Infertility

Infertility is a condition that makes it difficult or impossible for a man or woman to have a child. Both men and women can be infertile.

About 1 in 10 couples in the United States have fertility problems.
You should talk to your health care provider about the possibility of fertility problems:
* If you and your partner don't get pregnant after trying for 12 months.
* If you are a woman over the age of 35 who doesn't get pregnant after trying for 6-10 months. Older women are more likely to have fertility problems than younger women.


Causes
Infertility can be caused by many things, including:

* Problems with ovulation (a woman's ability to produce an egg)
* Problems with sperm in men (amount, quality or both)
* Aging (fertility declines as men and women age)
* Sexually transmitted infections
* Other reproductive infections
* Genetic conditions
* Certain chronic illnesses, such as diabetes or Hodgkin's disease
* Damage to the reproductive organs
* Smoking, drinking and drugs
* Exposure to radiation and certain chemicals, such as pesticides
* Cancer treatment
Often couples have more than one reason for infertility.


Finding a Doctor
Most couples begin by seeing an obstetrician-gynecologist or their family doctor. Because infertility is a highly technical field of medicine, talk with your doctor about whether you should see a specialist.

Advanced medical training is needed to be a specialist. Doctors often study the fields of reproductive endocrinology for women and urology for men. Specialists are more likely than other doctors to offer a variety of treatments, including formation about their risks and benefits. They may be helpful with both nonsurgical and surgical fertility treatments (see below).

Diagnosis and Treatment
For both women and men, the doctor performs a physical examination, takes a medical history and, sometimes, orders specialized tests.When a possible cause of infertility is found, the most common treatments are:

* Giving medications to the woman to help her body release eggs (ovulate).
* Performing surgery on the man or woman to repair part of the reproductive system.
For instance, a woman may have scars in herfallopian tubes. These tubes carry the eggs to the uterus (womb). A man may have a problem that makes it hard for sperm to flow normally. Conditions such as these can often be corrected with surgery.

According to the American Society for Reproductive Medicine (ASRM), most infertility cases (85-90 percent) are treated with drugs or surgery.

More advanced types of infertility treatment include:

* Inserting sperm from the man or a donor into the woman's uterus. This is called artificial insemination or intrauterine insemination (IUI).
* Assisted reproductive technologies (ART). A woman's eggs are surgically removed, combined with sperm in the laboratory, and then returned to her body. In vitro fertilization (IVF) is the most common ART procedure.

Couples sometimes choose to ask another person to donate eggs, spermor an embryo. (Embryo is the word for the human organism from conception until approximately the eighth week.) Others make an agreement with a woman to bear a child for them. These choices involve serious ethical and legal issues and should be made with care.