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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Infertility

Inability to conceive; Unable to get pregnant

Last reviewed: February 24, 2014.

Infertility means you cannot get pregnant (conceive).

There are two types of infertility:

  • Primary infertility refers to couples who have not become pregnant after at least 1 year having sex without using birth control methods.
  • Secondary infertility refers to couples who have been able to get pregnant at least once, but now are unable.

Causes

Many physical and emotional factors can cause infertility. It may be due to problems in the woman, man, or both.

FEMALE INFERTILITY

Female infertility may occur when:

  • A fertilized egg or embryo does not survive once it attaches to the lining of the womb (uterus)
  • The fertilized egg does not attach to the lining of the uterus
  • The eggs cannot move from the ovaries to the womb
  • The ovaries have problems producing eggs

Female infertility may be caused by:

MALE INFERTILITY

Male infertility may be due to:

  • Decreased number of sperm
  • Blockage that prevents the sperm from being released
  • Defects in the sperm

Male infertility can be caused by:

Healthy couples under age 30 who have sex regularly will have a 25-30% per month chance of getting pregnant each month.

A woman is most fertile in her early 20s. After age 35, the chance a woman can get pregnant drops greatly after age 35 (and especially after age 40). The age when fertility starts to decline varies from woman to woman.

Exams and Tests

Deciding when to get treated for infertility depends on your age. Doctors often suggest that women under 30 try to get pregnant on their own for 1 year before getting tested.

Infertility testing involves a medical history and physical exam for both partners.

Blood and imaging tests are most often needed. In women, these may include:

Tests in men may include:

Treatment

Treatment depends on the cause of infertility. It may involve:

  • Education and counseling about the condition
  • Fertility treatments such as intrauterine insemination (IUI) and in vitro fertilization (IVF)
  • Medicines to treat infections and clotting disorders
  • Medicines that help the growth and release of eggs from the ovaries

Couples can increase the chances of becoming pregnant each month by having sex at least every 3 days before and during ovulation.

Ovulation occurs about 2 weeks before the next menstrual cycle (period) starts. Therefore, if a woman gets her period every 28 days the couple should have sex at least every 3 days between the 10th and 18th day after her period starts.

Having sex before ovulation occurs is especially helpful.

  • Sperm can live inside a woman's body for at least 3 days.
  • However, a woman's egg can only be fertilized by the sperm for a few hours after it is released.

Women who are under or overweight, may increase their chances of becoming pregnant by getting to a healthier weight.

Support Groups

Many people find it helpful to take part in support groups for people with similar concerns. You can ask your health care provider to recommend local groups.

Outlook (Prognosis)

As many as 1 in 5 couples diagnosed with infertility eventually become pregnant without treatment.

More than half of couples with infertility become pregnant after treatment. This figure does not include advanced techniques such as in vitro fertilization (IVF).

When to Contact a Medical Professional

Call your health care provider if you are unable to get pregnant.

Prevention

Preventing sexually transmitted infections (STIs), such as gonorrhea and chlamydia, may reduce your risk of infertility.

Maintaining a healthy diet, weight, and lifestyle may increase your chance of getting pregnant and having a healthy pregnancy.

References

  1. American Society for Reproductive Medicine. Diagnostic evaluation of the infertile female: a committee opinion. Fertil Steril. 2012;98:302-307. [PubMed: 22698637]
  2. American Society for Reproductive Medicine. Diagnostic evaluation of the infertile male: a committee opinion. Fertil Steril. 2012;98:294-301. [PubMed: 22698639]
  3. Bulun SE. Physiology and pathology of the female reproductive axis. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 17.
  4. Lobo RA. Infertility: etiology, diagnostic evaluation,management, prognosis. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, Pa: Elsevier Mosby; 2012: chap 41.

Review Date: 2/24/2014.

Reviewed by: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • The effectiveness of fallopian tube surgery to overcome infertility caused by tubal disease cannot be determined at present.The effectiveness of fallopian tube surgery to overcome infertility caused by tubal disease cannot be determined at present.
    Tubal surgery to overcome infertility caused by tubal disease is becoming popular due to the success rates (livebirths), advances in surgical techniques. including microsurgery, and because of the adverse outcomes and costs related to in vitro fertilisation (IVF), which is another option for overcoming tubal infertility. Tubal surgery, however, is also expensive; it requires additional specialist training for gynaecologists, experience to perform, and can have adverse effects (including ectopic pregnancies), and operative risks. Waiting to become pregnant without treatment (expectant management) is another option for women with tubal infertility. This review could not identify any clinical trials that compared tubal surgery with either IVF or expectant management.  The authors conclude that at present the available research is not adequate to determine the effectiveness, or otherwise, of tubal surgery compared to either IVF or expectant management. More research is needed, including information about adverse outcomes and costs.
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Figures

  • Pelvic laparoscopy.
    Female reproductive anatomy.
    Male reproductive anatomy.
    Primary infertility.
    Sperm.

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