What is an infertility evaluation?
An infertility evaluation includes exams and tests to try to find the reason why you and your partner have not become pregnant. If a cause is found, treatment may be possible. In many cases, infertility can be successfully treated even if no cause is found.
When should I consider having an infertility evaluation?
You should consider having an infertility evaluation if any of the following apply to you:
- You have not become pregnant after 1 year of having regular sexual intercourse without the use of birth control.
- You are older than age 35 years and have not become pregnant after trying for 6 months without using birth control.
- You are older than age 40 years and have not become pregnant within 6 months of trying without using birth control.
- Your menstrual cycle is not regular.
- You or your partner have a known fertility problem.
What type of doctor does an infertility evaluation?
Your obstetrician–gynecologist (ob-gyn) usually will do the first assessment. You also may choose to see a specialist. Infertility specialists are ob-gyns with special training in evaluating and treating infertility in women and men. These specialists are called reproductive endocrinologists. Men also may be evaluated and treated by a urologist. Some urologists have special training in male infertility.
What causes infertility?
The most common cause of female infertility is lack of or irregular ovulation. The most common causes of male infertility are problems in the testes that affect how sperm are made or how they function.
Other factors in women include problems with the reproductive organs or hormones. Scarring or blockages of the
fallopian tubes may contribute to infertility. This may be the result of past sexually transmitted infections (STIs) or endometriosis. Problems with the thyroid gland or pituitary gland also may contribute to infertility. In men, blockage of the tubes that carry sperm from the testes may be a cause of infertility.
How does age affect fertility?
For healthy couples in their 20s or early 30s, the chance that a woman will become pregnant is about 25–30% in any single menstrual cycle. This percentage decreases rapidly after age 37 years. By age 40 years, a woman’s chance of getting pregnant drops to less than 10% per menstrual cycle. A man’s fertility also declines with age, but not as predictably.
Can lifestyle affect fertility?
In women, being underweight, being overweight, or exercising too much may be associated with infertility. In both men and women, drinking alcohol at moderate or heavy levels may be a factor in infertility. In men, smoking cigarettes and marijuana can reduce sperm count and movement.
What should I expect during my first visit for infertility?
The first visit with a fertility specialist usually involves a detailed medical history and a physical exam. You will be asked questions about your menstrual period, abnormal bleeding or discharge from the vagina, pelvic pain, and disorders that can affect reproduction such as thyroid disease. You and your partner will be asked about the following health issues:
- Medications (both prescription and over-the-counter) and herbal remedies
- Illnesses, including STIs and past surgery
- Birth defects in your family
- Past pregnancies and their outcomes
- Use of tobacco, alcohol, and illegal drugs
- Occupation
You and your partner also will be asked questions about your sexual history:
- Methods of birth control
- How long you have been trying to become pregnant
- How often you have sex and whether you have difficulties
- If you use lubricants during sex
- Prior sexual relationships