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Infertility

If you and your partner are struggling to have a baby, you're not alone. In the United States, 10% to 15% of couples are infertile. Infertility is defined as not being able to get pregnant despite having frequent, unprotected sex for at least a year for most couples. Infertility may result from an issue with either you or your partner or a combination of factors that prevent pregnancy. Fortunately, there are many safe and effective therapies that significantly improve your chances of getting pregnant.

Symptoms

The main symptom of infertility is not getting pregnant. There may be no other obvious symptoms. Sometimes, a woman with infertility may have irregular or absent menstrual periods. In some cases, a man with infertility may have some signs of hormonal problems, such as changes in hair growth or sexual function. Most couples will eventually conceive, with or without treatment.

When to see a doctor

You probably don't need to see a doctor about infertility unless you have been trying regularly to get pregnant for at least one year. Women should talk with a doctor earlier, however, if they:

  • Are age 35 or older and have been trying to conceive for six months or longer
  • Are over age 40
  • Have irregular or absent periods
  • Have very painful periods
  • Have known fertility problems
  • Have been diagnosed with endometriosis or pelvic inflammatory disease
  • Have had multiple miscarriages
  • Have undergone treatment for cancer
  • Men should talk to a doctor if they have:
  • A low sperm count or other problems with sperm
  • Undergone treatment for cancer
  • Small testicles or swelling in the scrotum
  • Others in your family with infertility problems
Infertility causes can affect one or both partners. In general:
  • In about one-third of cases, there is an issue with the man
  • In about one-third of cases, there is an issue with the woman
  • In the remaining cases, there are issues with both the man and the woman, or no cause can be found
Risk factors

Age: Women's fertility gradually declines with age, especially in the mid-30s, and it drops rapidly after age 37. Infertility in older women is likely due to the lower number and quality of eggs, and can also be due to health problems that affect fertility. Men over age 40 may be less fertile than younger men.

Tobacco use: Smoking tobacco or marijuana by either partner may reduce the likelihood of pregnancy. Smoking also reduces the possible effectiveness of fertility treatment. Miscarriages are more frequent in women who smoke. Smoking can increase the risk of erectile dysfunction and a low sperm count in men.

Alcohol use: For women, there's no safe level of alcohol use during conception or pregnancy. Alcohol use may contribute to infertility. For men, heavy alcohol use can decrease sperm count and motility.

Being overweight: Among American women, an inactive lifestyle and being overweight may increase the risk of infertility. For men, sperm count also may be affected by being overweight.

Being underweight: Women at risk of fertility problems include those with eating disorders, such as anorexia or bulimia, and those who follow a very low-calorie or restrictive diet. Exercise issues. A lack of exercise contributes to obesity, which increases the risk of infertility. Less often, ovulation problems may be associated with frequent strenuous, intense exercise in women who are not overweight.

Prevention:Some types of infertility aren't preventable. But several strategies may increase your chances of pregnancy.