You may be infertile if you have not been able to get pregnant after trying for at least 1 year.
A woman's fertility drops from her mid-30s into her 40s because of the natural aging of the egg supply. A man's fertility is not affected as much by age.
As a woman's eggs get older, the risk of miscarriage increases.
In about 35 out of 100 couples, testing finds a male fertility problem, such as a problem with sperm production or ejaculation.1
In about 50 out of 100 couples, testing finds a female fertility problem with ovulation, fallopian tube function, or other pelvic problems.1
Some couples find that both partners have a fertility problem.
In 10 out of 100 couples, no cause is found.1 Of these 10 couples, even without treatment, about 3 will get pregnant within 3 years and about 5 will get pregnant within 7 years.2
It can be stressful for you and your partner to find out the reason for infertility. Knowing where the problem is may create feelings of guilt and blame and may put strain on your relationship. Not being able to find any cause can also create stress. You may want to talk with a counselor or join an infertility support group before you make your decision. Talking with other people can help you feel less alone.
Infertility treatment usually starts with making sure you are having sex during your 6-day fertile window, which is your day of ovulation and the 5 days before it. This is called fertility awareness. If that doesn't work, then you may choose surgical, hormonal, or assisted reproductive technology (ART) treatment to help you get pregnant. Some of these treatments can be stressful, costly, and painful.
Depending on what is causing the problem, couples can:
The success of IVF depends on your age and your doctor’s skill and experience. For women, the older you are, the less likely it is that IVF will work unless you use donor eggs. Also, the cause of your infertility can affect the success of IVF.
Keep in mind that some infertility problems are more easily treated than others. In general, as a woman ages, especially after age 35, her chances of getting pregnant decrease and her risk of miscarriage increases.
Treatment for fertility problems can be stressful, costly, and hard on your body. Before you start testing, make some decisions about what you want to do. You may change your mind later, but it’s a good idea to start with a plan.
Treatments for infertility can increase your chance of getting pregnant. But they also increase your chance of having more than one baby at a time (multiple pregnancy). Be sure to discuss this risk with your doctor.
There may be a higher risk of birth defects for babies conceived by certain assisted reproductive techniques. Talk with your doctor about these possible risks.
Even though many fertility clinics give information about how many babies have been conceived, those numbers can be misleading. They may not include how many pregnancies miscarry. Treatment for infertility doesn't guarantee that you will have a baby.
Your doctor may recommend treatment if:
|Have fertility treatment||Don't have treatment|
|What is usually involved?|
|What are the benefits?|
|What are the risks and side effects?|
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"We have been trying for awhile to have a baby on our own. Now that we've had some tests, our doctor has recommended treatments that will give us a better chance. We are much more hopeful now. We feel very good about the clinic where we will have the treatments done, and their live birth rates are above the national average."
— Jamie, age 33
"We can't afford some of the expensive ART treatments. We have one child, and we need to think about his future needs, like college. I don't know where we would get $10,000 or maybe even $15,000 for treatment, since our insurance doesn't cover the costs. Luckily, some of the more successful treatment options for our problem are covered by our insurance. We feel fortunate about that."
— George, age 45, and Bonita, age 40
"We have had every possible test to try to find out why we can't get pregnant. There doesn't seem to be anything wrong. After almost 2 years, we don't have a baby yet. We know there is still a chance that we will get pregnant, and that gives us hope. Knowing that there isn't anything wrong, at least anything that the doctors can find, helps some. We've heard about the side effects of treatment, and the stress involved, and we just aren't sure that we want to put ourselves through that. We are going to try for a few more months, and then consider our treatment options."
— Frank, age 37
"My husband has sperm problems, so our least costly option is to use donor sperm. We are trying to decide if we want to spend the money for treatment or use it to adopt. It's a hard decision. Each of us feels differently about having a child that isn't biologically related to us, so we are talking about it a lot. We feel lucky because at least we have some options and enough time to consider them before we finally decide what's best for us."
— Carole, age 29
"I feel so guilty for having waited so long to try to have a baby. I can't help wondering if something I did when I was in my 20s is the reason why I can't get pregnant now. My husband really wants kids, and I feel like I'm letting him down and that he is disappointed in me. My husband has started talking about taking a break from all of this treatment. He said he doesn't like what this is doing to me emotionally and physically and thinks that a break might help. I worry that if we take a break I will feel like I am being lazy and just expecting to get pregnant without putting any work into it. But maybe it would be best, even for a couple of months. Every month just seems so precious!"
— Gail, age 36
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have infertility treatment
Reasons not to have infertility treatment
Having a biological child is very important to me.
I need to think about how important having a biological child is to me.
I'm not concerned about the cost of infertility treatment.
I'm worried about how I will pay for treatment.
I think I can handle the emotional stress of treatment.
I'm not sure I can handle the stress of treatment.
I accept that I may not get pregnant even with treatment.
I don't want to have treatment if I might not get pregnant.
My other important reasons:
My other important reasons:
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having infertility treatment
NOT having infertility treatment
1. Does having infertility treatment guarantee that you will deliver a baby?
2. Can infertility treatment increase your chances of getting pregnant with more than one baby at a time?
3. If you decide to start treatment, is it important to know how far you are willing to go with it before you get started?
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
3. Use the following space to list questions, concerns, and next steps.
|Primary Medical Reviewer||Sarah Marshall, MD - Family Medicine|
|Specialist Medical Reviewer||Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology|