Infertility is a long, hard, lonely road. You may have spent months waiting in vain for a positive pregnancy test. Perhaps for a while, you thought that if you just waited one more month, just tried one more time, perhaps it could work. Or maybe you’ve struggled with the agony of frequent miscarriages.
When it comes to infertility you can feel lost or overwhelmed with having little to no control over your situation. If you’re ready to chart a new course forward, you may be full of questions.
Such as:
Infertility can feel profoundly isolating. Everyone around you seems to be pregnant without any effort, as you continue to struggle. But as much as it seems so, this isn’t really the case.
Approximately one in eight couples struggle with fertility issues. Additionally, after a year of trying, 12-15% of couples are unable to conceive. And the statistics show that after two years of trying 10% of couples are still unable to conceive.
Some other important reproductive medicine statistics about infertility include:
A healthy couple under the age of 33 has a 20-25% chance of pregnancy each month they try.
After six months of trying, 40% of couples still have not conceived.
About a quarter of women ages 35-39 have difficulty getting pregnant.
These statistics are not exactly hopeful, but treatment really does work. 65% of people who seek infertility treatment end up giving birth. Seeing help from a fertility specialist can help you identify and treat the problem, and become a parent as quickly and as safely as possible. Don’t waste precious time scouring the internet for answers or with general practitioners who aren’t infertility experts. If you’re worried about cost, there are options there too, and in some cases, insurance may even cover all or a portion of treatment. The key in all of this is to get started and stop wasting time.
Some infertile couples have no symptoms at all. For them, the only symptom is the inability to get or stay pregnant after many months of trying. Other symptoms for men and women vary, and may not be as easy to identify as you might think.
The most common infertility symptom for women is to experience issues with ovulation. They may have irregular or heavy periods, pain during their periods -- aside from normal menstrual cramping -- or some women will not get a period at all. These problems can be tied to a number of underlying issues, such as ovarian reserve (egg count), hormonal imbalance, structural issues with the fallopian tubes or uterine wall.
Every woman's body is different and it's possible that any of these menstrual warming signs may or may not be the culprit to your inability to conceive. If you are experiencing issues with your period it’s best to seek help from an infertility specialist, so they can recommend and perform the proper testing.
Other indicators and/or symptoms women should be aware of are:
Men on the other hand, may notice issues with sex, such as trouble ejaculating or getting an erection. Some have painful ejaculation or urination. Some might notice a swollen lump on the penis or testicles. In most cases, though, men with infertility have no symptoms at all.
Some symptoms a man might experience include:
A miscarriage is devastating, particularly if you have tried for months or years to have a baby. Many couples are desperate to get pregnant again as soon as possible after miscarriage. Others need time to grieve. There is no right amount of time to wait to get pregnant after a miscarriage. Most couples can begin trying right away. In fact, there’s some evidence that the odds of getting pregnant may even improve immediately following a miscarriage.
While a single misscarriage isn’t definitive evidence of fertility issues, it’s important to understand that if you have experienced any of the below items or have been trying for over a year unsuccessfully to get pregnant, it may be beneficial to seek out a fertility specialist to get the proper testing done:
A proper diagnosis is instrumental when treating infertility. While gynecologists and family physicians might know the basics, they may not be up to date on the most recent research and methods. You need a fertility specialist to get the right diagnosis.
A fertility specialist offers the fastest, safest, and most affordable route to pregnancy. As an expert, your fertility specialist knows about the most recent research, best practices in the field of fertility medicine, and the strategies that are most likely to succeed based on your diagnosis. They guide and recommend the right battery of tests, starting with the most conservative and money-saving approach and progressing until they’ve left no stone unturned.
A fertility specialist will work with you and your partner to develop a custom treatment plan that aligns with your goals and lifestyle. Don’t waste time, money, resources, and your emotional sanity; working with a fertility specialist will ease the struggle, provide the proper diagnosis, and recommend the best course of treatment for you.
There are a number of infertility tests a specialist might conduct. Once they have a full workup of both you and your partner's overall health and medical history they can choose an appropriate course of action. While it is still very common to jump to the conclusion the issue is with the woman, approximately one-third of infertility cases are due to issues with the man. Additionally, another third of infertility cases are due to a problem with both the man and the woman.
A man can be completely infertile and seem perfectly healthy. Which explains why most men do not experience any symptoms when it comes to infertility. However, unless there is a good reason to test the woman first, it is often cheaper, quicker, and less invasive to start with testing the man. For most men, infertility testing is as simple as giving a sperm sample. It will then be sent to a lab for examination to assess the overall health and quality of their semen.
