Infertility


Infertility is the result of a disease (an interruption, cessation, or disorder of body functions, systems, or organs) of the male or female reproductive tract which prevents the conception of a child or the ability to carry a pregnancy to delivery.

Infertility

Transcript

Infertility is the result of a disease (an interruption, cessation, or disorder of body functions, systems, or organs) of the male or female reproductive tract which prevents the conception of a child or the ability to carry a pregnancy to delivery. 

A 34-year-old woman and her husband come to their doctor for evaluation and treatment for infertility. She gave birth to a healthy girl 3 years earlier but she and her husband have been trying to conceive again for 1 year without success. Although her menstrual periods used to come regularly every 26-28 days apart, they now occur up to 40 days apart. Her doctor noticed hair growth under her chin and down the middle of her abdomen. After further testing she was diagnosed with polycystic ovary syndrome and she was found not to be ovulating regularly. Her husband was evaluated as well and his sperm count and sperm motility was found to be mildly low on several occasions. The couple discussed different options for fertility treatment with their doctor and they decided to use clomiphene citrate pills to improve her ovulation. She also had an intrauterine insemination that was timed around her ovulation. After three months of treatment, the couple conceived and 9 months later she delivered a healthy baby boy by vaginal delivery.

If you are trying to get pregnant, you are not alone.

If you are watching this because you have been having difficulty becoming pregnant – remember – you are one of many who are experiencing the same difficulty! Millions of men, women, and couples seek medical care each year for the same reason! The good news is that many patients are successful in achieving their dream!

10%-15% of all couples have difficulty becoming pregnant or meet the definition for infertility. There are many reasons why couples may not become pregnant as quickly as they would like. Seeking assistance will often help you to achieve your goal!  Over 80% of couples will achieve pregnancy after trying to conceive for 1 year and 90% will get pregnant if they continue trying for another year. For many couples, pregnancy is just a matter of time. Some couples may even become pregnant during the process of seeking help! It is important to have patience. However, it is also important to seek medical care from a trained fertility specialist to help provide answers and guidance.

As time goes on without a pregnancy, couples should strongly consider seeing an expert. The purpose of seeing a fertility specialist is to determine if any specific reason can be identified that may be causing a delay in achieving pregnancy. Reproductive endocrinologists are specialists trained for this very purpose. They have training in obstetrics and gynecology with further training in fertility. They stay up to date on the best diagnostic and treatment options available. A specialist can sit down and talk with you and explain what treatment options may be best for you!

Many couples choose to wait until they have been trying to conceive for 12 months with regular sexual intercourse. It is also appropriate for some women to see a specialist earlier. Women over the age of 35 should consider seeing a specialist after 6 months of trying to become pregnant. Others may wish to seek care earlier, particularly if something in your medical history suggests a potential reason for infertility. Some of these reasons include very irregular menstrual cycles, a previous history of ectopic pregnancy or pelvic infection, male or female exposure to radiation or chemotherapy, or a history of endometriosis.

Who should be evaluated by a specialist?

Both men and women should meet with a specialist together, at least at some point in the evaluation.  Both partners may have an underlying problem that is contributing to infertility. In almost every case, the stress of not achieving pregnancy affects both partners. It is important to support each other in order to make the process easier. Sometimes men will be advised to consult with a urologist who specializes in male infertility. We will discuss this later in more detail.

Many couples will find one or more reasons for their infertility after evaluation by a specialist.   Sometimes the reason may be straightforward and easy to address, while other times more advanced treatment is required. Some of the main causes of infertility are problems with ovulation (releasing an egg from the ovaries), abnormalities of the sperm, a blockage in one or both fallopian tubes, fibroids, endometriosis, and age-related changes in the function of the ovaries.  In some cases, no obvious explanation can be found (unexplained infertility). This does not mean that no reason exists. It simply means that no common, easily detectable cause has been found. But be assured – regardless of your diagnosis, treatment options exist!

Couples often wonder: What will the specialist say? What tests will be ordered? How long will it take to find a cause? Will the tests hurt? My friend had this test, will I have the same test myself? 

You should know that no standard set of tests is used for every patient and for every couple. Some patients need more tests than others. Most tests are easily and quickly performed and are not painful in any way. In just a moment, we will go through some of the most common tests you may have performed by your specialist.

At the same time that you undergo fertility testing, your doctor may order laboratory tests for you and your partner. These are tests that make sure your body is ready for pregnancy. The tests often include checking for infections such as HIV and hepatitis, your blood count and blood type, and may include genetic screening. If you have any chronic medical conditions such as high blood pressure or diabetes, your doctor may run tests to make sure these conditions are optimized.

