer from unexplained infertility, according to ASRM.
This means a doctor hasn’t been able to find a cause for the couple’s infertility. It can be very frustrating for couples because it isn’t something that can be fixed.
Some couples have both male factor and female factor infertility. The male partner might have a low sperm count and the female partner might have a blocked fallopian tube, for example.
These couples usually need help in order to conceive.
There are several options available to treat infertility. Your diagnosis, age, and budget will help your doctor determine which treatments might work for you.
Some treatment options can be very expensive and will not likely be covered by your health insurance.
Here are four treatments your doctor might recommend.
This is the simplest form of treatment available. It is appropriate for women who either don’t ovulate or have difficulty detecting their ovulation.
The doctor will either give you medication to make you ovulate, or will monitor your own natural ovulation. When the time is “right,” you’ll be given instructions to have sex over the next few days. If you aren’t pregnant within a few cycles, your doctor will probably recommend a more aggressive treatment.
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During intrauterine insemination, your partner will produce a sperm sample that will be specially washed to remove extra cells.
The doctor will then pass a small catheter into your uterus. Finally, the sperm will be injected through the catheter and into the uterus. This is done right around the time of ovulation. It can be done with your natural cycle, or while taking medication to cause ovulation.
In Vitro Fertilization (IVF)
IVF can be a stressful process for a couple to go through. The woman takes a series of injections to help her ovaries to make a lot of eggs. Once those eggs are mature, they are removed from the ovary during a simple surgical procedure.
The eggs are fertilized with the partner’s sperm in the lab. Fertilized eggs, known as embryos, are grown in the lab for a few days. One or two good quality embryos are then transferred into the woman’s uterus three to five days after the egg retrieval procedure.
Third Party Reproduction
Third party reproduction involves using a third person to help you get pregnant. This can be a sperm donor, an egg donor, or a gestational carrier.
Sperm donors can be used in either insemination or IVF cycles. Egg donors and gestational carriers must be used during an IVF cycle.
The good news is that most couples will eventually get pregnant, even if it doesn’t happen in the way that they imagined.
Remember you are not alone in this journey. Don’t hesitate to reach out to the many resources available to support you along the way. Visit resolve.org to learn more.
Nicole is a registered nurse specializing in women's health and infertility issues. In the last eight years, she has cared for hundreds of couples across the country and is currently working in a large IVF center in southern California. Her book, “The Everything Fertility Book,” was published in 2011. She also runs Tiny Toes Consulting, Inc., which allows her to provide personalized support to couples in all stages of their infertility treatment. Nicole earned her nursing degree from Pace University in New York City, and also holds a B.S. in biology from Philadelphia University.