Infertility

Infertility Overview

Most couples who decide to have a baby expect to achieve pregnancy shortly after they stop using contraception. Unfortunately, one in every ten couples will have difficulty becoming pregnant. For many couples, the cause of their fertility problem is easy to identify, and relatively inexpensive treatment methods result in a successful pregnancy. For other couples, treatment can take years and ultimately require expensive "high tech" solutions, such as in vitro fertilization (IVF).

The goal for every couple faced with infertility is to start a family using the least costly, most effective methods. It can be daunting for couples to know where to start and what to expect.

This series of articles offers guidance to couples newly faced with infertility. We begin with a brief overview of the causes of infertility. This is followed by a description of the most commonly used diagnostic tests. We finish with an introduction to the methods most frequently used to help couples achieve pregnancy.

Getting Started

Physician Visit prior to Attempting Pregnancy

There are several basic tests that can be performed prior to conception to optimize the chances of a healthy baby. For this reason, it is recommended that, prior to attempting pregnancy, women should obtain a prenatal health evaluation by their family practice physician or obstetrician-gynecologist. Their physician will confirm that they have had the appropriate immunizations and give them prenatal vitamins containing extra folic acid, which decreases the risk of birth defects called neural tube defects. This "preconception" physician visit is particularly important for women with any serious health issues that could worsen during pregnancy or affect the developing fetus.

Things to Keep in Mind

Having children and raising a family is an expectation of most couples. Here are some things to keep in mind as you move forward:

Those who have difficulty are often able to achieve pregnancy with the aid of modern treatment options, which have evolved over the last three decades to be more successful and somewhat less expensive.
The approach for each couple must be individualized to achieve pregnancy with the least cost, lowest risks and fewest multiple pregnancies.
The stress of fertility treatment on each member of a couple and on their relationship should be actively managed.
Understanding the options and alternatives at every step of the way is important for dealing with the stress associated with this process.

Sources:

American Society for Reproductive Medicine. Infertility: an overview, United States. 2003. Birmingham, Ala: American Society for Reproductive Medicine.
Centers for Disease Control and Prevention. 2006 Assisted Reproductive Technology Success Rates, National Summary and Fertility Clinic Report. Atlanta: 2008.
Falcone T, Hurd WW, eds. Clinical Reproductive Medicine and Surgery, New York: Elsevier, 2007.

Prepared in partnership with Melina Dendrinos, MD, Class of 2008, Case Western Reserve University School of Medicine, 1st year resident in Obstetrics and Gynecology at University of Chicago.

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Last Reviewed: Jul 11, 2010

William W Hurd, MD
Professor of Reproductive Biology
Department of Reproductive Biology
School of Medicine
Case Western Reserve University