Your doctor will want to know whether or not you are ovulating, or releasing an egg, and exactly when each month this occurs.  You may be asked if you have regular menstrual cycles, how far apart your cycles are, and if you have any bleeding between your menstrual cycles. Most women who have regular bleeding patterns (every 25-32 days), usually ovulate on a regular basis. But your doctor may perform one or more tests to verify this. Some doctors may advise using a basal body temperature or BBT chart. When using a BBT chart, you take your temperature everyday when you first wake up.  Usually an electronic thermometer is used and you record your findings on a special chart or graph.  Some couples may prefer to use the many computer programs or applications that are available.  Because your temperature rise is noted after you’ve already ovulated, this test is not considered reliable in predicting when you release an egg.  

You can also use a urine test kit to detect a rise in luteinizing hormone or LH.  LH is produced by the brain in the pituitary gland and is the trigger for ovulation.  An LH test (ovulation predictor kit) determines the time of ovulation approximately 12-36 hours before it occurs.  When the test is positive, a couple can time intercourse.  However, this test should only be used by women who have monthly menstrual cycles.  Your doctor may also order a blood test of your progesterone level. This hormone usually rises after ovulation. If the progesterone level is above 3 ng/mL, then you have ovulated.  It’s important to know that the progesterone test does not give any information about the quality of ovulation.  

If you have a male partner, a semen analysis should be performed. A semen analysis evaluates the number, shape, and movement of sperm. In up to 50% of all couples, there can be abnormalities identified in the sperm. Don’t be alarmed. The vast majority of these are very mild. And there can be variation between sperm samples, so usually when an abnormality is seen, the test is repeated. The laboratory measures many things when running a semen analysis, but several parts of the test are important. Certainly the number of sperm is important. This number may be given to you as a total sperm count or as a sperm concentration. Generally a sperm concentration of greater than 15 million sperm per milliliter is considered normal. The number of moving sperm, the sperm motility, is measured as the percent of sperm that are moving-- 40% or more moving sperm is considered normal.  Finally, a specialized test called sperm morphology may be performed. For this particular test, individual sperm are viewed under a microscope to check their size and shape. Determining normal sperm morphology varies among laboratories.  

Men might be asked to see a urologist for a variety of reasons. There may be abnormalities in one or a combination of sperm measurements on the semen analysis. Explanations for these problems can be further investigated. For instance, a urologist will perform a physical examination of the penis and testicles to check for a varicocele, which are enlarged blood vessels next to the testicles. These enlarged blood vessels increase the temperature of the testicles and can affect sperm number and quality. When appropriate, there may be lifestyle or surgical interventions that can help improve this problem. In rare cases, there may be no sperm seen on a semen analysis, called azoospermia.  A urologist, preferably one trained in male infertility, can work with your fertility specialist to help investigate whether azoospermia is because no sperm is being produced or because the sperm that are produced are blocked from being released during ejaculation. Additional hormonal and genetic blood tests may be needed. In some cases, surgical removal of sperm may be necessary. The important thing to remember is that very successful treatments are available for couples with normal sperm, mildly abnormal sperm, and for couples with severe sperm abnormalities.

For many couples, the choice of infertility treatment often depends on how a woman’s fallopian tubes are working. Women normally have 2 fallopian tubes and each tube serves as a passageway to allow sperm to travel upward and the egg to travel downward so that the two can meet. The fallopian tubes can be damaged in many ways. Damage often occurs from past infections inside the abdomen including appendicitis, pelvic inflammatory disease, or cervical infections such as gonorrhea and chlamydia. Not all infections cause symptoms, so it’s possible to have an infection and never know it. Damage to, scarring, or blockage of one or both fallopian tubes may result from endometriosis and previous surgery such as laparoscopy or open surgery near or on the fallopian tubes or ovaries.

A common test to evaluate fallopian tubes is a hysterosalpingogram, also known as an HSG. This test is usually performed in a hospital or outpatient radiology center, either by your fertility specialist or by a radiologist. While the doctor injects contrast material or dye into the cervix, x-rays are taken to see if the endometrial cavity, the inside of the uterus where a pregnancy would grow, has a nice smooth shape, and to see if the contrast material goes into and travels out the ends of each fallopian tube, confirming whether one or both fallopian tubes are open.

