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How Is Infertility Treated?
The doctor will meet with you and your partner after the evaluation is completed and outline a treatment plan according to the diagnosis, duration of infertility, and the woman's age. If pregnancy has not been accomplished within a reasonable time, the couple and the doctor may consider further evaluation or a different treatment plan. The doctor should be able to counsel the couple in forming realistic expectations for pregnancy.
Most infertility can be treated with conventional therapies, such as drug treatment (fertility drugs) to promote ovulation or surgery to repair problems with reproductive organs.
When to See a Fertility Specialist
A fertility specialist is usually an obstetrician-gynecologist (specialist in women's reproductive health) with advanced education, research, and professional skills in reproductive endocrinology. These highly trained and qualified doctors are the specialists to see about infertility.
Couples may want to talk to a health care professional for a referral to a clinic where doctors and staff have this special training. In addition, fertility clinics often have specialized equipment and imaging technology needed to make a diagnosis and to do semen testing and other specialized tests right at the office.
Check the American Society for Reproductive Medicine for a specialist and clinic in your area. A primary care physician or gynecologist will also be able to refer you to a fertility clinic.
Infertility is a problem that involves both partners. Therefore, the infertility specialist evaluates both the woman and the man. Testing for infertility is usually not done until after the couple has tried to become pregnant for at least 1 year if the woman is younger than 35 years, or older than 35 years and have not conceived during a six-month period of trying.
How Is Infertility Diagnosed?
A health care professional will take a complete medical history. Couples may be asked to provide the following information:
A health care professional may perform a physical examination on both partners, including the following aspects:
A health care professional will discuss the findings from the medical history and physical examination. Sometimes, a complete infertility evaluation may take up to two menstrual cycles before the factors causing the infertility can be found.
Further testing for men
The male partner will be asked to submit a semen sample for a complete semen analysis. Even though a man has fathered a child in the past, he will still be asked to submit a semen sample because his reproductive system may have changed.
The semen sample may be collected at the laboratory (in a private room through masturbation). If a sample is collected at home, it must be collected in a sterile plastic container and delivered to the lab at a body temperature no more than 60 minutes after ejaculation.
Some men cannot produce a semen sample through masturbation. Therefore, the sample can be collected through intercourse, using a special non-spermicidal condom provided by the laboratory. For best results, the semen sample should be collected 3 to 5 days after a period of having no sexual intercourse.
A man may produce no sperm for various reasons. He may produce few sperm or sperm that have defects that prevent them from reaching or fertilizing the egg.
Further testing for women
Several conditions may affect a woman's ability to get pregnant. A health care professional will evaluate the entire reproductive system.
The cervix plays a key role in the transport of the sperm after intercourse. Cervical mucus production, amount, and characteristics change according to the estrogen concentration depending on the menstrual cycle.
The uterus is the final destination for the embryo and the place where the fetus develops until delivery. Therefore, the uterus may be associated with primary infertility or with pregnancy problems and premature delivery. Other problems affect the development and function of the uterus (specifically the endometrium or inner layer of the uterus).
Ovaries may not release eggs. Fallopian tubes may be blocked. The doctor will want to evaluate all parts of the reproductive system.
The health care professional may use any of several procedures to examine the woman's reproductive organs:
What Is the Prognosis for Infertility?
For most couples, a cause for the infertility is found. Pregnancy occurs with the use of fertility drugs or corrective surgery in a majority of infertile couples, once they are evaluated and treated. Advanced techniques such as surgery, insemination, or in vitro fertilization can help even more couples achieve pregnancy.
Medically reviewed by Wayne Blocker, MD; Board Certified Obstetrics and Gynecology
Medically Reviewed by a Doctor on 9/16/2016
Jairo E Garcia, MD
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