How to Manage Infertility

Infertility occurs when a couple is unable to conceive after 12 consecutive months of unprotected sex. If the woman is over age 35, most doctors evaluate fertility after six months of trying to conceive. In either case, if you’ve been trying diligently to get pregnant but you aren’t having any success, schedule a fertility evaluation with your doctor.   

The main, and often only, symptom of infertility is the inability to get pregnant. For some couples, it may have to do with the woman’s age, as ovarian reserve declines more rapidly the closer a woman is to menopause. Others may have a pre-existing condition that interferes with their ability to conceive, such as endometriosis or an autoimmune or thyroid disease. Some medications and cancer therapies also compromise fertility. Still, most don’t suspect infertility until they can’t conceive.  

The First Steps to Manage Infertility  

Before you and your partner delve into tests and procedures, your doctor will conduct a thorough health screening and history, discuss the role genetics plays in fertility, and review your sex life.   

Semen Analysis for Male Factor Infertility  

After the health screening and history is complete, the next step is an examination of the man’s semen (ejaculate). A semen analysis examines semen under a microscope and evaluates sperm for count, movement (motility), and shape (structure).   

It’s difficult to pinpoint the cause of sperm abnormalities. Sperm regenerates every 64 days on average, so your doctor may begin with lifestyle changes such as limiting alcohol, smoking, and hot tubs, for example. However, additional evaluation may be necessary, including an examination to ensure the penis and testicles are free from injury, check for a swollen or enlarged prostate, a history of mumps post-puberty, a varicocele or dilated vein in the testicles, and discharge from the penis which may indicate infection.  

Fertility Assessments for Women  

After an initial screening, women also move on to infertility testing, including:   

  • Ovulation Testing: Using a blood test, your doctor will measure your hormone levels, looking for any imbalance that may impact ovulation.  
  • Hysterosalpingography, or otherwise commonly known as “HSG”: Your doctor will inject contrast, a liquid containing iodine visible to x-rays, into your uterus and, using imaging, evaluate the condition of your uterus and fallopian tubes to ensure they are normal.  
  • Checking Ovarian Reserve: A woman is born with all of the eggs she will have in her lifetime, and that reserve diminishes with age. Your doctor will monitor your hormone levels throughout your menstrual cycle to determine whether your store of eggs is adequate.   
  • Other Imaging Tests: A saline-infusion ultrasound will determine any issues within the uterus that may impact fertility, and a pelvic ultrasound will find signs of uterine or ovarian disorders.  
  • Additional Hormone Testing: Other hormone tests evaluate the reproductive hormones released by your pituitary gland and other hormones supporting ovulation.   

Depending on the results of your fertility tests, your doctor may require further testing before giving a diagnosis and recommending treatment. On that rare occasion, you may need the following:   

  • Hysteroscopy: Your will doctor inserts a thin, lighted camera device into your uterus through the cervix. This allows a close-up view to check for any abnormalities. 
  • Laparoscopy: A minimally invasive procedure in which your doctor makes a small incision below your navel and inserts a very tiny laparoscope to inspect your pelvic region for scars, blockages, endometriosis, and abnormalities with your uterus, fallopian tubes, and ovaries.  

Several possibilities could cause infertility in women. Depending on your test results, your doctor will work with you to determine a diagnosis and treatment plan. To learn more about the assessment process, go to  

Infertility Diagnosis and Treatment   

Depending on the cause of your infertility, treatment for both men and women may begin with a surgical procedure or medication to address your infertility issues. For men, these treatments might include:  

  • Medications to improve sperm count and increase testicular function.  
  • A surgical procedure reversing a blockage or surgically repairing a varicocele to restore male fertility.  
  • When there are no sperm present in the ejaculated fluid or ejaculation is an issue, your doctor will perform a sperm retrieval. There are a few different methods for sperm extraction, depending on your diagnosis. But in all cases, your doctor surgically extracts sperm directly from the testes.   

Initial treatment for managing infertility in women typically follows the process below :  

  • Medication that stimulates the ovaries into producing more eggs and increases your opportunity to conceive.  
  • Surgery for those with endometriosis, uterine polyps, fibroids, or scarring.  
  • Additional surgical options for removal of fallopian tube blockages and other issues affecting your fallopian tubes.  

Based on the initial tests and treatment results, your doctor will advise the best path forward for you to achieve a healthy pregnancy.  

Intrauterine Insemination (IUI)  

This procedure involves inserting your partner’s sperm or donor sperm directly into your uterus at the time of ovulation. During this in-office, painless procedure, the doctor inserts a long thin cannula into your vagina, through your cervix, and into your uterus to place the sperm.   

In-Vitro Fertilization (IVF)

IVF begins with medication that stimulates your ovaries to produce multiple eggs at one time. The mature eggs are removed during an egg retrieval procedure and then go to the lab for fertilization with your partner’s sperm or donor sperm. Once the lab confirms viable embryos, your doctor places the embryo directly into your uterus for implantation. After that, you may choose egg freezing or cryopreservation for your remaining embryos. 

Third-Party Assisted Reproductive Technology  

There are a few ways pregnancy occurs with the help of a third party. You may opt for sperm donation, egg donation, or even donated embryos. For those who can’t carry a pregnancy to term, the option for a gestational carrier is a solution. Your fertility team will help you determine the best way forward and facilitate any of these treatments.  

We Help You Manage Infertility  

An infertility diagnosis can be overwhelming. However, once you have a handle on your specific issues, you’ll be able to work with your doctor to determine the most appropriate treatment. If you suspect you may have issues with your fertility, please contact Rise Fertility today.  

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