Your doctor may discuss the term “ovarian reserve.” This is a medical term used to describe how your ovaries work, specifically their ability to produce eggs and respond to treatment. Not everyone needs this type of testing. Women with irregular menstrual cycles will often be tested. As women become older, their ovarian reserve is expected to decline. There is no specific age as to when this happens and there is tremendous variation among women. There are several ways to test for ovarian reserve. One method is an ultrasound during the first few days of the menstrual period to count the number of very small follicles on each ovary, also called an antral follicle count. Having more follicles is generally a good prognostic sign. 

You may also have some blood tests performed. The most common test is the follicle stimulating hormone, or FSH level. This is a natural hormone in your body that plays a large role in the growth and development of your eggs. Your doctor may perform an FSH level on Day 3 of your menstrual cycle.  Over time, a woman’s FSH level tends to go up and that is expected. Your doctor is usually looking to make sure it has not risen too high.  The FSH test is feared by many women and for some women is it the source of a significant amount of stress. It’s important that you understand this is a screening test. It is simply a test. And whether the test is high or low, normal or abnormal, it does not tell your doctor exactly what happens in your body and it does not determine whether or not you will become pregnant. More than anything else it can help your doctor counsel you on the best options for treatment.

Another test that can be used to determine ovarian reserve is antimüllerian hormone or AMH. This hormone can be tested at any time of the menstrual cycle or while taking hormonal contraceptives.  AMH is produced by the cells inside the follicles.  The levels of AMH go down months or years before an abnormal rise in FSH is detected.  The cut-off point to determine an abnormal value varies depending on the laboratory.

You may have an ultrasound, also called a sonogram, at some point in your evaluation. An ultrasound may be performed to evaluate the uterus and the ovaries. As mentioned earlier, an ultrasound may be used for an antral follicle count at the beginning of your menstrual cycle, or it may be used to follow the growth and development of follicles later in your cycle. An ultrasound can also measure the thickness of the inner lining of your uterus where a pregnancy would implant and grow. Fibroids, which are common noncancerous overgrowths on the uterus, may also be detected by ultrasound and followed over time. Although an ultrasound is sometimes uncomfortable, it is not a painful test.

A laparoscopy is a minimally invasive surgical procedure. Even though it is a minimally invasive surgery, it is probably the most invasive of any of the tests that your doctor may recommend. A laparoscopy involves a camera attached to a telescope that is usually placed through a very small incision in your belly button into your abdomen to look at the internal structures. These structures include the uterus, the fallopian tubes, the ovaries, and the pelvis in general. Most women do not have a laparoscopy and it should not be performed on a routine basis.  However, your doctor may recommend this for several reasons. These include an abnormality of the fallopian tubes requiring further investigation, an abnormality of the uterus, a high suspicion for endometriosis, or for further clarification if nothing else in your testing explains your difficulty in getting pregnant.

This basic review of testing procedures is meant to be a guide.

Not every patient undergoes the same tests. Your specialist will review your history and make individual recommendations.  Most tests are very simple, but some tests are a little more time consuming. In most cases, you will be able to complete all the tests over the course of about 4-5 weeks. The purpose of these tests is to try to provide answers as to why achieving pregnancy has not been easy for you. These tests also help you doctor tailor an appropriate treatment plan.  But remember - in some couples all of the tests will be normal and no explanation will be found. That is ok.  Plenty of treatment options exist and the vast majority of couples are able to conceive. 

Discuss your options with your doctor. You will soon discover that each option has its own set of distinct advantages and disadvantages. Together with your doctor you can make a treatment plan that you are comfortable with and that makes the most sense for you!  Always keep in mind that the goal is not to have a particular test or to have a specific treatment, but to have a happy and healthy child! 

Videos

Resources For You

The American Society for Reproductive Medicine (ASRM) is committed to providing patients with the highest quality information about reproductive care.

Infertility

PR Bulletin Icon

ASRM announces support for HOPE with Fertility Services Act

The American Society for Reproductive Medicine is proud to endorse the HOPE with Fertility Services Act (HR 8821).

View the Press Release
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SART Fertility Experts - Environmental Impacts on Fertility

In this episode, the fertility experts discuss the impact of the environment, including air, climate, and chemical exposures on infertility.   Listen to the Episode
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Survey shows strong support for increased access to fertility treatments

A new public opinion poll reveals strong support for improved access to In Vitro Fertilization (IVF). 

View the Press Release
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Leave Your Mark! NIAW April 21-27

National Infertility Awareness Week Action Round-Up Click here to leave your mark during NIAW2024
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National Infertility Awareness Week 2024: Leave Your Mark

Next week is National Infertility Awareness Week, a federally recognized health observance founded to increase awareness of infertility.

