Frequently Asked Fertility Questions
What is infertility?
Infertility is the inability to conceive after one year of unprotected intercourse or the inability to carry a pregnancy to term. This definition is reduced to six months for women over 35, those with a history of painful periods, irregular cycles, pelvic inflammatory disease and miscarriages, and couples whose male partner has a low sperm count. 10 percent of women (6.1 million) in the United States ages 15-44 have difficulty getting pregnant or staying pregnant, according to the Centers for Disease Control and Prevention (CDC).
What causes infertility?
Your fertility doctor will work with you to determine the cause of your infertility and the best treatment options.
Female infertility can result from a range of factors. Common causes of female infertility include advanced age, fallopian tube damage, endometriosis, polycystic ovarian syndrome, cervical abnormalities, polyps and fibroids.
Common causes of male infertility include a problem with testicular production of sperm, no sperm (azoospermia), a blockage in the testicles, a dilated vein in the scrotum (varicocele), a hormonal imbalance, or any previous health issues.
For how long should I try to get pregnant before calling a doctor?
Most experts suggest at least one year for women under the age of 35. Women 35 or older should see their doctors after six months of trying. A woman’s chances of having a baby decrease rapidly every year after the age of 30. Some health problems also increase the risk of infertility, so women should talk to their doctors if they have irregular periods, a lack of menstrual periods, very painful periods, endometriosis, pelvic inflammatory disease or more than one miscarriage. Ideally, it’s also beneficial to talk with a doctor before trying to get pregnant. Doctors can help you get your body ready for a healthy baby and can also provide tips on conceiving.
How do doctors treat infertility?
Infertility can be treated with medicine, surgery, artificial insemination, or assisted reproductive technology. Many times these treatments are combined. In most cases infertility is treated with drugs or surgery. Doctors recommend specific treatments for infertility based on test results, how long the couple has been trying to get pregnant, the age of both the man and woman, the overall health of the partners, and the preferences of the partners.
Treatment options include assisted reproductive techniques such as IVF (in vitro fertilization), ovulation induction to enhance the production of eggs, surgery to repair reproductive organs, and intrauterine insemination (IUI) to increase the chances for egg fertilization by the sperm. Additional treatment options include PGD ““ a test which detects detect genetic abnormalities, and egg freezing ““ a service for those facing chemotherapy/radiation therapy for cancer, or want to delay childbearing.
What happens at an initial consultation?
Your initial consultation at a fertility clinic begins the process of your medical team getting to know you, the patient. During this meeting, your physician will gather more information about your medical and fertility history — and then begin to develop an individualized treatment plan. Here you’ll have an opportunity to ask any questions you have about infertility and your potential treatment options. You’ll also meet with an experienced financial coordinator (a liaison between you and your insurance company) to learn what exactly will be covered by your insurance provider.
What if I need emotional support?
Counseling for individuals and couples can offer help in coping with the unique stresses of ongoing medical treatments and the uncertainty of the outcome — including the possibility of unsuccessful treatment cycles, as well as help in dealing with family, friends, and the fertile world.
It’s also important to find a clinic that focuses on the mind/body aspect of infertility, as new studies have shown links between stress and infertility. Numerous disciplines including acupuncture, psychology, nutrition, and restorative yoga have shown to decrease stress and improve conception rates.
How do I get started?
Research suggests that many couples who can become pregnant with assisted reproductive technology (ART) do not because they are afraid of initiating treatment. The best advice in this situation is to always see a doctor as soon as possible — and to remember that you are not alone.
Know that your future infertility team will help guide you every step of the way.
How do I know which is Cycle Day 3?
The first day of real bleeding, not spotting, is considered cycle day 1; cycle day 3 is 2 days later.
Why is it OK to collect semen at home if you live within about 30 minutes of your office?
After ejaculation a semen sample must liquefy for about 30 minutes prior to lab processing. Delaying lab processing excessively after this interval will give poorer results. Specimens should be transported as close to body temperature as possible.
Can I have intercourse if I am pregnant?
There is no evidence that intercourse has any adverse effects on the pregnancy, but some patients prefer to err on the side of caution, and to refrain from having intercourse. The best advice is: if you’re concerned that intercourse may make you uncomfortable or cause bleeding, then it’s best to avoid it.
How long should I pursue a certain treatment plan prior to moving on to a different treatment?
The greatest chance for success with any plan is about 3–4 cycles. You should schedule a revisit every 4 months in advance to avoid delays in having a consultation.
I don’t understand how to do my injections; what should I do?
We have designed our website to address these issues and have instructional videos/DVDs in our office to help you. We strongly recommend that you review this information before your cycle to help identify your questions and feel more comfortable. We often use mail order pharmacies for their convenience, and they often have a nurse on staff 24 hours a day to answer your medication questions.
Do I have to have an IUI?
Even if IUI is recommended for you, some patients aren’t comfortable with it for ethical or other reasons. Monthly pregnancy rates are higher with IUI compared with intercourse. If you don’t wish to have IUI, you’ll be asked to have intercourse during ovulation. For some patients, including couples having difficulty with intercourse, cervical mucous, and poor sperm count or motility, IUI will be a stronger part of our overall treatment plan, and we will encourage you to have this treatment.
Do most couples have an IUI?
Yes. Because IUI is a basic part of advanced reproductive treatments, most couples are advised to have this procedure.
How do I schedule my monitoring clinic appointment?
On the first day of your menses, you must call the clinic scheduling line (518)434-9759, ext.401) to leave a message indicating the date for which you are scheduling clinic (cycle day 2,3 or 4). Your message should include a requested appointment time. A member of our staff will contact you only if this time is unavailable. Return calls are made between 9am-5pm, seven days a week.
Do I have to fast when I come in for blood work?
Generally, you don’t need to fast except when we’re drawing blood for certain hormones. You’ll be advised to fast if you need to do so.