If you’re having trouble conceiving, ask your healthcare provider for an evaluation. This may include a gynecologist or urologist, or it might be a fertility specialist.
Irregular periods or a history of pelvic disease may indicate problems with ovulation, a condition known as polycystic ovary syndrome. Other conditions can also cause infertility, such as blocked fallopian tubes and endometriosis.
Causes
For women, infertility often starts with a physical exam and blood tests. Your doctor will check to make sure your ovaries are releasing eggs regularly and that the fallopian tubes are clear of blockages. She may also order a test that captures an injectable dye as it travels through the fallopian tubes and uterus to look for scar tissue, uterine fibroids or other conditions.
For men, blood tests and semen analysis check sperm count, mobility and genetic content. A needle biopsy of the testicles may be needed to remove a sample for testing. Genetic causes of infertility can include chromosomal abnormalities or gene mutations that affect how sperm are made. Mutations in genes such as TEX11 and AUR have been linked to male infertility.
During the infertility evaluation, you should think about other options for having children — such as using donor eggs or sperm, adopting or not having children at all. Considering these options early in the process can ease anxiety during treatment and help you cope if the treatment doesn’t work.
You might also want to consider counseling before, during or after infertility treatment. It can help you stay positive during treatment and cope with feelings of sadness or anger if it doesn’t work for you. Counseling is available from many organizations. It’s also helpful to find a support group for people with infertility.
Symptoms
The main symptom of infertility for a woman is the inability to get pregnant after having unprotected, regular sex for six months to a year. Women with infertility may also have irregular menstrual periods or no periods, and they often have trouble conceiving multiple pregnancies. They can sometimes have other symptoms, such as pelvic pain or a history of STIs.
In about half of all cases of infertility, a male problem contributes or causes it, and in 5%-15% of couples, the cause is not found. Men with fertility problems should see a urologist and women should see an OB/GYN.
For a woman, the first step is getting a complete medical history and having a physical exam, including a pelvic exam. The doctor will check that the ovaries are releasing eggs, and blood tests can check hormone levels. X-rays can also examine the fallopian tubes and uterus. The doctor may also recommend a test that measures basal body temperature, or other ways to find out when the ovaries ovulate.
A minor surgical procedure called laparoscopy may be needed to look for conditions that can cause infertility. The doctor makes a small cut under the navel, and then uses a thin viewing device to see the fallopian tubes, uterus and ovaries. It might find problems like scarring, blockages or endometriosis. It can also remove submucosal fibroids and polycystic ovary syndrome (PCOS) growths.
Treatments
If you and your partner have been trying to conceive for more than a year without success, it’s a good idea to see your family doctor or gynecologist. They will refer you to a fertility specialist if necessary.
Medications to treat infertility include birth control pills, ovulation-stimulating drugs and hormone treatments like progesterone injections. Surgical treatment to restore fertility includes surgery to remove fibroids from the uterus and laparoscopic treatment for endometriosis and blocked fallopian tubes. Donor sperm and eggs can also help people with infertility problems if the problem is due to low sperm count or motility, polycystic ovary syndrome or other health conditions that affect ovulation.
Most insurance policies cover at least some infertility treatments. If yours does not, you can ask to add fertility coverage. Some plans cover ovulation-stimulating medications. Others offer fertility procedures such as intrauterine insemination and in vitro fertilization (IVF).
Fertility treatments for men can be expensive, especially if they do not work. If you and your partner decide to go ahead with treatment, be sure to explore financial options with a counselor. You can also consider adopting a child, either by choosing a foster child or through a private adoption agency. Adoption costs range from nearly nothing to as much as $40,000. If you find that the stress of infertility treatment for women, pregnancy, or parenting is too heavy for your relationship, a counselor can help you explore other options.
Solutions
While involuntary childlessness has been a serious problem for some people, safe and effective treatments are available. These include medications, surgery and assisted reproductive technology. Many couples and single people find that a combination of these approaches works best for them. A gynecologist or fertility specialist can help you decide which options are right for you.
In some states, laws require private insurers to cover infertility treatment. However, these laws often include monetary caps and exclusions. In addition, only one state — New York — requires Medicaid to cover infertility treatment (though it does require it to cover gynecologic care that impacts fertility).
Many people who seek infertility treatment face significant financial barriers. This can include the cost of care, deductibles and co-pays, as well as lost wages from time off work for treatment visits. These barriers can be more difficult for people who are struggling with economic hardship or those from disadvantaged communities. In addition, cultural and societal stigmas, language barriers, and prior negative experiences with the health care system can discourage some individuals from seeking treatment.
Studies indicate that when insurance coverage is offered, fewer embryos are transferred during each cycle, and the rate of multiple birth decreases. This improves the likelihood of conceiving and having a healthy pregnancy, which is desirable for both patients and public health.
Know more: Infertility treatment Solutions And Guide
