Infertility is defined as the inability of a couple to achieve a pregnancy after a considerable amount of time.
The amount of time is usually one year for females under the age of 35 or six months for a female over the age of 35 with regular unprotected sexual relations. Infertility also includes a woman being unable to carry a pregnancy to live birth.
Infertility can affect both men and women, and is quite common. One in eight couples have trouble getting pregnant.
How long should a couple try to get pregnant before seeing a doctor?
Each couple’s fertility journey is unique and the timing of when to seek medical advice will vary on each individual situation. Many couples may find it beneficial to meet with their doctor prior to trying to conceive for more information.
It is reasonable to see a “regular” OB-GYN to initiate a conversation about fertility even if the couple has already started trying to conceive. Your gynecologist can often help navigate the initial evaluation and treatment of some common causes of infertility. The OBGYN may also help decide when it is appropriate to refer to a sub-specialist in reproductive endocrinology. These specialists complete additional training to help diagnose and treat fertility issues.
Preparing for Infertility Testing
Typically, an initial evaluation for infertility will include a detailed discussion with the patient and partner regarding their past medical history including menstrual and sexual health.
It may be helpful to bring in a list of current medications and also to jot down any specific questions for your provider that you would like answered.
Since fertility issues can arise in both men and women, it is often helpful to have your partner present for discussion.
Female fertility testing typically will involve a detailed medical history as well as lab work and imaging studies to help understand the underlying problem.
Basic principles include identifying if a woman ovulates during her menstrual cycle and what factors of her health may be preventing this from occurring. Additionally, assessment of the woman’s female organs with imaging studies (ultrasound or x-ray) can help identify any underlying problems that would prevent the sperm from reaching the egg. Sometimes, surgery is required to aid in the diagnosis.
Male infertility can be attributed to issues with sperm production or delivery and testing will include semen analysis. Other medical history including evaluation of medical conditions that can alter fertility will be discussed.
Myths Surrounding Infertility
There are too many myths about infertility to count! Below, we dispel a few popular myths.
Myth: “35 is too old to have a baby.”
It is safe and common for women over age 35 to get pregnant. It is estimated that as many as 20% of women or more in the US have their first child at or after the age 35.
Myth: “Infertility is always because of the female partner.”
Only 1/3 of infertile couples are due to the female partner only.
Myth: “If I see a fertility specialist, I will have to get IVF.”
The majority of infertile women are treated successfully without needing IVF.
Always feel free to ask your OBGYN if you have a question about fertility.
About Elizabeth Jarvis, MD
Dr. Elizabeth Jarvis is an OB-GYN with WakeMed Physician Practices – OB-GYN. Her clinical interests include fertility, abnormal uterine bleeding, minimally invasive and robotic-assisted surgery, family planning and contraception, high risk and routine obstetrics care.