Topic Overview
What are fertility problems?
You may have fertility problems if you have not been able to get
pregnant after trying for at least 1 year. Another word for this is
infertility. Infertility may not mean that it is impossible to get pregnant.
Often, couples conceive without help in their second year of trying. Some do
not succeed, but medical treatments help many couples.
Age is an important factor if you are trying to decide whether to
get testing and treatment for fertility problems. A woman is most fertile in
her late 20s. After age 35, fertility decreases and the risk of miscarriage
goes up.
- If you are younger than 35, you may want to
give yourself more time to get pregnant.
- If you are 35 or older,
you may want to get help soon.
What causes fertility problems?
Fertility problems can have many causes. In cases of
infertility:1
- About 50 out of 100 are caused by a problem
with the woman’s reproductive system
. These may be problems
with her
fallopian tubes or
uterus or her ability to release an egg (ovulate). - About 35 out of 100 are caused
by a problem with the
man's
reproductive system
. The most common is low sperm
count. - About 5 out of 100 are caused by an uncommon problem, such
as the man or woman having been exposed to a medicine called
DES before birth.
- In about 10 out of 100,
no cause can be found in spite of testing.
Should you be tested for fertility problems?
Before you have fertility tests, try fertility awareness. A woman
can learn when she is likely to ovulate and be fertile by charting her
basal body temperature and using home tests. Some
couples find that they simply have been missing their most fertile days when
trying to conceive.
If you are not sure when you ovulate, try this
Interactive Tool: When Are You Most Fertile?
.
If these methods don't help, the first step is for both partners
to have some simple tests. A doctor can:
- Do a physical examination of both of
you.
- Ask questions about your past health to look for clues, such
as a history of
miscarriages or
pelvic inflammatory disease.
- Ask about
your lifestyle habits, such as how often you exercise and whether you drink
alcohol or use drugs.
- Do tests that check
semen quality and both partners'
hormone levels in the blood. Hormone imbalances can be
a sign of ovulation problems or sperm problems that can be treated.
Your family doctor can do these tests. For more complete testing,
you may need a referral to see a fertility specialist.
How are fertility problems treated?
A wide range of treatments is available. Depending on what is
causing the problem, you may be able to:
- Take a medicine that helps the woman
ovulate.
- Have a procedure that puts sperm directly inside the woman
(insemination).
- Have a surgery that corrects a problem caused by
endometriosis or blocked fallopian
tubes.
- Have a procedure to increase the man’s sperm count.
If these options are not possible or don't work for you, you may
want to consider in vitro fertilization (IVF). During in IVF, eggs and sperm
are mixed in a lab so the sperm can fertilize the eggs. Then the doctor puts
one or more fertilized eggs into the woman’s uterus. Many couples try IVF more
than once. Of women who try IVF:2
- Up to 40 out of 100 of those younger than 35
have a baby.
- About 20 out of 100 women who are age 39 have a
baby.
- About 20 out of 100 women who are age 39 have a baby.
Treatment for fertility problems can be stressful, costly, and
hard on your body. Before you start testing, make some decisions about what you
want to do. You may change your mind later, but it’s a good idea to start with
a plan.
- Learn all you can about the tests and
treatments, and decide which you want to try. For example, some couples agree
to try medicines but don't want surgery or other treatments.
- Find
out how much treatments cost and whether your provincial health plan or private
insurance will cover them. If you don't have insurance coverage, decide what
you can afford.
Treatments for infertility can increase your chances of getting
pregnant. But they also increase your chance of having more than one baby
(multiple pregnancy). Be sure to discuss the risks with
your doctor.
Fertility problems can put a lot of strain on a couple. It may
help to talk to a counsellor with experience in infertility. Think about
joining an infertility support group. Talking with other people with the same
issue can help you feel less alone.
Learning about
infertility:
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Being diagnosed:
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Getting treatment:
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Personal considerations:
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