What is Infertility?: 1 of 5 things you really need to know about infertility
A Couple’s Guide to Infertility
(Dr Eric Daiter, Board Certified in Reproductive Endocrinology and Infertility)
The goal of this guide is to provide a medical expert’s answers to the common questions:
- Do I have infertility?
- What causes infertility?
- How are specific problems with fertility diagnosed?
- Which treatments for infertility are successful and what are their risks?
- What options exist if all of the infertility testing and treatments do not successfully result in a pregnancy?
Couples have their own expectations on how quickly a pregnancy should occur, usually based on a combination of personal, family, community and cultural beliefs. When these expectations are not met, a concern about infertility often develops.
Medical scientists have studied normal human fertility rates by looking at the number of months (or ovulation cycles) from stopping contraception to achieving a pregnancy (called time to pregnancy or TTP), using large amounts of data compiled from several different countries around the world. These scientists at the World Health Organization discovered that 85% of couples would achieve a pregnancy on their own within 12 months of intercourse without contraception. One year of unprotected intercourse without a spontaneous pregnancy has become the basis for the standard medical definition of infertility.
The American Society of Reproductive Medicine re-examined this definition in 2008 and suggested that an infertility evaluation should be considered after 6 months of unprotected intercourse without a spontaneous pregnancy in couples where the woman is 35 or more years old. They identify a general decrease in fertility rates with increasing maternal age, making early diagnosis and treatment especially important for women at least 35 years of age.
Many couples already know that they have a fertility problem, based solely on their own histories. These couples can seek medical advice on fertility without 6-12 months of unprotected intercourse. Examples include but are not limited to the following list.
- If a woman does not have menstrual cycles or has highly irregular menstrual cycle intervals with only a few cycles per year, then she should anticipate a problem getting pregnant. A reproductive age woman will normally ovulate each month and have monthly menstrual intervals if she does not become pregnant.
- A woman with signs of impending menopause, such as increasingly irregular and longer menstrual cycle intervals and hot flashes, should have her egg reserve checked by an infertility expert with blood work or an ultrasound.
- A woman with a prior tubal ligation, who currently desires to become pregnant again.
- A woman with extensive pelvic surgery for such problems as endometriosis, pelvic adhesions, fibroids, and ovarian cysts may have reduced fertility or an increased chance of an ectopic pregnancy.
- A woman with previously identified pelvic problems such as large fibroids, blocked fallopian tubes, prior sexually transmitted disease (which often damage the fallopian tubes), ovarian cysts, endometrial polyps, or scar tissue in the uterus or pelvis.
- A man with a prior vasectomy, trying to have a baby.
- A man with prior chemotherapy or radiation therapy for cancer.
The final section of this Guide, “What options exist if all of the infertility testing and treatments do not successfully result in a pregnancy?,” is only available on the complete downloaded copy. If you like what you have been reading then download your entire free copy of “A Couple’s Guide to Infertility,” written entirely by Dr. Daiter
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