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Infertility

"Fertility" (fur-til-uh-tee) is the ability to have children. Sometimes couples want children but can't seem to get pregnant. This is called "infertility" (in-fur-til-uh-tee). If you have not gotten pregnant after trying for one year, you may have this problem. About 6.1 million Americans have this problem. (This is 9 percent of the people who are at the age during which they could have children.)

Is there any way to protect against infertility?

• STDs (sexually transmitted diseases) are a major cause of this problem. Condoms prevent STDs. So use a condom when you are not trying to get pregnant.

When is the best time to have sex if you are trying to get pregnant?

• A couple must have sex during the woman's fertile time of the month. That time is right before and during ovulation (ahv-yoo-lay-shun). Ovulation is when the woman's egg drops to a place in her body where the sperm can reach it. The most fertile time is hard to pinpoint. So couples should try several times during the days around ovulation.

What should I do if I don't get pregnant within a year?

• You should see a doctor if you don't get pregnant after a year of having sex often. In some cases, you may need to get help even before a year is up.

At what age does it get harder to become pregnant?

• A woman slowly loses her ability to get pregnant starting at age 30. The older she gets, the greater her chance of losing the baby (miscarriage). A woman's chance of getting pregnant takes a big drop around age 40. You may not want to wait a whole year to see a doctor if you are over 30. You may want to get tested sooner.

Do men lose their fertility at the same age as women?

• A man starts losing his ability to have children 20 or 30 years later than a woman. A man's body starts to make fewer sperm after age 25. But some men stay fertile into their 60s and 70s.

Is infertility only a "woman's problem"? No.

• In about half the cases, the problem is at least partly the man's. For example, the man's body may make no sperm or too few sperm.

What affects a man's sperm?

• Lifestyle affects the number and health of a man's sperm. For example, getting enough rest and eating well can help. Overwork and stress can hurt.
• Alcohol and drugs can also have a bad effect on a man's sperm. Examples are marijuana, nicotine, and certain medicines.
• Chemicals in the environment may cause some problems, too. Examples are insect killers and lead.

Can a man's underwear affect his sperm? Yes.

• Tight underwear is not a good choice for men trying to father a child. They should avoid hot tubs and saunas, too. Anything that heats up the testes may get in the way of making sperm. (The testes are the organs that make sperm. They hang outside a man's body, below the penis. They need to stay cool to make sperm.)

Are there tests to check fertility in a woman or man? Yes.

• There are several tests for both men and women.
• The man's test checks how many sperm he has and how healthy they are. They start by looking at a sperm sample under the microscope. They count the sperm and check the sperm's shape and how they move.

The first step for a woman is to see if she is ovulating each month.
This can be done by:

• making a chart of changes in morning body temperature,
• using a home ovulation test kit approved by the FDA, or
• having a doctor look at mucus from the woman's cervix. (The cervix is the opening to the womb, or uterus.)

A couple should ask for advice if:

• The woman isn't having regular periods. This could mean that she is not ovulating
• The woman has had three or more miscarriages. Or the man has had three or more miscarriages with another partner.
• The woman or man has had any infections that could affect fertility. For example: woman -- pelvic infections; man -- mumps or prostate infection
• The woman or man thinks there may be a fertility problem. For example, they could not get pregnant with another partner.

Treatment

• Most cases are treated with drugs or surgery (80 to 90 percent). Surgery can repair woman's ovaries and womb. It can also repair a man's testes.
• Other couples may choose artificial insemination. (This is when the doctor collects sperm from the man and injects it into the woman's womb through a tube.)
• Other options include many ways of putting the sperm and egg together and then putting it back into the women's womb.

October 2003

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FDA Office of Women's Health