The inability to become pregnant and have children affects 8% to 18% of people in the United States. Usually, 80% to 90% of normal couples become pregnant during 1 year of attempting to do so. Infertility usually means being unable to get pregnant after 1 year of trying.
Infertility may be divided into primary and secondary on the basis of reproductive history. Women who were never pregnant are in the primary group. Women who were pregnant more than 1 year before are in the secondary group. Slightly more than half of people with infertility fall into the primary group. It’s harder to become pregnant after the age of 30.
About 35% to 50% of infertility is due to a male factor such as low sperm count, abnormal sperm shape, or abnormal sperm motion (motility).
About 50% to 60% of infertility is related to female conditions. These conditions include fallopian tube disease, disorders related to ovaries (ovulation), and factors related to the uterus or cervix. The reason for infertility of the other 10% to 20% of couples isn’t known (idiopathic).
There are usually no symptoms associated with male infertility. Some females with infertility may experience symptoms due to causes of their infertility such as lower abdominal cramping with endometriosis or uterine fibroids.
Testing to find a cause ranges from simple things, such as getting a sperm count, to much more complicated testing. This testing includes blood tests (to measure female hormones, such as estrogen, progesterone, and follicle-stimulating hormone), ultrasound of the uterus and ovaries, and even laparascopic surgery to look at the reproductive organs. Before testing, it is important to understand what’s involved in an infertility evaluation, including the methods, how long it will take, the limits, and the cost.
Treatment is based on finding out the reasons for infertility and overcoming them so that it’s possible to get pregnant. Ways to do this include lifestyle changes (such as losing or gaining weight), medicines (for medical conditions), hormones, and drugs, such as clomiphene citrate, to make the ovaries start to release eggs. Surgery (such as to unblock fallopian tubes) and other methods, such as intrauterine insemination and in vitro fertilization, may also be tried.
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