Infertility is not being able to conceive after a year of trying. This means having regular, unprotected sex. About one-third of cases are caused by male factors. An equal number are caused by female factors. In the remaining cases, the cause is unknown or is due to problems with both partners.
Successful conception involves many steps:
Most cases of infertility are due to problems with ovulation or problems with fallopian tubes.
If the egg is not released from the follicle in the ovary, you will not be able to conceive. Up to 40% of cases are due to this. Some factors that can cause problems are:
If the fallopian tubes are damaged or blocked, it is difficult for the egg to be fertilized or to travel to the uterus. Problems can be caused by:
These factors increase your chance of developing infertility:
During the first visit, you will both be evaluated. The doctor will ask about symptoms and medical history. Your doctor will look for physical problems that might cause infertility.
The following tests may be done to see if you are ovulating:
The following may be done to check if your uterus and fallopian tubes are normal:
Treatment depends on what is causing the condition. Treatments can be costly and lengthy. They often are not covered by insurance.
Your doctor may suggest that you first try:
You may be given medications that cause ovulation. The likelihood of multiple births is increased with these medications.
If the fallopian tubes are blocked, you may need surgery to open them. Surgery is also used to repair problems with organs or to remove:
ART involves using human sperm and eggs or embryos in a lab to help with conception. The eggs and sperm can be from you and your partner or donated. ART methods include:
Not all causes of infertility can be prevented. The following steps may help:
RESOURCES:
American Society for Reproductive Medicine
http://www.asrm.org
The Hormone Foundation
http://www.hormone.org/
RESOLVE: The National Infertility Association
http://www.resolve.org/
CANADIAN RESOURCES:
SexualityandU.ca
http://www.sexualityandu.ca/home_e.aspx/
Women's Health Matters
http://www.womenshealthmatters.ca/index.cfm
References:
American Medical Association website. Available at: http://www.ama-assn.org/ .
Female Infertility Best Practice Policy Committee of the American Urological Association; Practice Committee of the American Society for Reproductive Medicine. A practice committee report: optimal evaluation of the infertile female. American Society for Reproductive Medicine . 2000;86:S264-S267.
Infertility. American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/publications/patient_education/bp137.cfm . Published 2007. Accessed July 8, 2008.
Infertility. International Council on Infertility Information Dissemination website. Available at: http://www.inciid.org . Accessed July 8, 2008.
RESOLVE website. Available at: http://www.resolve.org . Accessed July 8, 2008.
Last reviewed November 2008 by Jeff Andrews, MD, FRCSC, FACOG
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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