View the Press Release
Announcement Icon

ASRM reacts to Alabama legislation

We are pleased that the legislation passed into law by the Alabama General Assembly will at least allow our members in the state to care for their patients.

View the Press Release
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IVF at the SOTU: Fertility care expected to be major focus at State of the Union

Protecting access to IVF care is expected to be a major theme of the State of the Union on Thursday.

View the Press Release
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ASRM Responds to Proposed Alabama Legislation

We are proud of our Alabama members and their patients, who have been such incredible advocates working to motivate their legislators to protect IVF.

View the Press Release
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Senate Budget Hearing is Well Timed Following Alabama IVF Ruling

ASRM statement regarding the Senate Budget Committee’s hearing entitled: No Rights to Speak of: The Economic Harms of Restricting Reproductive Freedom.

View the Press Release
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ASRM Responds to Senate’s Failure to Pass Access to Family Building Act

We are disappointed by the Senate’s failure to meet the moment and pass federal legislation protecting access to in vitro fertilization (IVF).

View the Press Release
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Society of Reproductive Biologists and Technologists (SRBT) Condemns Recent Court Decision in Alabama

The recent ruling by the Alabama Supreme Court that frozen embryos are legally considered people has sparked controversy and concern.

View the Press Release
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ASRM Condemns Profoundly Misguided and Dangerous Court Decision in Alabama

In LePage v Mobile Infirmary Clinic, the Alabama Supreme Court made a decision that flies in the face of medical reality and the needs of the citizens.

View the Press Release
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SART Fertility Experts - Recurrent Pregnancy Loss and Implantation Failure

"I can get pregnant, but I can't stay pregnant," is echoed by patients with recurrent pregnancy loss.   Listen to the Episode
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SART Fertility Experts - Wellness and Fertility: Diet, Sleep and Exercise

Drs. Timothy Hickman and Rashmi Kudesia discuss the links between lifestyle and fertility. Listen to the Episode
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SART Fertility Experts - Navigating IVF as a Couple

Mary Casey Jacob, PhD is interviewed by Dr. Daniel Grow, and together they explore the emotional and practical support that couples need. Listen to the Episode
Patient Ed Icon

Male Fertility Journey

About 20% of infertility cases are due to a male factor alone. Another 30% involves both male and female factors.

View the Patient Journey
Patient Ed Icon

Female Fertility Journey

If you've been trying to get pregnant for more than a year, you may have infertility. Infertility is a disease of the reproductive system that impairs one of the body's most basic functions: the conception of children.

View the Patient Journey
Patient Ed Icon

Stress and infertility

It is not clear how exactly stress impacts fertility. Read the Fact Sheet
Patient Ed Icon

Defining Infertility

Infertility is “the inability to conceive after 12 months of unprotected intercourse.” View the Fact Sheet
Patient Ed Icon

Infertility Counseling and Support: When and Where to Find It

Infertility is a medical condition that touches all aspects of your life. View the fact sheet
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Male infertility evaluation: what do I need to know?

Infertility is the inability to achieve pregnancy after one year of unprotected sex. View the fact sheet
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Smoking and infertility

Most people understand that smoking increases the risk for heart, vascular, and lung disease. View the fact sheet
Patient Ed Icon

What are fibroids?

Uterine fibroids (also called myomas or leiomyomas) are benign (noncancerous) tumors of muscle tissue found in the uterus. View the fact sheet
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SART Fertility Experts - Endometriosis

Endometriosis is a condition that can affect many facets of a person’s life, from pelvic pain to struggles with infertility.   Listen to the Episode
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SART Fertility Experts - Recurrent Pregnancy Loss

Candace discusses her experience with infertility, IVF, multiple pregnancy losses and ultimately a successful delivery with Dr. Julia Woodward.
Listen to the Episode
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SART Fertility Experts - Financial Aspects of Infertility Treatment

“I know what treatment I want and need to do, but how can I afford it?”  This is a common question infertility patients often ask themselves. Listen to the Episode
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SART Fertility Experts - Infertility Advocacy and Government Affairs

In today's episode, Dr. Mark Trolice interviews Sean Tipton about the fact that many infertility patients do not have insurance coverage for treatment. Listen to the Episode
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SART Fertility Experts - Your Infertility Nurse: Partner in Your Care

Infertility nurse practitioner and health coach Monica Moore explains the essential role of the infertility nurse in the IVF process.  Listen to the Episode
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SART Fertility Experts - IVF: Cycles of Hope and Heartbreak

Does stress cause infertility or is it the other way round?  Listen to the Episode
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SART Fertility Experts - RESOLVE and Infertility

Due to the unique stress of infertility, patients often look for resources and support in addition to those provided by their medical provider. Listen to the Episode
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SART Fertility Experts - Safe Surfing: The Pros and Perils of Social Media

Dr. Kenan Omurtag, MD joins host Dr. Mark Trolice to discuss the use of social media in the field of infertility.  Listen to the Episode
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SART Fertility Experts - What is an REI?

