Trying to Conceive (cont.)
Treating Infertility
You should talk to your doctor about your fertility if
you:
- are under age 35 and, after a year of frequent sex without birth control, you
are having problems getting pregnant, or
- are age 35 or over and, after six months of frequent sex without birth
control, you are having problems getting pregnant, or
- believe you or your partner might have fertility problems in the future (even
before you begin trying to get pregnant).
Your doctor can refer you to a fertility specialist, a
doctor who focuses in treating
infertility
. This doctor can recommend treatments such as drugs,
surgery, or assisted reproductive technology. Don't delay seeing your doctor
because age also affects the success rates of these treatments.
There are many ways to treat infertility. They include the following.
Tests
The first step to treat infertility is to see a doctor for a fertility evaluation
. He or she will test both the woman and the man, to find out where
the problem is. Testing on the man focuses on the number and health of his
sperm. The lab will look at a sample of his sperm under a microscope to check
sperm number, shape, and movement. Blood tests also can be done to check hormone
levels. More tests might be needed to look for infection, or problems with hormones. These tests can
include:
- an x-ray (to look at his reproductive organs)
- a mucus penetrance test (to see if sperm can swim through mucus)
- a hamster-egg penetrance assay (to see if sperm can go through hamster egg
cells, somewhat showing their power to fertilize human eggs)
Testing for the woman first looks at whether she is
ovulating each month. This can be done by having her chart changes in her
morning body temperature, by using an FDA-approved home ovulation test kit
(which she can buy at a drug store), or by looking at her cervical mucus, which
changes throughout her menstrual cycle. Ovulation also can be checked in her
doctor's office with an ultrasound test of the ovaries, or simple blood tests that check hormone levels,
like the follicle-stimulating hormone (FSH) test. FSH is produced by the
pituitary gland. In women, it helps control the menstrual cycle and the
production of eggs by the ovaries. The amount of FSH varies throughout the
menstrual cycle and is highest just before an egg is released. The amounts of
FSH and other hormones (luteinizing hormone, estrogen, and progesterone) are
measured in both a man and a woman to determine why the couple cannot achieve
pregnancy. If the woman is ovulating, more testing will need to be done. These
tests can include:
- an hysterosalpingogram (an x-ray to check if the fallopian tubes are open and
to show the shape of the uterus)
- a laparoscopy (an exam of the tubes and other female
organs for disease)
- an endometrial biopsy (an exam of a small shred of the uterine lining to see
if monthly changes in it are normal)
Other tests can be done to show whether the sperm and mucus are interacting
in the right way, or if the man or woman is forming antibodies that are
attacking the sperm and stopping them from getting to the egg.
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