Heartland Women's Group March 05, 2013

The road to pregnancy: Tackling infertility issues

James Whiddon, MD, OB/GYN
Heartland Women’s Group

If you and your partner are having trouble getting pregnant, you're not alone. Some 15 to 20 percent of couples in the United States are infertile.

Infertility is defined as not being able to get pregnant after one year of regular, unprotected sex without the use of birth control.

Infertility may be due to a single cause in either you or your partner, or a combination of factors that may prevent a pregnancy from occurring or continuing. They typically include problems with ovulation, reproductive organs, hormones or sperm.

Fortunately, there are safe and effective therapies for overcoming many infertility issues. These treatments significantly improve your chances of becoming pregnant. Since I see only female patients, I will focus in this article on topics that impact female infertility.

One of the first things physicians do when seeing a new patient with fertility questions is to look at the patient’s history, including general history, past pregnancies and menstrual history. They will perform a physical exam. Initially, a physician will want to determine if the problem is a sperm issue or a female issue.

Once a physician looks at a patient’s history and physical, the doctor also will look at other external factors, such as smoking, drug use or sexually transmitted diseases, all which can affect fertility.

Age also can impact fertility. If a woman is over 35 years old, pregnancy naturally becomes more difficult. Fertility in a woman over 40 declines significantly. Male fertility declines much slower and men are capable of fathering children into their 60s and beyond.

Research shows that female issues account for about a third of fertility problems, male issues another third; both male and female issues account for 15 percent of problems and in 20 percent of cases, no cause is found.

For women, there are some initial blood tests that can be ordered and a doctor may order a sonogram or a hysterosalpingogram (HSG), which is an X-ray test that looks at the inside of the uterus and fallopian tubes and the area around them.

Treatment depends on the cause, and also, in some cases, how much money a patient is willing to spend to pursue expensive treatment options.

Infertility can be treated with medicine, surgery, artificial insemination, or assisted reproductive technology. Many times these treatments are combined. In most cases infertility is treated with drugs or surgery.

If you suspect fertility issues, don’t hesitate to talk with your OB/GYN. A number of fertility medicines are used to treat women with ovulation problems. It is important to talk with your doctor about the pros and cons of these medicines and make the best decision for you.

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