What is Infertility? And what can be done to help achieve pregnancy?

Infertility means not getting pregnant after 1 year of actively having unprotected intercourse.  Further testing and evaluation by an OB/GYN physician is recommended after 6 months of trying for couples over 35 years old.  

The most common cause of female infertility is a lack of or irregular ovulation.  Age is a major factor in infertility. Most women have about a 20% chance of becoming pregnant in any single menstrual cycle.  By age 40, this chance decreases to under 10% per cycle. Lifestyle factors such as being underweight or overweight may affect infertility.  Unhealthy behaviours such as drinking heavy amounts of alcohol, a poor diet, smoking and illegal drugs all contribute to infertility.  

Treatment of infertility involves lifestyle changes, medication, surgery and other options.  Many of these options can be combined for success in achieving pregnancy. A balanced diet and exercise to stay at a healthy weight is important to get pregnant and have a healthy pregnancy.  Surgery such as the treatment of polyps (polypectomy) and fibroids (myomectomy) in the uterus can be helpful to increase the chance for pregnancy. Medication for infertility can range from ovulation induction to gonadotropins to assisted reproductive technologies (ART).  

Ovulation induction is the use of medication to help the ovaries release an egg.  This directly addresses the most common cause of female infertility and hormonal imbalance.  Medications such as clomid, letrozole, and ovidrel are helpful along with follicle monitoring using ultrasound in the office.  Another helpful adjunct to ovulation induction is intrauterine insemination which is an office procedure to place healthy sperm into the uterus where they have a chance to fertilize an egg.  

The risk of ovulation induction is a slightly higher risk of twins or multiple gestation.  This is also a possibility with ART such as in vitro fertilization (IVF) in which strong medications are used to help the woman produce many eggs which are retrieved and mixed with sperm in a laboratory setting.  The embryo can be tested for normal genetics before implantation which increases the chance for a successful pregnancy. Due to the cost and complexity of these advanced treatment we generally suggest the most natural and least complicated solutions for pregnancy first before progressing to ART.

Infertility can be very distressing and can take time to treat.  The help of a team of women’s health specialists like Harmony OB/GYN can be vital to taking the stress out of the process. 

Sources: ACOG FAQ137, “Treating Infertility”

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