These experts in infertility lead IVF programs, perform reproductive surgery, and perform research to enhance the field of reproductive medicine. Listen to the Episode
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Stress and Infertility

Medical procedures, cost, outcome uncertainty, and unwanted or unhelpful advice from friends and family are stressors associated with infertility treatment. Watch Video
Patient Ed Icon

Infertility: an Overview (booklet)

Infertility is typically defined as the inability to achieve pregnancy after one year of unprotected intercourse. View the booklet
Patient Ed Icon

Optimizing Natural Fertility

Before attempting pregnancy, a woman should make sure she is healthy enough for pregnancy by adopting a healthier lifestyle and taking prenatal vitamins. If she has a medical or genetic condition or risk of one, she should seek advice from a medical professional before conceiving (becoming pregnant) View the fact sheet
Patient Ed Icon

Optimizing Male Fertility

About 20% of infertility cases are due to a male factor alone. Another 30% involves both male and female factors. View the fact sheet
Videos Icon

Male Fertility and Infertility - a patient education video

Male Factor Infertility is responsible for about 30% of infertility cases and can contribute infertility to an additional 20% of cases. Watch Video
Videos Icon

Infertility

Infertility is the result of a disease (an interruption, cessation, or disorder of body functions, systems, or organs) of the male or female reproductive tract which prevents the conception of a child or the ability to carry a pregnancy to delivery.  Watch Video
Videos Icon

Basic Infertility Evaluation

Dr. Roger Lobo of the American Society for Reproductive Medicine discusses the various methods to evaluate infertility. Watch Video
Videos Icon

Fibroid Tumors

An educational video that answers patient questions about the causes, symptoms, diagnosis and management of uterine fibroids. Watch Video
Videos Icon

Infertility Treatments

Dr. Roger Lobo of the American Society for Reproductive Medicine discusses the various treatments for infertility. Watch Video
Videos Icon

Understanding Fertility

In this video series, Dr. Roger Lobo explains the basics of infertility, including causes, treatments and coping methods. Watch Video
Videos Icon

Surviving the Roller Coaster Emotions of Infertility Treatment

The experience of infertility is a rollercoaster of hope and disappointment. Treatment presents an opportunity for hope as well as a new set of challenges. Watch Video
Patient Ed Icon

What is Recurrent Pregnancy Loss (RPL)?

This is a condition when a woman has 2 or more clinical pregnancy losses (miscarriages) before the pregnancies reach 20 weeks. View the fact sheet
Patient Ed Icon

Endometriosis: Does It Cause Infertility?

When tissue like the tissue that normally lines the inside of the uterus (endometrium) is found outside the uterus, it is termed “endometriosis.” View the Fact Sheet
Patient Ed Icon

What is Premature Ovarian Insufficiency (Previously Called Premature Ovarian Failure)?

When a woman’s ovaries stop working before age 40, she is said to have premature ovarian insufficiency (POI).  View the fact sheet
Patient Ed Icon

What is intracytoplasmic sperm injection (ICSI)?

A procedure called intracytoplasmic sperm injection (ICSI) can be done along with in vitro fertilization (IVF) if a sperm cannot penetrate the outer layer of an egg. Read the Fact Sheet
Patient Ed Icon

Acupuncture and Infertility Treatment

Acupuncture is an alternative medical treatment that involves placing very thin needles at different points on the body. View the Fact Sheet
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What is In Vitro Maturation (IVM)?

