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Future of Fertility

What to Expect When You Want to Be Expecting

Having trouble getting pregnant is a common problem in the United States and can be heartbreaking.

Dmitry Kissin, MD, MPH

Lead Health Scientist, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Prevention and Control

Infertility is generally defined as not being able to get pregnant after one year of unprotected sex for heterosexual couples, and affects both men and women. Some couples may also experience pregnancy loss, and over one in eight women of reproductive age have difficulty getting pregnant or carrying a pregnancy to term

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There are certain conditions, signs, and symptoms that can contribute to infertility. Problems with making healthy sperm are common causes of male infertility, and conditions affecting a woman’s ovaries, fallopian tubes, or uterus can contribute to female infertility. A fertility specialist, or reproductive endocrinologist, can help couples better understand what might be contributing to their infertility and provide options to help achieve pregnancy.

When to see a doctor

Pregnancy might not happen right away. Most experts suggest that couples with no apparent health or fertility problems and in which a woman is under age 35, try to conceive for at least one year before seeing a health care provider. However, couples in which the woman is 35 years or older should see a provider after six months of trying unsuccessfully.

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However, couples that are trying to conceive a child should not delay seeing a doctor when a woman experiences irregular periods or no menstrual periods, very painful periods, signs of endometriosis, pelvic inflammatory disease, have had more than one miscarriage, or if there is a reason to suspect male factor infertility.

What to expect

A reproductive specialist will begin by getting a thorough history from both partners, perform a physical examination, and order tests that are appropriate based on couple’s specific circumstances. An initial evaluation may include a semen analysis, a tubal evaluation, or ovarian reserve testing.

There are a variety of treatment options for infertility. Male and female infertility can be treated with medicine, surgery, intrauterine insemination, or assisted reproductive technology like in-vitro fertilization (IVF). The types of treatment recommended would depend on the individual factors contributing to a couple’s infertility.

It’s important to remember that there are many options for starting a family, and many people who struggle with infertility do end up having children. Talk to a healthcare provider as early as possible when deciding to try to get pregnant. They can help you prepare for a healthy pregnancy and answer any questions on fertility.

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