About 10% of couples in the United States are infertile. Couples may be infertile if the woman has not been able to conceive after 6–12 months of having sex without the use of birth control. The number of months depends on many factors, such as your age, your partner's age, and how long you have been trying to get pregnant.
If you and your partner are trying to have a child and you have not gotten pregnant, you may want to have an infertility evaluation. Tests can be done to find the cause of the problem. Based on the results of these tests, treatment may be needed.
Infertility may be caused by more than one factor. Some are easy to find and treat, while others are not. The factor may relate to the woman (65%) or the man (20%). In some cases, no cause can be found in either partner (15%).
The couple's age can be a factor. For healthy, young couples, the odds are about 20% that a woman will conceive in any one menstrual cycle. This figure starts to decline in a woman's late 20s and early 30s and decreases even more after age 35 years. A man's fertility also declines with age, but not as early. For this reason, older couples may not want to wait 6–12 months to seek care if they are having problems conceiving.
Male factors most often involve problems with the amount or health of the sperm. Abnormal hormone levels may be a cause. Infection or scarring from a sexually transmitted disease (STD) also may be a cause. Female factors also may involve abnormal hormone levels. The ovaries may not produce enough eggs at the right time. Scarring or blockages in the cervix or tubes also may be a cause.
Lifestyle factors, such as poor nutrition, anorexia, and obesity can play a part in infertility. Exposure to a drug called diethylstilbestrol (DES) can cause problems. This might be a concern if you were born in the United States before the late 1970s or in another country before the 1980s. Other health problems also can play a role.
The decision to begin testing depends on a number of factors. They include your age and your partner's age, as well as how long you have been trying to get pregnant. You and your partner will receive care as a couple.
Testing involves an evaluation as follows:
Tests to check for a normal uterus and open fallopian tubes
Discussion about how often and when you have sex
The basic workup of an infertility evaluation can be finished within a few menstrual cycles in most cases. Ask your doctor about the costs involved. Find out whether they are covered by your insurance.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, the information found on the following link will help you understand what your choices are so that you can talk to your doctor about them.