What is infertility?

Infertility is not being able to get pregnant after 12 months of trying. It may be caused by medical problems in you, your partner, or both. About 25% of couples do not have a clear reason for their infertility. If you are 35 to 40 years old, ask your doctor for an evaluation after you have tried to get pregnant for six months. If you are older than 40 years or you have risk factors for infertility, like endometriosis, pelvic inflammatory disease, or a previous pelvic surgery, you should make an appointment to talk to your doctor about infertility.

How is it evaluated?

Both partners should be tested. Men give a semen sample to test the quality and number of sperm. Women have tests based on their history and exam. You may need hormone tests (blood work) to see if you are ovulating (releasing eggs from your ovary). You may need tests to look for blockages in your fallopian tubes or uterus. This may include taking x-rays or having ultrasonography after putting dye through your cervix. It could also include looking at your organs using a thin tube through the vagina (hysteroscopy) or a small cut in the abdomen (laparoscopy).

How is it treated?

If your doctor can't find a reason for your infertility, you may choose to keep trying to get pregnant for another year. Your best chance to get pregnant is in the few days before ovulation. You can use an ovulation kit to predict when this will happen and to know when to have sex with your partner. Some fertility experts recommend having sex every two to three days rather than on specific days.

Other treatment options include hormone therapy, like clomiphene or letrozole to help with ovulation, or other hormones to treat an underlying problem. If you have blocked tubes or endometriosis, surgery may be needed. You may also need to see an infertility specialist for treatments like intrauterine insemination or in vitro fertilization to help achieve pregnancy.

Both partners should exercise regularly, limit alcohol use, and avoid tobacco and illicit drugs. If you are underweight, try to reach a healthy weight to normalize your hormone levels. If you are overweight, try to lose weight through a healthy diet and exercise plan.

Where can I get more information?

• Your doctor

• American Society for Reproductive

  Medicine

  https://www.reproductivefacts.org

• Fertility Appreciation Collaborative to

  Teach the Science

  https://www.factsaboutfertility.org

• National Library of Medicine

  https://medlineplus.gov/infertility.html