Am Fam Physician. 2015;91(5):online
See related article on infertility
What is infertility?
Infertility is defined as not being able to get pregnant after 12 months of trying. It may be caused by medical problems in you or your partner. In about 40% of cases, there are factors in both partners. About 25% of couples do not have a clear reason for their infertility. If you are 35 years or older or have risk factors for infertility, like endometriosis, pelvic inflammatory disease, or pelvic surgeries, ask your doctor for an evaluation after you have tried for six months to get pregnant.
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 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 after putting dye through your cervix. It could also include looking at your organs using a thin tube through the vagina or through a small cut in the stomach.
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 help time when to have sex with your partner. Some fertility experts now recommend having sex every two to three days rather than on specific days.
Other treatment options include hormone therapy like clomiphene (one brand: Clomid) 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 with pregnancy.
Both partners should try to be as healthy as possible and avoid tobacco, alcohol, and illegal drugs. You should achieve a healthy weight and get regular exercise. If you are underweight, try to reach a healthy weight for normal hormonal activity. If you are overweight, you should lose weight through a healthy diet and exercise plan.
Where can I get more information?
American Society for Reproductive Medicine