Infertility is not being able to conceive after a year of trying. This means having regular, unprotected sex. About one-third of cases are caused by male factors. An equal number are caused by female factors. In the remaining cases, the cause is unknown or is due to problems with both partners.
Successful conception involves many steps:
Most cases of infertility are due to problems with ovulation or problems with fallopian tubes.
If the egg is not released from the follicle in the ovary, you will not be able to conceive. Up to 40% of cases are due to this. Some factors that can cause problems are:
If the fallopian tubes are damaged or blocked, it is difficult for the egg to be fertilized or to travel to the uterus. Problems can be caused by:
These factors increase your chance of developing infertility:
During the first visit, you will both be evaluated. The doctor will ask about symptoms and medical history. Your doctor will look for physical problems that might cause infertility.
The following tests may be done to see if you are ovulating:
The following may be done to check if your uterus and fallopian tubes are normal:
Treatment depends on what is causing the condition. Treatments can be costly and lengthy. They often are not covered by insurance.
Your doctor may suggest that you first try:
If you do not ovulate, you may be given medications that cause ovulation. The likelihood of multiple births is increased with these medications.
If the fallopian tubes are blocked, you may need surgery to open them. Surgery is also used to repair problems with organs or to remove:
ART involves using human sperm and eggs or embryos in a lab to help with conception. The eggs and sperm can be from you and your partner or donated. ART methods include:
Not all causes of infertility can be prevented. The following steps may help:
The American College of Obstetricians and Gynecologists
American Society for Reproductive Medicine
The Hormone Foundation
RESOLVE: The National Infertility Association
Women's Health Matters
American Medical Association website. Available at: http://www.ama-assn.org/.
Cronin M, Schellschmidt I, Dinger J. Rate of pregnancy after using drospirenone and other progestin-containing oral contraceptives. Obstet Gynecol. 2009;114:616-622.
Female Infertility Best Practice Policy Committee of the American Urological Association; Practice Committee of the American Society for Reproductive Medicine. A practice committee report: optimal evaluation of the infertile female. American Society for Reproductive Medicine. 2000;86:S264-S267.
Fritz MA, Speroff L. Clinical Gynecologic Endocrinology and Infertility. Section IV. Lippincott, Williams & Wilkins; 2011.
Infertility. American College of Obstetricians and Gynecologists website. Available at: http://www.acog.or... . Published 2007. Accessed July 8, 2008.
Infertility. International Council on Infertility Information Dissemination website. Available at: http://www.inciid.org. Accessed July 8, 2008.
RESOLVE website. Available at: http://www.resolve.org. Accessed July 8, 2008.
6/5/2009 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Luttjeboer FY, Verhoeve HR, van Dessel HJ, et al. The value of medical history taking as risk indicator for tuboperitoneal pathology: a systematic review. BJOG . 2009;116:612-625.
Last reviewed October 2012 by Andrea Chisholm
Last Updated: 10/31/2012