In vitro maturation (IVM) is when a woman’s eggs are collected and matured outside the body. This is done as part of an in vitro fertilization (IVF) procedure. View the fact sheet
Patient Ed Icon

Saline infusion sonohysterogram (SHG)

Saline infusion sonohysterography (SIS or SHG) is aprocedure to evaluate the uterus and the shape of the uterine cavity. View the fact sheet
Patient Ed Icon

Sexual dysfunction and infertility

Sexual dysfunction is a problem in a person’s sexual desire, arousal, or orgasm. View the fact sheet
Patient Ed Icon

Hyperprolactinemia (High Prolactin Levels)

Prolactin is a hormone produced by your pituitary gland which sits at the bottom of the brain. Read the fact sheet
Patient Ed Icon

Fertility Rights and Responsibilities

Can a fertility program or clinic deny treatment to patient(s) if there is concern about the ability to care for the child(ren)? Yes. Fertility programs can withhold services if there are signs that patients will not be able to care for child(ren). View this Fact Sheet
Videos Icon

Coping With Infertility

Dr. Roger Lobo of the American Society for Reproductive Medicine discusses various methods of coping with infertility. Watch Video
Videos Icon

Endometriosis

Endometriosis is a condition in which endometrial tissue, which normally lines the uterus, develops outside of the uterine cavity in abnormal locations. Watch Video
Videos Icon

Causes of Female Infertility

Dr. Roger Lobo, of the American Society for Reproductive Medicine explains the causes of female infertility. Watch Video
Patient Ed Icon

Age and Fertility (booklet)

Generally, reproductive potential decreases as women get older, and fertility can be expected to end 5 to 10 years before menopause. View the Booklet
Videos Icon

Causes of Male Infertility

Dr. Roger Lobo, of the American Society for Reproductive Medicine explains the causes of male infertility. Watch Video
Patient Ed Icon

Diagnostic Testing for Male Factor Infertility

When a couple has trouble having a baby, there's about a 50-50 chance that the man has a problem contributing to the pregnancy.

  View the Fact Sheet
Info Icon

FAQ About Infertility

Infertility is not an inconvenience; it's a disease of the reproductive system that impairs the body's ability to perform the basic function of reproduction. Learn the facts
Info Icon

FAQ About the Psychological Component of Infertility

Infertility often creates one of the most distressing life crises that a couple has ever experienced together. Learn the facts
Patient Ed Icon

Mary Dolan's Story

I was diagnosed with diminished ovarian reserve/premature ovarian failure at 28 years old.
Read the story
Infographic Icon

Infertility Infographics

ASRM has prepared infographics to illustrate the subject of Infertility better. View the infographics

Female Fertility

Podcast Icon

SART Fertility Experts - Fertility Myths and Realities for Black Women

Black women are more likely to experience infertility and less likely to seek and receive timely treatment. Listen to the Episode
Podcast Icon

SART Fertility Experts - Wellness and Fertility: Diet, Sleep and Exercise

Drs. Timothy Hickman and Rashmi Kudesia discuss the links between lifestyle and fertility. Listen to the Episode
Podcast Icon

SART Fertility Experts - Preconception Counseling

This podcast episode covers the topic of preconception counseling.  Listen to the Episode
Patient Ed Icon

Female Fertility Journey

If you've been trying to get pregnant for more than a year, you may have infertility. Infertility is a disease of the reproductive system that impairs one of the body's most basic functions: the conception of children.

View the Patient Journey
Patient Ed Icon

Stress and infertility

It is not clear how exactly stress impacts fertility. Read the Fact Sheet
Patient Ed Icon

Am I Ovulating?

Ovulation is the release of an egg from a woman’s ovaries and is essential for getting pregnant. View the Fact Sheet
Patient Ed Icon

Conditions Treated with Surgery on the Fallopian Tubes and Ovaries

Surgery can be used to treat problems with the ovaries or fallopian tubes, such as cysts, endometriosis, or infections. View the Fact Sheet
Patient Ed Icon

Diagnostic Testing for Infertility

An evaluation of a woman for infertility is appropriate for women who have not become pregnant after having 12 months of regular, unprotected intercourse. View the Fact Sheet
Patient Ed Icon

Dilation and Curettage (D&C)

“Dilation and curettage” (D&C) is a short surgical procedure that removes tissue from your uterus (womb). You may need this procedure if you have unexplained or abnormal bleeding or if you have delivered a baby and placental tissue remains in your womb. View the Fact Sheet
Patient Ed Icon

Hypothyroidism and pregnancy: what should I know?

