If getting pregnant has been a challenge for you and your partner, you're not alone. Ten to 15 percent of couples in the United States are infertile. Infertility is defined as not being able to get pregnant despite having frequent, unprotected sex for at least a year — or for at least six months if the woman is age 35 or older.
Infertility may be due to a single cause in either you or your partner, or a combination of factors that may prevent a pregnancy from occurring or continuing. Fortunately, there are many safe and effective therapies for overcoming infertility. These treatments significantly improve your chances of becoming pregnant.
Most couples achieve pregnancy within the first six months of trying. Overall, after 12 months of unprotected intercourse, approximately 90 percent of couples will become pregnant. The majority of the remaining couples will eventually conceive, with or without treatment.
The main sign of infertility is the inability for a couple to get pregnant. There may be no other obvious symptoms.
In some cases, an infertile woman may have abnormal menstrual periods. An infertile man may have some signs of hormonal problems, such as changes in hair growth or sexual function.
When to see a doctor
If you're a man, talk with your doctor if you have:
To become pregnant, the complex processes of ovulation and fertilization need to work just right. For some couples attempting pregnancy, something goes wrong along the way, resulting in infertility.
The cause or causes of infertility can involve one or both partners. In general:
Causes of male infertility
Causes of female infertility
Other causes in women
During each menstrual cycle, an egg is released by one of the ovaries (ovulation). The egg travels into the fallopian tube. If fertilization is to occur, sperm ejaculated into the vagina must swim up ...
Many of the risk factors for both male and female infertility are the same. They include:
Preparing for your appointment
If you and your partner have been trying to get pregnant for six months or longer, call your doctor. Depending on your age and personal health history, your doctor may recommend a medical evaluation.
A woman's gynecologist or a man's urologist or a family doctor can help determine whether there's a problem that requires a specialist or clinic that treats infertility problems. Both you and your partner will likely undergo a comprehensive infertility examination.
Here's some information to help you get ready for your first appointment, and know what to expect from your doctor.
What you can do
Prepare a list of questions so that you can make the most of your time with your doctor. For infertility, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment.
What to expect from your doctor
Questions for the couple
Questions for the woman
Questions for the man
Tests and diagnosis
Before undergoing infertility testing, be aware that a certain amount of commitment is required. Your doctor or clinic will need to determine what your sexual habits are and may make recommendations about how you may need to change those habits. The tests and periods of trial and error may extend over several months. In about one-third of infertile couples, no specific cause is found (unexplained infertility).
Evaluation is expensive and in some cases involves uncomfortable procedures, and the expenses may not be reimbursed by many medical plans. Finally, there's no guarantee — even after all the testing and counseling — that conception will occur.
Tests for men
Tests for women
After your doctor asks questions regarding your health history, menstrual cycle and sexual habits, you'll undergo a general physical examination. This includes a regular gynecological examination. Specific fertility tests may include:
Not everyone needs to undergo all, or even many, of these tests before the cause of infertility is found. Which tests are used and their sequence depend on discussion and agreement between you and your doctor.
Treatments and drugs
Treatment of infertility depends on the cause, how long you've been infertile, your age and your partner’s age, and many personal preferences. Some causes of infertility can't be corrected. However, a woman can still become pregnant with assisted reproductive technology or other procedures to restore fertility.
Treatment for men
Treatment for women
If you have endometriosis, your doctor may treat you with ovulation therapy, in which medication is used to stimulate or regulate ovulation, or in vitro fertilization, in which the egg and sperm are joined in the laboratory and transferred to the uterus.
Assisted reproductive technology (ART)
The most common forms of ART include:
ART works best when the woman has a healthy uterus, responds well to fertility drugs, and ovulates naturally or uses donor eggs. The man should have healthy sperm, or donor sperm should be available. The success rate of ART is lower after age 35.
Complications of treatment
In vitro fertilization
With in vitro fertilization, the doctor uses a needle to remove eggs from the ovary (A). The eggs and sperm are combined in a petri dish (B) and placed in an incubator (C). If fertilization occurs, ...
Coping and support
Coping with infertility can be difficult. It's an issue of the unknown — you can't predict how long it will last or what the outcome will be. Infertility isn't necessarily solved with hard work. The emotional burden on a couple is considerable.
Taking these steps can help with coping:
Managing emotional stress during treatment
Managing emotional effects of the outcome
Most types of male infertility aren't preventable. However, avoid drug and tobacco use and excessive alcohol consumption, which may contribute to male infertility. Also, high temperatures can affect sperm production and motility. Although this effect is usually temporary, avoid hot tubs and steam baths.
For couples, having intercourse two to three times a week may improve fertility. Too-frequent ejaculation can lessen sperm quality. Sperm survive in the female reproductive tract for up to 72 hours, and an egg can be fertilized for up to 24 hours after ovulation.
A woman can increase her chances of becoming pregnant in a number of ways:
Last Updated: 2011-09-09
© 1998-2014 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "Mayo Clinic Health Information," "Reliable information for a healthier life" and the triple-shield Mayo logo are trademarks of Mayo Foundation for Medical Education and Research.
Terms and conditions of use