Are We Infertile?

by Arthur L. Wisot, M. D. of Reproductive Partners Medical Group

It’s as American as apple pie, motherhood and baseball. You grow up, get an education, get married and have a baby. It sounds simple. But it’s not so simple for the 15% of couples trying to conceive who cannot after one year of trying. They are considered to be infertile.

The generally accepted definition of infertility is not achieving a pregnancy after one year of trying. But now there are some factors which can modify that definition for certain couples. First, today many women are trying to start a family at older ages than when this definition was formulated. Secondly, there are more sophisticated techniques for couples to time relations more accurately than in the past. Both of these factors may hasten when couples seek help if they have been unable to conceive.

I recommend that women over 35 see a physician if they have been trying to conceive for only six months, especially if they have been using a sophisticated method for timing intercourse like an ovulation predictor kit or other fertility monitor. Other factors which should drive couples to seek help early are irregular menstrual cycles or known gynecologic condition such as fibroids or endometriosis in the female partner or urologic issues in the male. Couples in which the female partner is under age 35 may want to seek help earlier than one year if they have been using an ovulation predictor for more than six months without success.

The best place to start looking for help is usually the woman’s gynecologist or primary care doctor. She can expect that the doctor will take this concern seriously and not just tell her to “keep trying” if she has met the criteria described above. The doctor should order a series of tests to evaluate the couple’s fertility factors and not simply give the woman a prescription for the fertility drug Clomid. If there is a history of gynecologic conditions known to cause fertility problems or other serious fertility issues suspected, the woman may choose to see a reproductive endocrinologist who treats patients for only infertility problems and recurrent miscarriage.

If a couple can answer “yes” to the question, “Are we infertile,” they can achieve their goal more quickly by seeking assistance at the appropriate time and place for their situation, and by being knowledgeable about what to expect when they do decide to get help.