Hypothyroidism (underactive thyroid) is when the thyroid gland produces less  thyroid hormone than it should. View the Fact Sheet
Podcast Icon

SART Fertility Experts - Endometriosis

Endometriosis is a condition that can affect many facets of a person’s life, from pelvic pain to struggles with infertility.   Listen to the Episode
Podcast Icon

SART Fertility Experts - IVF: Cycles of Hope and Heartbreak

Does stress cause infertility or is it the other way round?  Listen to the Episode
Podcast Icon

SART Fertility Experts - Fibroids and Fertility

Fibroids and their impact on fertility are discussed in this episode featuring Dr. Elizabeth Stewart, interviewed by host Dr. Brooke Rossi.  Listen to the Episode
Patient Ed Icon

Infertility: an Overview (booklet)

Infertility is typically defined as the inability to achieve pregnancy after one year of unprotected intercourse. View the booklet
Patient Ed Icon

Optimizing Natural Fertility

Before attempting pregnancy, a woman should make sure she is healthy enough for pregnancy by adopting a healthier lifestyle and taking prenatal vitamins. If she has a medical or genetic condition or risk of one, she should seek advice from a medical professional before conceiving (becoming pregnant) View the fact sheet
Videos Icon

Basic Infertility Evaluation

Dr. Roger Lobo of the American Society for Reproductive Medicine discusses the various methods to evaluate infertility. Watch Video
Videos Icon

Fibroid Tumors

An educational video that answers patient questions about the causes, symptoms, diagnosis and management of uterine fibroids. Watch Video
Videos Icon

Infertility Treatments

Dr. Roger Lobo of the American Society for Reproductive Medicine discusses the various treatments for infertility. Watch Video
Videos Icon

Understanding Fertility

In this video series, Dr. Roger Lobo explains the basics of infertility, including causes, treatments and coping methods. Watch Video
Videos Icon

Surviving the Roller Coaster Emotions of Infertility Treatment

The experience of infertility is a rollercoaster of hope and disappointment. Treatment presents an opportunity for hope as well as a new set of challenges. Watch Video
Patient Ed Icon

What is Recurrent Pregnancy Loss (RPL)?

This is a condition when a woman has 2 or more clinical pregnancy losses (miscarriages) before the pregnancies reach 20 weeks. View the fact sheet
Patient Ed Icon

Female Cancers, Cryopreservation, and Fertility

Yes! New technology lets your doctor remove and freeze eggs, fertilized eggs (embryos), or ovarian tissue before treating your cancer. This way, you may be able to have children after your treatment. View the Fact Sheet
Patient Ed Icon

Weight and fertility

One of the easiest ways to determine if you are underweight or overweight is to calculate your body mass index (BMI). View the fact sheet
Patient Ed Icon

Evaluation of the Uterus

If you haven’t been able to get pregnant after trying for 6 months, some tests can be done to help find the reason. Your doctor may test your hormone levels, your partner’s sperm, and your reproductive organs (ovaries, fallopian tubes, and uterus [womb]). View the Fact Sheet
Videos Icon

Causes of Female Infertility

Dr. Roger Lobo, of the American Society for Reproductive Medicine explains the causes of female infertility. Watch Video
Patient Ed Icon

Abnormalities of the Female Reproductive Tract (Müllerian Defects)

Sometimes the uterus and fallopian tubes may not form like they should. These malformations are called müllerian anomalies or defects. Müllerian anomalies may make it difficult or impossible to become pregnant. View the Fact Sheet
Patient Ed Icon

Endometriosis (booklet)

Women with endometriosis may experience infertility, pelvic pain, or both. This booklet will describe options for diagnosing and treating pain or infertility that may be attributed to endometriosis. View the Booklet
Patient Ed Icon

Fertility Drugs And The Risk of Multiple Births

Infertility treatments that cause multiple eggs to develop make it more likely that you will become pregnant with twins, triplets, or more. This is called multiple gestation. View the Fact Sheet
Patient Ed Icon

Ovulation Detection

Ovulation, the release of an egg from its follicle in one of a woman’s two ovaries, is one of the most important factors in conceiving a child. View the fact sheet
Info Icon

FAQ About Infertility

Infertility is not an inconvenience; it's a disease of the reproductive system that impairs the body's ability to perform the basic function of reproduction. Learn the facts
Infographic Icon

Female Fertility Infographics

ASRM has prepared infographics to illustrate the subject of Female Fertility better. View the Infographics
Infographic Icon

Ovarian Reserve Infographics

ASRM has prepared infographics to illustrate the subject of Ovarian Reserve better. View the Infographics

Male Fertility/Andrology

Podcast Icon

SART Fertility Experts - Wellness and Fertility: Diet, Sleep and Exercise

Drs. Timothy Hickman and Rashmi Kudesia discuss the links between lifestyle and fertility. Listen to the Episode
Patient Ed Icon

Male Fertility Journey

About 20% of infertility cases are due to a male factor alone. Another 30% involves both male and female factors.

