Learning About Infertility

Infertility is a medical condition. It affects both women and men, with men having fertility problems just as often as women. Usually the diagnosis is made if you have not gotten pregnant after trying for a year, or six months if you are over age 35. One in eight American couples has fertility problems. The ability to diagnose and treat fertility problems continues to advance, and today, about two out of three couples who get treatment have a baby.

The Reproduction Process
Getting pregnant involves many steps. There may be a problem in any of these steps.
1. A healthy egg must grow in an ovary (OH-vur-ee).
2. The ovary must release the mature egg into a fallopian (fuh-LO-pee-un) tube. This is called ovulation (aw-view-LAY-shun).
3. A healthy sperm must fertilize the egg. The fertilized egg is called an embryo (EM-bree-oh).
4. The embryo must attach to the uterus (YOU-dur-us).

The Fertility Evaluation
Both men and women should get fertility evaluations.
The woman’s evaluation may include:
• A medical history. You will discuss your periods, birth control history, and sexual patterns. You will also discuss your history of health problems, medicines, and surgeries.
• A physical exam. Your obstetrician/gynecologist will look for things like extra hair growth, breast discharge, and infection or growths in your vagina. You may also have a Pap smear.
• Blood tests. Your hormone levels may be tested with blood tests. Abnormal levels may cause a problem with ovulation.
• X-rays or ultrasounds of organs. These may reveal noncancerous growths.
• Diagnostic surgery. Minor surgery may reveal scar tissue, fibroids, or polyps.

Most fertility problems can be diagnosed. Common problems in women are:
• Ovulatory disorders. These are usually caused by hormone imbalances. Polycystic (polly-SIS-tik) ovary syndrome (PCOS) is one example.
• Endometriosis (en-doe-me-tree-OH-sus). This is a condition in which tissue that normally lines the uterus grows outside of the uterus.
• Blockages. These may occur in your organs.

Treatment
Once there is a diagnosis, treatment can begin.
This may include:
• Fertility drugs to help your body ovulate.
• Surgery to remove growths, tissue, or blockages. Surgery may also help to balance hormone levels.
• Assisted reproductive technologies (ARTs). Most of these procedures involve joining an egg and sperm outside the body and then implanting the embryo into the uterus. The most common ART is in vitro (in-VEE-tro) fertilization.

Make an appointment with your ob/gyn if any of these is true:
• You have not gotten pregnant after trying for a year (6 months if you are 35 or older).
• A home fertility test shows that you or your partner may have a problem.
• Your periods are irregular or very painful.
• You have had more than one miscarriage.
• You or your partner has had health problems that may affect your fertility, such as sexually transmitted infections (STIs) or eating disorders.

To learn more about fertility problems, talk to your ob/gyn.
You may want to ask:
• What approach will you take?
• When will we have answers?
• How quickly will we be able to get appointments?
• Does your office provide support services?
• At what point will you refer us to a specialist?

Provided as an educational resource by Merck