A couple is considered to be infertile if they have not conceived after 12 consecutive months of unprotected intercourse (6 months if the woman is over 35 years old) or earlier if there are known issues. If pregnancy does not happen as expected, or there are are infertility issues, both male and female partners need to get tested for fertility.
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The first step in any infertility work up is to see your doctor and have a complete medical history and physical examination and the following is reviewed:
- Menstrual history
- Medical history
- Sexual technique and timing
- Lifestyle issues (such as smoking and drug, alcohol, and caffeine consumption)
- Medications being taken
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Next in the infertility work-up are the following free or low-cost steps:
- Does he have enough sperm: Sperm count
- Are you ovulating? Monitor basal body temperature and cervix mucus
- Do you make love at the right time? Keep a calendar
- Take an over-the-counter urine test for detecting luteinizing hormone (LH) surges. This helps determine the day of ovulation.
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Infertility is a disease of the reproductive system that impairs one of the body's most basic functions: the conception of children.
Conception is a complicated process that depends upon many factors:
- The production of healthy sperm by the man
- The production of healthy eggs by the woman
- Open fallopian tubes that allow the sperm to reach the egg
- The sperm's ability to fertilize the egg when they meet
- The ability of the fertilized egg (embryo) to become implanted in the woman's uterus
- Sufficient embryo quality
Finally, for the pregnancy to continue to full term, the embryo must be healthy and the woman's hormonal environment adequate for its development. When just one of these factors is impaired, infertility can result.
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About one in 7 couples (15%) are affected by infertility. Healthy couples in their 20’s have a one in four chance of getting pregnant each month. About 40% to 50% of couples get pregnant within 4-5 months and 85% get pregnant within 12 months.
Read up on Causes of Infertility HERE
Up to 90% of infertility cases are treated with conventional therapies, such as drug treatment or surgical repair of reproductive organs. Less than 5% get treated with IVF in-vitro fertilization.
Before you get treated you need to get tested so you can find out the right treatment. Infertility testing: 5 Steps in 5 Weeks
One of the most important factors when you have difficulties getting pregnant is the mother's age. During infertility workup, over 80% of infertile couples have one or more of these three problems:
- Male Factors (sperm problems: Not enough, not moving, bad shapes
- Ovulation Problems (PCOS or age related issues, Good eggs versus Bad eggs)
- Pelvic factors (infections, endometriosis, scar tissue)
Read her more Infertility FAQs
Male Issues
The first test done when a couple has difficulties getting pregnant is a SpermCount. 35% of infertility cases are due to male factors such as an abnormal sperm count (for example, oligospermia or not enough sperm, increased semen viscosity, decreased sperm motility, or decreased semen volume) which makes this test the first and easiest to do.
Ovulation Issues
About 25% of cases of infertility are due to ovulation problems such as anovulation and polycystic ovary syndrome (PCOS);
Pelvic issues
30% of infertility cases are caused by pelvic factors such as endometriosis, adhesions, or tubal disease.
Less than 5% of infertility is caused by abnormal cervical mucus penetration, antisperm antibodies, or corpus luteum defects (CLP).
In about 10-15% of couples, no specific reason for infertility can be found on initial evaluation. This is called (unexplained infertility). But on further evaluation and treatment, occasionally factors such as poor sperm penetration or abnormal-appearing oocytes (eggs) are discovered.