Infertility

The main symptom of infertility is being unable to get pregnant after 6 to 12 months of trying, depending on your age.

Sometimes infertility is related to lifestyle or other health conditions. To help protect your fertility:

• Avoid using tobacco (cigarettes) and marijuana.
• Avoid exposure to harmful chemicals.
• Avoid excessive alcohol use.
• Limit sex partners and use condoms to reduce the risk of getting a sexually transmitted infection (STI). Untreated STIs can damage the reproductive system and cause infertility. If you think you may have an STI, get treatment right away to reduce the risk of damage.
• Stay at a body weight that's close to the ideal for your height. It will reduce the chance of hormone imbalances.

If you have been diagnosed with cancer and hope to have children in the future, talk to your doctor about your options to help preserve fertility.

Things that increase your risk for infertility include:

• Age. Eggs and sperm can decrease in number or quality with age.
• Birth defects. Some people were born with problems in their reproductive systems.
• Moderate or severe endometriosis.
• Past exposure to very high levels of environmental toxins, certain drugs, or high doses of radiation. This includes cancer chemotherapy or radiation.
• Past infection with a sexually transmitted infection (STI) that has since damaged the reproductive system. This includes gonorrhea or chlamydia.
• Polycystic ovary syndrome. This is a hormone imbalance that can affect ovulation. This can make it harder to get pregnant.

To check for infertility, a doctor can:

• Do a physical exam.
• Ask questions about your past health. This may help your doctor find clues, such as a history of miscarriages or pelvic inflammatory disease.
• Ask about your lifestyle habits. This includes how often you exercise and whether you drink alcohol or use drugs.
• Do tests that check semen quality. Other tests can measure hormone levels. Hormone imbalances can be a sign of ovulation problems or sperm problems that can be treated.
• Check the uterus, fallopian tubes, and ovaries.

Before you have fertility tests, it may help to try fertility awareness. Chart basal body temperature and use home tests to learn when you are likely to ovulate and be fertile. Some people find that they have been missing the most fertile days when trying to conceive.

A wide range of treatments may be used for infertility (fertility problems). Depending on the cause, they include:

• Medicine that helps with releasing an egg (ovulating).
• A procedure that puts sperm directly inside the uterus (insemination).
• Surgery for a problem caused by endometriosis or blocked fallopian tubes.
• A procedure to concentrate sperm count for insemination.

You may also consider in vitro fertilization (IVF). During IVF, eggs and sperm are mixed in a lab to fertilize the eggs. Then the doctor puts one or more fertilized eggs into the uterus.

Treatment for fertility problems can be stressful and costly. Before you start, think about how far you're willing to go with treatment. You may change your mind later, but it's a good idea to start with a plan.

For your first fertility questions and testing, you can see:

• A family medicine physician.
• An internist.
• A nurse practitioner (NP).

For complete fertility testing, see an obstetrician/gynecologist with special training and experience in fertility problems. This doctor may be called a reproductive endocrinologist or fertility specialist. When looking for a specialist, ask what percentage of a doctor's practice is fertility treatment. Also ask if the doctor has training in reproductive endocrinology.

Watch closely for changes in your health and be sure to contact your doctor if you have any problems.