Infertility

Infertility is not being able to get pregnant after trying to have a baby for at least a year.

For most couples, having frequent sex without birth control results in a pregnancy within a year. For about half of couples, pregnancy happens within the first 3 months.

Ovulation is the release of an egg from a woman’s ovary.

Typically, women ovulate about halfway between one period and the next. For example, if your menstrual cycle is 28 days (counting from the first day of one period to the first day of the next period), you usually ovulate around day 14.

A woman is most likely to get pregnant if she has frequent sex during the 3 days before ovulation. This is when there's the best chance for the egg to be exposed to sperm.

If you want to figure out when you ovulate, there are better ways than counting days. These methods are more accurate:

Body temperature: Take your temperature at the same time each morning before you get out of bed. This is your basal body temperature. Your temperature will be a little lower starting a few days before ovulation. Then when you ovulate, your temperature goes up and stays up until your next period.

Ovulation predictor kit: You can buy a home ovulation prediction kit in the drugstore. The kit tests your urine for a hormone that goes up right before you ovulate. These kits are more accurate than the body temperature method.

Infertility in women is most often caused by:

Lack of ovulation has many possible causes. For example, it can be due to hormone problems, polycystic ovaries Polycystic Ovary Syndrome (PCOS) Polycystic ovary syndrome is characterized by irregular or no menstrual periods and often obesity or symptoms caused by high levels of male hormones (androgens), such as excess body hair and... read more , eating disorders, early menopause Menopause Menopause is when women stop having periods (stop menstruating) and can no longer get pregnant. Menopause usually happens after age 40. In the United States, the average age for menopause is... read more , too much exercise, and use of certain drugs.

Blocked fallopian tubes prevent sperm from reaching the egg or keep a fertilized egg from entering the uterus. Tubes may be blocked by scar tissue. Scar tissue may result from infections such as pelvic inflammatory disease Pelvic Inflammatory Disease (PID) Pelvic inflammatory disease may affect the lining of the uterus, the fallopian tubes, and sometimes the ovaries. Pelvic inflammatory disease is usually caused by bacteria from the vagina. The... read more , a ruptured appendix, or having had a pregnancy in the tubes (ectopic pregnancy Ectopic Pregnancy An ectopic pregnancy is when a fertilized egg attaches in the wrong place, such as in the fallopian tubes An ectopic pregnancy does not result in a baby being born If not diagnosed and treated... read more ).

Problems in the abdomen or womb can keep an egg from entering the fallopian tubes or keep a fertilized egg from attaching inside the uterus. Problems in the abdomen or womb include scar tissue from previous surgery, birth defects of the uterus, and abnormal growths such as endometriosis Endometriosis Endometrium is the tissue that lines the inside of your uterus (womb). That tissue grows every month during your menstrual cycle because it's getting ready to support a baby. If you don't become... read more or fibroids Uterine Fibroids A uterine fibroid is a tumor in a woman's uterus (womb). The uterus is the organ where babies grow before they are born. Fibroids aren't cancer, but they can be painful and cause bleeding and... read more .

Other things that make it harder for a woman to get pregnant include getting older, having diabetes, being overweight, drinking a lot of coffee (more than 5 or 6 cups a day), and smoking.

Infertility in men is most often caused by:

Low sperm count has many possible causes. It can be due to hormone problems, too much heat on the testicles, infections such as mumps Mumps Mumps is a contagious viral infection that causes painful enlargement of the salivary glands. The infection may also affect the testes, brain, and pancreas, especially in adolescents and adults... read more , undescended testicles Undescended Testes and Retractile Testes Undescended testes (cryptorchidism) are testes that remain in the abdomen or the groin instead of descending into the scrotum. Retractile testes (hypermobile testes) have descended into the... read more , and varicose veins of the testicles Scrotal Swelling Swelling of the scrotum (the sac that surrounds and protects the testes) on one or both sides may be a symptom of a urinary tract disorder. Swelling can be small and detectable only by carefully... read more . Certain medical treatments, including many drugs, chemotherapy, and radiation, can affect sperm count. Too much alcohol or marijuana can also lower the number of sperm.

Problems getting sperm from the testicles to the penis may happen if the pathway is blocked or damaged because of previous surgery or certain birth defects. Diabetes or nerve problems can also affect how sperm gets from the testicles to the penis.

Sometimes doctors can't figure out the reason why a couple is infertile.

Doctors will examine both of you after you've been trying to get pregnant without success for a year.

They'll see a woman sooner if:

Doctors may do tests, including:

Doctors will treat the cause of infertility, if known. They'll advise the couple to stop smoking and to not drink too much alcohol, to watch their weight, and to exercise regularly.

Sometimes doctors can’t identify the cause of infertility. But they can still treat you to raise the chances of getting pregnant or getting pregnant sooner.

Doctors may:

In some cases, doctors may recommend assisted reproductive techniques. With these techniques, a woman's eggs are fertilized with a man's sperm in the laboratory to produce one or more embryos. Fertilizing eggs in a laboratory is called in vitro fertilization. The embryo can then be put into the woman's womb.

These treatments don't always work. Couples may want to consider adoption as an alternative to pregnancy.

Being treated for infertility can be very stressful. You may feel frustrated, upset, or guilty. This can put a strain on your relationship. Infertility treatment can also cost a lot and take a lot of time. The stress can lead to anxiety, sleep or eating problems, and can interfere with your life and work. This is normal. Counseling and support groups can help.