Infertility is not being able to conceive after a year of trying. This means having regular, unprotected sex. About one-third of cases are caused by male factors. An equal number are caused by female factors. In the remaining cases, the cause is unknown or is due to problems with both partners.
Successful conception involves many steps:
Most cases of infertility are due to problems with ovulation or problems with fallopian tubes.
If the egg is not released from the follicle in the ovary, you will not be able to conceive. Some factors that can cause problems are:
If the fallopian tubes are damaged or blocked, it is difficult for the egg to be fertilized or to travel to the uterus. Problems can be caused by:
Infertility is more common in women who are older than 35 years old.
These factors increase your chance of developing infertility:
During the first visit, you will both be evaluated. You will be asked about symptoms and medical history. Your doctor will look for physical problems that might cause infertility.
The following tests may be done to see if you are ovulating:
The following may be done to check if your uterus and fallopian tubes are normal:
Treatment depends on what is causing the condition. Treatments can be costly and lengthy. They often are not covered by insurance.
Your doctor may suggest that you first try:
If you do not ovulate, you may be given medications that cause ovulation. The likelihood of multiple births is increased with these medications.
If the fallopian tubes are blocked, you may need surgery to open them. Surgery is also used to repair problems with organs or to remove:
ART involves using human sperm and eggs or embryos in a lab to help with conception. The eggs and sperm can be from you and your partner or donated. ART methods include:
Not all causes of infertility can be prevented. The following steps may help:
The American College of Obstetricians and Gynecologists
American Society for Reproductive Medicine
SexualityandU.ca—The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters
Cronin M, Schellschmidt I, Dinger J. Rate of pregnancy after using drospirenone and other progestin-containing oral contraceptives. Obstet Gynecol. 2009;114:616-622.
Female Infertility Best Practice Policy Committee of the American Urological Association; Practice Committee of the American Society for Reproductive Medicine. A practice committee report: optimal evaluation of the infertile female. American Society for Reproductive Medicine. 2000;86:S264-S267.
Infertility. American College of Obstetricians and Gynecologists website. Available at: http://www.acog.org/~/media/For%20Patients/faq137.pdf?dmc=1&ts=20130211T1206240241. Published April 2013. Accessed October 30, 2014.
6/5/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Luttjeboer FY, Verhoeve HR, van Dessel HJ, et al. The value of medical history taking as risk indicator for tuboperitoneal pathology: a systematic review. BJOG. 2009;116:612-625.
Last reviewed December 2014 by Andrea Chisholm, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.