Infertility 101 : What is it, How do I seek help?

Kiira Contributor
April 18, 2022
(5 mins read)
Pregnancy

What is infertility 

When a woman cannot get pregnant (conceive) after one year or longer of unprotected sex, it can be determined that she is experiencing infertility. With age, a woman's ability to conceive can decline. Fertility providers can evaluate and treat women aged 35 years or older after 6 months of unprotected sex for infertility. Women with infertility should consider an appointment with a reproductive endocrinologist, a doctor specializing in managing infertility. Reproductive endocrinologists may also be able to help women with recurrent pregnancy loss, defined as having two or more spontaneous miscarriages.

Here is what happens for a woman to get pregnant:

  1. A woman’s body must release an egg from one of her ovaries.
  2. Fertility must occur when a man’s sperm joins with the egg along the way. 
  3. The fertilized egg must go through a fallopian tube toward the uterus, which is the womb.
  4. Implantation then occurs when the embryo attaches to the inside of the uterus. 

Infertility results when there is a problem with several of these steps.

Is it only a women’s condition?

No. It s not. It takes a man and woman to make a baby and with that in mind, Infertility is not always a woman's problem. Infertility in men can be caused by various factors and is typically evaluated by a semen analysis. This involves collecting sperm and evaluating it. 

When a semen analysis is performed, the number of sperm (concentration), motility (movement), and morphology (shape) are assessed by a specialist. A slightly abnormal semen analysis does not mean that a man is necessarily infertile. Instead, a semen analysis helps determine if and how male factors contribute to infertility.

Do my pregnancy chances change with age?

A woman’s chances of having a baby decrease rapidly every year after 30. Most experts suggest women younger than age 35 with no apparent health or fertility problems and regular menstrual cycles should try to conceive for at least one year before seeing a doctor. However, for women aged 35 years or older, couples should see a health care provider after 6 months of trying unsuccessfully. Women over 40 years may consider seeking more immediate evaluation and treatment.

How is infertility determined in men and women?

Some health problems can increase the risk of infertility. A few signs and symptoms can indicate infertility, and these are different in men and women. Some of these include;

For women:

  1. Irregular periods or no menstrual periods
  2. Endometriosis
  3. A history of pelvic inflammatory disease
  4. Known or suspected uterine or tubal disease
  5. A history of more than one miscarriage
  6. Genetic or acquired conditions that predispose to diminished ovarian reserve (chemotherapy, radiation)

For men:

  1. A history of testicular trauma
  2. Prior hernia surgery
  3. Prior use of chemotherapy
  4. A history of infertility with another partner
  5. Sexual dysfunction

Your healthcare provider will ask you a few questions before deciding whether or not to proceed with fertility treatments. 

Can I still get pregnant?

Infertility does not necessarily mean you will not be able to conceive. Once a person or couple has been diagnosed with infertility, it is crucial to weigh your options and seek Assisted Reproductive Technology (ART). This includes all fertility treatments in which either eggs or embryos are handled outside of the body. ART procedures typically involve removing mature eggs from a woman’s ovaries using a needle, combining the eggs with sperm in the lab, and returning the embryos to the woman’s body or donating them to another woman. 

The main types of ART are;

  1. In vitro fertilization (IVF) - a complex series of procedures used to help with fertility or prevent genetic problems and assist with the conception of a child.
  2. Intrauterine Insemination (IUI) - a fertility treatment that involves placing sperm inside a woman's uterus to facilitate fertilization. 

https://www.mayoclinic.org/tests-procedures/in-vitro-fertilization/about/pac-20384716#:~:text=In%20vitro%20fertilization%20(IVF)%20is,by%20sperm%20in%20a%20lab.

https://americanpregnancy.org/getting-pregnant/intrauterine-insemination/#:~:text=Intrauterine%20Insemination%20(IUI)%20is%20a,increase%20the%20chance%20of%20fertilization.

How do I pick the right fertility doctor?

Infertility can be very challenging and can be a very emotionally and financially tasking process. So it is imperative to be careful and analytical when choosing a doctor or fertility clinic. Whoever you pick will be helping you achieve your pregnancy dreams, so it is vital that you feel comfortable, safe, and cared for through the process. 

A few questions to ask;

  1. How much will this process cost? - Fertility treatments can be costly, so it is essential to know precisely how much it will cost to prepare for the financial obligations.
  2. Do you accept insurance? - Once you know the cost of care, it is also essential to know what portion of the treatments you are responsible for. Please ask your insurance provider if they cover fertility treatments and understand possible out-of-pocket costs. 
  3. What's your success rate? - Fertility clinics typically report their success rates, so some of this is public information. It's vital to ask, gain word-of-mouth success stories, and know your chances. To find success rates, visit the Society for Assisted Reproductive Technology. 
  4. Can I schedule appointments around my schedule? Accessibility during the fertility treatment process because fertility treatment requires many appointments, tests, and checkups. Getting your provider's availability and scheduling appointments is a vital part of the process. So be sure that you can reach your provider when you need to. 
  5. How do you communicate with patients? This is one of the most critical questions to ask. Is the doctor available to answer my questions? Do I get ahold of my care coordinator when I call the office? Do staff answer my emails? Will they remember me?
  6. Finally, do I like this doctor, and do I feel comfortable with their treatment process. Although all those mentioned above are important, it is equally important to trust your gut and know whether or not you will like this doctor who is caring for a very sensitive and personal process so make sure they are the right fit for you. 

If you are trying to get pregnant or have trouble conceiving, please contact your doctor and find out your options.