Infertility

Infertility affects about 6.1 million women and their partners in the U.S. -- about ten percent of the reproductive-age population (Source: National Survey of Family Growth, CDC 1995). Infertility affects men and women equally. Most infertility cases -- 85% to 90% -- are treated with conventional medical therapies such as medication or surgery.

When should you seek help?

We recommend you seek infertility counseling:

• If you are under age 35, and have been trying to conceive for one year or longer.
• If you are over age 35 and have been trying to conceive for six months or longer.
• If you have a history of pelvic inflammatory disease, painful periods, two or more miscarriages, irregular cycles, or if you know that your partner has a low sperm count, you should consult with your physician about becoming pregnant.

How is infertility diagnosed?

The first step in the diagnosis of the causes of infertility is a complete gynecological exam which includes the medical and sexual histories of both partners. This exam may uncover obvious problems, such as improperly timed intercourse or absence of ovulation. However, in many cases, additional tests may be needed.

For a man, testing usually begins with tests of his semen to look at the number, shape, and movement of his sperm. Sometimes other kinds of tests, such as hormone tests, are done.

For a woman, the first-stage includes monitoring ovulation and checking fallopian tube patency.

Ovulation can be checked through the monitoring of the morning body temperature, by using an over-the-counter home ovulation test kit, by blood tests of hormone levels and by an ultrasound test of the ovaries.

Patency and internal structure of the fallopian tubes is checked with a test called a hysterosalpigogram.

If the sperm, the tubes and ovulation are satisfactory and pregnancy has not occurred, endometriosis is present about 40% of the time. This disease can be detected and treated using laparoscopy.

• Hysterosalpingogram: An x-ray of the fallopian tubes and uterus after they are injected with dye. It shows if the tubes are open and shows the shape of the uterus and inside of the tubes.
• Laparoscopy: A surgical proceedure in which a narrow scope is passed into the abdominal cavity. Organs and tissues can be seen and certain conditions can be treated with special instruments that can also be passed into the abdomen through small incisions.
• Endometriosis: A common disease that occurs when the tissue that normally grows only inside the uterus, the endometrium, is found in other locations. This disease can cause pain and infertility in some women who have it.

What is the treatment for infertility?

Depending on the test results, different treatments can be suggested. Most cases can be treated with drugs that cause or improve ovulation or with surgery to repair damage to the fallopian tubes. If endometriosis is found, removal of the abnormally located tissue can improve the chances of conception. In cases of low sperm count, poor cervical mucous and when no cause for the infertility can be found, intrauterine insemination can often help.

If you require more advanced treatment for infertility such as in-vitro fertilization, we can refer you to providers in the Albany/Schenectady area who provide these services.

• In-vitro fertilization: In this treatment, ova (eggs) are removed from a woman’s ovaries and fertilized outside of her body. The fertilized eggs are then placed in the uterus through the cervix.
• Intrauterine insemination: In this technique, sperm are separated from semen and inserted directly into the uterus just before or during ovulation.

For more information about infertility, please click on the link below:

Infertility: http://www.acog.org/~/media/For%20Patients/faq136.pdf