Seeing a Doctor for Infertility: Questions and Treatments

When you and your partner see your doctor to talk about problems getting pregnant, it helps to do some planning on the topics you'd like to bring up.

The doctor will ask you questions, but you can bring your own list of questions to your appointment. It's a good starting point for your discussion on infertility and ways to treat it. They can include:

1. Could smoking, alcohol, or stress affect my fertility?
2. Could my job or my partner's job contribute to our problems?
3. Are there any nonmedical approaches, such as relaxation or meditation, that could improve our chances of getting pregnant?
4. Is it important to get an infertility evaluation now, or should we wait?
5. Which specific tests would you recommend to diagnose infertility? What do they cost?
6. What are our treatment options, and how much do they cost?
7. How much of the cost of fertility treatments or testing does health insurance typically cover?
8. What's the success rate, measured by "live births," for each type of treatment?
9. How many procedures like the one you recommend for me has this fertility clinic done? What's the success rate?
10. Can you put us in touch with former patients who’ve had similar treatments?

How Does the Doctor Determine If I Am Infertile?

To determine whether you are infertile, your doctor will go over your health history, medications, sexual history, and sex habits, like how often you have sex.

Men will get a physical exam and often a sperm analysis, which tests the health of the sperm.

For a woman, testing begins with a medical history and physical exam, including a pelvic exam. The doctor then makes sure that they ovulate regularly and that their ovaries are releasing the eggs. Blood tests are taken to measure hormone levels. The ovaries and uterus may be examined by ultrasound, and a specific X- ray test can check the uterus and fallopian tubes.

In about 80% of couples, the cause of infertility is either an ovulation problem, blockage of the fallopian tubes, or a sperm problem. In 5%-15% of couples, all tests are normal, and the cause is not known.

What Are the Treatments for Infertility?

In men, fertility is treated with:

• Surgery, if the cause is a varicocele (widening of the veins in the scrotum) or a blockage in the vas deferens, tubes that carry sperm.
• Antibiotics to treat infections in the reproductive organs.
• Medications and counseling to treat problems with erections or ejaculation.
• Hormone treatments if the problem is a low or high level of certain hormones.

In women, infertility is treated with:

• Fertility drugs and hormones to help the woman ovulate or restore levels of hormones
• Surgery to remove tissue that is blocking fertility (such as endometriosis) or to open blocked fallopian tubes

Infertility in men and women can also be treated with assisted reproductive technology, or ART. There are several types of ART:

• IUI (intrauterine insemination): Sperm is collected and placed directly inside the woman's uterus while they are ovulating.
• IVF (in vitro fertilization): The sperm and egg are collected and brought together in a lab. The fertilized egg grows for 3 to 5 days. Then the embryo is placed in the woman's uterus.
• GIFT (gamete intrafallopian transfer) and ZIFT (zygote intrafallopian transfer): The sperm and egg are collected and quickly placed in a fallopian tube. With GIFT, both the sperm and eggs are placed into the fallopian tube. With ZIFT, the sperm and eggs are brought together in a lab and then a fertilized egg is placed into the tube at 24 hours.

Infertility Resources

Some resources for educating yourself and getting support are:

Resolve. This organization is a source for research, support, and advocacy.

American Society for Reproductive Medicine. This site has information for patients and medical professionals.

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