View the Patient Journey
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SART Fertility Experts - Urology and Male Reproductive Health

Male infertility is less often discussed than female infertility. Dr. Ajay Nangia discusses when a man should seek help with conceiving.
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Stress and infertility

It is not clear how exactly stress impacts fertility. Read the Fact Sheet
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Cancer and its impact on sperm, cryopreservation, and fertility

This can be confusing since the terms are often used interchangeably in the media and casual conversation. View the fact sheet
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Male infertility evaluation: what do I need to know?

Infertility is the inability to achieve pregnancy after one year of unprotected sex. View the fact sheet
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Testosterone use and male infertility

Testosterone (also referred to as “T”) is a hormone produced in men by the testes (testicles). View the fact sheet
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SART Fertility Experts - Male Factor

Infertility is not just a female problem. Dan candidly shares his journey with both diagnosis and treatment of male infertility with Dr. Paul Lin.
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SART Fertility Experts - IVF: Cycles of Hope and Heartbreak

Does stress cause infertility or is it the other way round?  Listen to the Episode
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Fertility Options After Vasectomy

Vasectomy is currently one of the most common methods of sterilization in the United States. After your vasectomy, if you change your mind about having children, there are two procedures that can help you have a child with your partner. View the Fact Sheet
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SART Fertility Experts - Male Fertility

Did you know that up to 40% of infertile couples suffer from male factor infertility? Listen to the Episode
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Infertility: an Overview (booklet)

Infertility is typically defined as the inability to achieve pregnancy after one year of unprotected intercourse. View the booklet
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Optimizing Natural Fertility

Before attempting pregnancy, a woman should make sure she is healthy enough for pregnancy by adopting a healthier lifestyle and taking prenatal vitamins. If she has a medical or genetic condition or risk of one, she should seek advice from a medical professional before conceiving (becoming pregnant) View the fact sheet
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Optimizing Male Fertility

About 20% of infertility cases are due to a male factor alone. Another 30% involves both male and female factors. View the fact sheet
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Male Fertility and Infertility - a patient education video

Male Factor Infertility is responsible for about 30% of infertility cases and can contribute infertility to an additional 20% of cases. Watch Video
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Basic Infertility Evaluation

Dr. Roger Lobo of the American Society for Reproductive Medicine discusses the various methods to evaluate infertility. Watch Video
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Infertility Treatments

Dr. Roger Lobo of the American Society for Reproductive Medicine discusses the various treatments for infertility. Watch Video
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Understanding Fertility

In this video series, Dr. Roger Lobo explains the basics of infertility, including causes, treatments and coping methods. Watch Video
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Surviving the Roller Coaster Emotions of Infertility Treatment

The experience of infertility is a rollercoaster of hope and disappointment. Treatment presents an opportunity for hope as well as a new set of challenges. Watch Video
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What is intracytoplasmic sperm injection (ICSI)?

A procedure called intracytoplasmic sperm injection (ICSI) can be done along with in vitro fertilization (IVF) if a sperm cannot penetrate the outer layer of an egg. Read the Fact Sheet
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Surgical techniques for sperm retrieval: what should I know?

As many as 10% to 15% of infertile men have no sperm in their ejaculate (the fluid released from the penis during orgasm). View the fact sheet
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Weight and fertility

One of the easiest ways to determine if you are underweight or overweight is to calculate your body mass index (BMI). View the fact sheet
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Sperm morphology (shape): Does it affect fertility?

The most common test of a man’s fertility is a semen analysis. View the fact sheet
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Spinal cord injury sperm retrieval

There are several reasons a man with a spinal cord injury (SCI) might have infertility. View the fact sheet
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Varicocele

A varicocele is a variation of normal anatomy in which veins in the scrotum (the sac that holds the testicles) become enlarged and sometimes even visible. View the fact sheet
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Causes of Male Infertility

Dr. Roger Lobo, of the American Society for Reproductive Medicine explains the causes of male infertility. Watch Video
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Diagnostic Testing for Male Factor Infertility

When a couple has trouble having a baby, there's about a 50-50 chance that the man has a problem contributing to the pregnancy.

  View the Fact Sheet
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FAQ About Infertility

Infertility is not an inconvenience; it's a disease of the reproductive system that impairs the body's ability to perform the basic function of reproduction. Learn the facts
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Male Fertility Infographics

ASRM has prepared infographics to illustrate the subject of  Male Fertility better. View the infographics

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