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How Do I Know if I Am Infertile?

By Cary L. Dicken, MD, FACOG

Infertility is a disease of the reproductive tract that makes conceiving and/or maintaining a pregnancy difficult. Infertility is one of the most common diseases in young people. It is estimated that between 10% - 15% of couples trying to conceive will be given an infertility diagnosis. We begin to worry about infertility when a woman has been trying to conceive for one year without success as nearly 90% of couples with normal fertility do conceive in the first year of trying. Without fertility treatment, the odds of getting pregnant after that unsuccessful year is quite low and declines over time – and this happens more quickly as women get older. This is why it is recommended that at the one year mark (6 months for women > 35yr) that couples seek out evaluation with a fertility specialist.

At an initial visit with a fertility specialist, the goal is two-fold. First, we want to try and determine why a couple is not conceiving naturally. To do this we evaluate the factors involved in achieving pregnancy:

  • Is there a problem with the sperm?
  • Is there a problem with the eggs?
  • Are one or both fallopian tubes blocked?
  • Could there be something going on in the uterus that’s preventing an embryo from implanting?
  • Is the hormonal environment correct?

Second, we want to discuss fertility treatment. The goal of fertility treatment is to not only increase the odds that a couple will achieve a successful pregnancy, but decrease the time it takes for them to succeed. The two broad categories of fertility treatment are intrauterine insemination (IUI) and in vitro fertilization (IVF). There are multiple factors taken into consideration when choosing the best course of treatment. Of course, the results of the initial testing will play into this, but so will a woman’s age and the number of children she wants.

Bottom Line: If you are having trouble getting pregnant naturally (12 months if < 35; 6 months if 35 or older), seek out a fertility specialist for testing and to discuss treatment options.