While sperm issues are the most common culprit in male infertility, they are not limited. Therefore, a doctor may recommend additional testing, particularly if you and your partner have unsuccessfully tried to get pregnant for longer than a year.
Other male tests may include:
Fertility is a two-way street, so while it’s often best to start with the man that doesn’t mean there is not an issue with the woman. For women, doctors will commonly check the female hormone system, ovarian reserve, pelvis, vagina, and cervix for any existing abnormalities. Since the most common cause of infertility with women is with ovulation many doctors will start here.
Some tests include but are not limited to:
Once you know what you’re up against, you can choose the options that are consistent with your goals, comfort level, values, and budget. Indeed, this is where the expertise of a reproductive specialist really shines.
Artificial reproductive technology is not technically a treatment. Instead, these procedures circumvent pre-existing fertility issues. The two most commonly used forms of ART are in vitro fertilization (IVF) and intrauterine insemination (IUI).
Both options can use the couple’s gametes (sperm or eggs), or can also use donor sperm if there is an issue with the man’s semen. If there is an issue with the woman’s eggs, IVF is the better solution because IVF allows the use of donor eggs.
The IVF procedure involves fertilizing an egg outside of the body, allowing it to grow into an embryo, and then placing the embryo back into the woman’s body. From here the hope is that it will implant into the uterine wall and begin to grow and develop into a healthy pregnancy.
This approach is remarkably versatile, and a doctor can tailor it to manage a number of fertility issues. A doctor can use you and your partner’s sperm and egg, or any combination of donor sperm or egg.
In most cases, a woman will take fertility medication that causes her to release multiple eggs, inevitably increasing her chances for success. And, some women will need additional hormonal treatments to sustain a pregnancy. However, IVF remains the single most effective fertility treatment for couples with serious infertility issues, as well as those with unexplained infertility.
Intrauterine insemination can work around many fertility issues as well. During IUI, a doctor implants a man’s sperm directly into the woman, increasing the chances of successful fertilization. For women with ovulation issues, men with low sperm count or low sperm motility, and couples with unexplained infertility, IUI Is a great option.
For couples who are good candidates, IUI’s success rate is similar to the success rate of IVF. However, IUI is significantly less expensive than IVF and much less invasive. It’s also a good option for people whose religious beliefs prohibit IVF.
Following an IUI procedure, many couples are eager for the first signs of pregnancy to appear. You won’t notice any signs or symptoms right away, though there may be some spotting following the procedure. Your doctor will test for pregnancy at the earliest point when pregnancy is likely, you may have heard of the dreaded two week wait before.
For women pursuing IVF or IUI a doctor may also use ovulation induction to ensure they ovulate at the right time. And in some cases, a doctor may recommend ovulation induction even if a woman appears to be ovulating regularly. This is because research has linked ovulation induction to improved chances of pregnancy in all women. This may be because ovulation induction makes it easier to time intercourse or insemination to optimize the chances of pregnancy.
Ovulation induction uses hormones similar to those a woman’s body naturally produces to induce the body to ovulate. This greatly increases a woman’s chances of getting pregnant, especially if she has a condition such as polycystic ovary syndrome (PCOS). Older women may also benefit from ovulation induction, since a woman may ovulate less frequently as she approaches menopause.
You have more choices than you realize. But time can erode those choices as it erodes your fertility. So don’t delay seeking help.
Reproductive technologies have come a long way. We can fix many problems that once seemed unsolvable. But there’s one problem we haven’t been able to solve: the age-fertility conundrum.
Age inevitably affects fertility. The decline is faster and more certain in women, who see significant drops in fertility in their thirties, and who are no longer able to get pregnant when they enter menopause. Men, too, see declining fertility with age. There’s no specific age at which it’s impossible to get pregnant. Some women easily get pregnant in their forties, and a few manage pregnancy in their fifties. Others struggle with infertility as early as their twenties.
If you’re not sure whether you’re ready to start trying, consider contacting your fertility specialist about preservation. You can freeze eggs or sperm, that offers considerable insurance against the ravages of age.
Perhaps the biggest myth about infertility treatments is that treatment has to be exorbitantly expensive. It’s true that IVF is pricey because of how much skill it requires and how effective it can be. But many infertility treatments are surprisingly affordable. Some may even be covered by insurance as medically necessary.
Texas has an insurance mandate for IVF that requires insurers to offer coverage for IVF procedures. You’ll have to meet certain criteria to be eligible, but insurance coverage is indeed possible. Moreover, at some employers, you can get additional coverage for other fertility services. Your fertility specialist can help you file claims with your insurer and estimate total out of pocket costs.
