Patients often come to their initial consultation filled with questions about infertility. Despite how many people need fertility services, we still have a long way to go when it comes to talking openly about infertility. Read on for answers to some of the most common questions we hear about infertility.

Question 1: What is infertility?

Infertility is a disease defined by the inability to conceive (become pregnant) and have a live birth after at least 12 months of unprotected, regular intercourse. We agree with the World Health Organization (WHO) and expand the definition of infertility to include individuals who cannot conceive traditionally, such as LGBTQ+ and single intended parents.

Question 2: How common is infertility?

Many of our patients are surprised to learn that infertility is very common. However, around 1 in 8 people (and 1 in 6 couples) trying to conceive experience infertility. This places it among the most common diseases for people aged 20 to 45.

Question 3: Who is affected by infertility?

Infertility can affect people regardless of all genders, ethnicity, age, or socioeconomic status. Men, women, and nonbinary individuals can all experience infertility. While some causes of infertility may have a genetic factor, others may not. Certain causes of infertility become more common as people get older.

Question 4: Are there different types of infertility?

Yes: Primary infertility includes people who have never become pregnant. Secondary infertility, on the other hand, refers to people who have had children in the past but have challenges conceiving again. Patients with recurrent miscarriage or recurrent pregnancy loss are able to become pregnant, but have difficultly carrying the pregnancies to term and delivery.

Question 5: When should I see a fertility specialist?

Generally, we recommend meeting with an infertility specialist after trying unsuccessfully to get pregnant for 12 months, or after 6 months if the female partner is over 35 years old. You might also consider consulting with an infertility specialist to ask questions if you:

•  Have irregular or unpredictable menstrual cycles, which can signal an ovulation issue or hormone imbalance
• Have a diagnosis of polycystic ovarian syndrome (PCOS), endometriosis, or chronic disease that impacts your health
• Have experienced multiple miscarriages
• Are interested in fertility preservation (egg freezing)
• Would need third-party reproductive assistance such as donor eggs, donor sperm, or surrogacy
• Have a family history of known genetic conditions such as cystic fibrosis

Question 6: How does age affect fertility?

Age affects fertility most significantly in people with ovaries. Over time, both the quality and quantity of eggs produced by the ovaries decrease. This makes it harder to become pregnant. This decline usually occurs gradually through a person’s mid-30s. It then decreases more steeply, and drops off significantly after age 40. As the number of available eggs decreases, the remaining eggs also become less likely to successfully develop into a healthy pregnancy. Sperm quality and quantity also decreases with age, albeit less dramatically than with eggs.

Question 7: What are the most common infertility tests?

The first step of any fertility treatment journey is a consultation with a specialist. During this visit, the doctor will recommend various tests based on your history. The most common tests include anatomy testing like a pelvic ultrasound and hysterosalpingogram (HSG), blood tests for egg supply and other hormone levels, and a semen analysis. Based on these results, your doctor may recommend additional tests.

Question 8: What are some common infertility treatment options?

Everyone’s fertility journey is unique, and all treatment plans should be individually tailored to your history and needs. In general, treatment options can include:

• Lifestyle adjustments to maximize chances of conception
• Hormonal medications to improve ovulation
• Surgery to remove anatomical challenges
• Assisted reproductive technology (ART), including:
• Intrauterine insemination (IUI)
• In vitro fertilization (IVF)
• Third party reproduction/collaborative reproduction

In IUI, a prepared sperm sample is placed directly into the uterus around the time of ovulation, increasing the chances of conception. IVF involves combining an egg and sperm in a lab, then implanting the resulting embryo into the uterus. Third party reproduction uses donor tissue (egg, sperm, or embryo), or a gestational carrier (surrogate) to conceive or carry a pregnancy.

Question 9: How much does infertility treatment cost?

Treatments vary in cost depending on the type of procedure and the number of treatments required. The costs can add up to a significant amount, especially if you require multiple treatment cycles or decide to use donor eggs or a gestational carrier. Unfortunately, many health insurance companies do not cover fertility treatments. However, there are many paths to creating an affordable plan, including grants and fertility loans.

Question 10: Only people who can’t get pregnant go to a fertility clinic, right?

Not necessarily! We also offer treatment services for patients who want to freeze their eggs or sperm (fertility preservation), as well as patients with conditions related to the reproductive system. These conditions, such as polycystic ovarian syndrome (PCOS), endometriosis, or fibroids, can affect quality of life in patients regardless of if they wish to become pregnant or not. Our doctors can help diagnose and treat a variety of reproductive health concerns.

Infertility is a complicated experience, and it can feel overwhelming. We are here to support you every step of the way. To discuss your infertility questions with one of our team members, schedule an initial consultation today.