What is female infertility?

Female Infertility

Infertility: Overview

Infertility means that you haven't been able to get pregnant after trying for at least 1 year (or 6 months if you're over 35). It doesn't mean you'll never get pregnant.

Your chances of getting pregnant are higher when you are younger. You are most able to get pregnant (fertile) in your late 20s. Then, in your mid-30s, you become less fertile. This is because your eggs get older.

Trouble getting pregnant can be caused by a problem with the reproductive organs. Talk with your doctor about testing and treatment. Testing will likely start with hormone and semen testing.

There is a wide range of treatment options. They include medicines, surgery, insemination, and in vitro fertilization (IVF).

Infertility

Infertility means not being able to get pregnant after trying for at least 1 year (or 6 months if you're over 35).

It can be caused by problems inside the body. But sometimes no cause can be found.

Being told that you have this problem doesn't necessarily mean that you will never get pregnant. Some people eventually conceive without help. But medical treatments do help many people.

What are the symptoms of fertility problems?

The main symptom of infertility is being unable to get pregnant after 6 to 12 months of trying, depending on your age.

How is infertility treated?

A wide range of treatments may be used for infertility. Depending on the cause, they include:

  • Medicine that helps with releasing an egg (ovulating).
  • A procedure that puts sperm directly inside the uterus (insemination).
  • Surgery for a problem caused by endometriosis or blocked fallopian tubes.
  • A procedure to concentrate sperm count for insemination.

You may also consider in vitro fertilization (IVF). During IVF, eggs and sperm are mixed in a lab to fertilize the eggs. Then the doctor puts one or more fertilized eggs into the uterus.

Treatment for fertility problems can be stressful and costly. Before you start, think about how far you're willing to go with treatment. You may change your mind later, but it's a good idea to start with a plan.

How is infertility treated in people who have polycystic ovary syndrome (PCOS)?

Weight loss may help improve ovulation in people with PCOS who are overweight. The medicines clomiphene and letrozole can also be used to help with ovulation. If that doesn't work, other medicines may help. If weight loss and medicines don’t work, surgery or IVF may sometimes be an option.

How are fertility problems diagnosed?

To check for fertility problems, a doctor can:

  • Do a physical exam.
  • Ask questions about your past health. This may help your doctor find clues, such as a history of miscarriages or pelvic inflammatory disease.
  • Ask about your lifestyle habits. This includes how often you exercise and whether you drink alcohol or use drugs.
  • Do tests that check semen quality. Other tests can measure hormone levels. Hormone imbalances can be a sign of ovulation problems or sperm problems that can be treated.

If your test results show no cause of infertility, your doctor may recommend checking the uterus, fallopian tubes, and ovaries.

Before you have fertility tests, it may help to try fertility awareness. Chart basal body temperature and use home tests to learn when you are likely to ovulate and be fertile. Some people find that they have been missing the most fertile days when trying to conceive.

Who can diagnose and treat infertility?

For your first fertility questions and testing, you can see:

  • A family medicine physician.
  • An internist.
  • A nurse practitioner (NP).

For complete fertility testing, see an obstetrician/gynecologist with special training and experience in fertility problems. This doctor may be called a reproductive endocrinologist or fertility specialist. When looking for a specialist, ask what percentage of a doctor's practice is fertility treatment. Also ask if the doctor has training in reproductive endocrinology.

How can you care for yourself when you have infertility?

Take care of yourself by exercising regularly (but don't overdo it), eating healthy foods, and staying at a healthy weight. Avoid smoking, marijuana, and illegal drugs. Track ovulation to find out when pregnancy is most likely.

How is surgery used to treat infertility?

For some people with infertility, a structural problem can be treated with surgery. Treatment can increase the chances of natural conception.

When thinking about surgery, ask your doctor questions about the procedure. For example, how many times has the surgeon done it? What are the chances that the treatment will be a success? How long will it take to recover?

Surgery may include:

  • Fallopian tube procedures. One example is sterilization reversal.
  • Laparoscopic surgery. This may help treat endometriosis.
  • Myomectomy. This may help treat uterine fibroids.
  • Laparoscopic ovarian drilling. This may be used when weight loss and medicine haven't stimulated ovulation in people who have polycystic ovary syndrome (PCOS).
  • Varicocele repair. This is used to cut or bypass an enlarged vein in the scrotum.
  • Vasectomy reversal. This reconnects the tubes (vas deferens) that were cut during a vasectomy.

How is complementary medicine used for infertility?

Complementary medicine may help you stay well and cope with infertility. Complementary medicine for fertility includes:

  • Acupuncture.
  • Dietary changes.
  • Relaxation techniques.
  • Mind-body medicine.

Talk with your doctor about any complementary health practice that you would like to try or are already using. Your doctor can help you manage your health better if they know about all of your health practices.

What is infertility?

Infertility means not being able to get pregnant. You may have fertility problems if you couldn't get pregnant after trying for at least 1 year (or 6 months if you're over 35). It doesn't mean you'll never get pregnant. Some people conceive without help in their second year of trying. Treatments help many people.

What causes infertility?

Infertility may be caused by:

  • Problems with the eggs or releasing an egg (ovulating).
  • Problems with the uterus or the fallopian tubes. This may result from things like endometriosis or pelvic inflammatory disease.
  • Problems with the sperm. These problems may include how sperm is made, how it functions, or how it moves.
  • An unknown issue. Sometimes the cause of infertility is not known.

Rates of infertility and miscarriage increase with age. Female fertility peaks in the late 20s. It slowly starts to decline in the early 30s. A larger drop in fertility and increase in miscarriage risk begins around the mid-30s. This is mainly because of the aging egg supply. Male fertility also decreases with age. But it's a more gradual decline.

Tracking ovulation at home

To decrease your risk of fertility problems and increase your chances of becoming pregnant, use the following guidelines.

  • Estimate when you are ovulating by practicing fertility awareness.
    • Track your cervical mucus changes.
    • Track your basal body temperature. Use a daily temperature chart to track the changes each month.
    • Track your luteinizing hormone (LH) levels. You can use a home ovulation predictor test. Many doctors now recommend these home tests as the best way to track ovulation at home.
  • Try having sex every day or every other day during your fertile period.

    This can improve the chance of pregnancy.

  • Reduce your level of activity, if you exercise strenuously most days of the week.

    Very strenuous exercise can cause you to ovulate less often.

  • Avoid using alcohol and medicines.

    This includes nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin.

Infertility: When to call

Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

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The content above contains general health information provided by Healthwise, Incorporated, and reviewed by its medical experts. This content should not replace the advice of your healthcare provider. Not all treatments or services described are offered as services by us. For recommended treatments, please consult your healthcare provider.