Infertility

Even when everything is working well, conception can take time. Healthy couples under 30 have roughly a 20 to 25% chance of getting pregnant in any given month, and most couples who are trying will conceive within a year. Because it’s normal for pregnancy not to happen right away, a few months without success isn’t usually a cause for concern. If you’ve been trying longer than recommended for your age, an evaluation can help identify what may be getting in the way.

In some cases, yes. You may benefit from an earlier fertility evaluation if you are over 40, have irregular or absent periods, or have a known history of endometriosis, pelvic inflammatory disease, or problems with your uterus or fallopian tubes. It’s also a good idea to seek care sooner if you’ve had two or more miscarriages, have undergone cancer treatment, or if your partner has a known fertility concern. Getting answers early can save valuable time.

Age is one of the most important factors in female fertility. Women are born with all the eggs they will ever have, and both the number and quality of those eggs decline over time. Fertility begins to decrease gradually in the early 30s and declines more quickly after age 35, with a significant drop after 40. Older eggs are also more likely to have chromosomal abnormalities, which can raise the risk of miscarriage. Male fertility declines with age as well, though usually more gradually.

Your fertile window includes the five days leading up to ovulation and the day of ovulation itself. In a typical cycle, ovulation happens about 14 days before your next period begins, though this varies from woman to woman. Having intercourse every 1 to 2 days during your fertile window gives you the best chance of conceiving. Tracking your cycle can help you better understand when you’re most likely to ovulate

No. Using birth control, even for many years, does not cause infertility. For most methods, including the pill, patch, ring, hormonal IUD, copper IUD, and implant, fertility typically returns quickly after you stop. The birth control shot is the exception, as it can take up to 10 months or longer for regular ovulation to resume. If your periods don’t return to a regular pattern within a few months of stopping birth control, talk with your provider.

Polycystic ovary syndrome (PCOS) is one of the most common causes of infertility in women. PCOS is a hormonal condition that can cause irregular or absent ovulation, which makes it harder to predict fertile days and conceive. The good news is that many women with PCOS are able to get pregnant with the right care. Treatment may include lifestyle changes, medications that help trigger ovulation, and management of related concerns such as insulin resistance.

Yes, it’s often possible to conceive naturally with one healthy, open fallopian tube, as long as you’re ovulating regularly and there are no other fertility concerns. Your chances may be somewhat lower than with two open tubes, and the timeline to pregnancy may be longer. Depending on your age and overall fertility, your provider may recommend treatments such as ovulation medications or IUI to improve your odds.

Yes. Because male factors play a role in many cases of infertility, evaluating both partners is an important part of the process. The primary test for men is a semen analysis, which measures sperm count, movement (motility), and shape (morphology). This simple, noninvasive test is often one of the first steps in a fertility workup, and the results can help guide the most effective treatment plan for you as a couple.

Male infertility can result from a number of factors, including a varicocele (enlarged veins in the scrotum), hormonal imbalances, infections, genetic conditions, and blockages in the reproductive tract. Lifestyle and environmental factors can also play a role, such as smoking, heavy alcohol use, obesity, frequent heat exposure, and the use of anabolic steroids or testosterone supplements. Many of these causes can be treated or improved once they are identified.

Most women experience mild to moderate cramping during an HSG, similar to menstrual cramps. The discomfort usually lasts only a few minutes and eases shortly after the procedure is complete. Your provider may recommend taking an over-the-counter pain reliever about an hour beforehand to help you stay comfortable. The test is typically scheduled after your period ends and before ovulation.

Recurrent pregnancy loss, generally defined as two or more miscarriages, is different from infertility, but the two can overlap and both deserve careful attention. Repeated miscarriages may be linked to factors such as chromosomal abnormalities, uterine abnormalities, hormonal imbalances, blood clotting disorders, or thyroid issues. An evaluation can help identify possible causes and guide treatment. Many women who experience recurrent miscarriages go on to have healthy pregnancies.

Some fertility treatments can raise the likelihood of twins or other multiples. Ovulation-inducing medications may cause the ovaries to release more than one egg, and transferring multiple embryos during IVF also increases the chance of a multiple pregnancy. Because carrying multiples comes with higher risks for both mother and babies, your care team will carefully monitor your treatment and discuss ways to reduce this risk, such as single embryo transfer.

Ovarian hyperstimulation syndrome is a possible side effect of injectable fertility medications. It occurs when the ovaries swell and become painful in response to the hormones. Mild cases may cause bloating, abdominal discomfort, and nausea and usually resolve on their own. Severe OHSS is rare but can cause rapid weight gain, severe abdominal pain, shortness of breath, and decreased urination. Contact your provider right away if you notice any of these