If you have been trying to get pregnant for more than a year, you may experience infertility.

Most medical specialists define infertility as the inability to conceive after 1 year or longer of sex without birth control.

If you are over 35 years old, many health professionals consider it infertility if you have not become pregnant after 6 months of trying.

Infertility is more common than many people think. In fact, it is estimated to be affected about 15 percent of couples around the world.

According to the Centers for Disease Control and Prevention (CDC)from research that grouped participants as women or men, in the United States alone, about 19 percent of women between the ages of 15 and 49 are unable to conceive for the first time after 1 year of trying. About 26 percent struggle to carry a pregnancy to term.

Infertility can also affect someone who has previously given birth to a baby. The CDC reported that about 6 percent of women who have had one or more previous births are unable to conceive after 1 year of trying, and 14 percent struggle to carry a pregnancy to term.

Infertility also affects men. The National Institutes of Health – which also divides their data into two groups, women and men – reports that about 9 percent of men in the United States experience infertility.

However, despite how common fertility issues can be, there is still a lot of confusion about what fertility treatment can involve.

So, we interviewed Dr. Samuel Brown, surgeon, founder and medical director of the Florida-based Brown Fertility Treatment Center, and Dr. Jenna Turocy of Columbia University Fertility Center, to help demystify infertility and how to treat it word.

If you have not been able to conceive for a year or more, make an appointment with a fertility consultant.

During this appointment, “the first step is to make a new patient consultation to discuss your specific circumstances,” Brown says. “Then they can have different tests to rule out the cause of infertility one by one.”

These tests may include the following:

  • ovulation detection
  • evaluation of your fallopian tubes
  • evaluation of your cervix
  • evaluation of your uterus
  • semen analysis (if necessary)

“Once the test is complete, your appropriate treatment plan can begin immediately,” says Brown.

Brown says in general, the fertility concerns he sees and treats are caused by:

  • Age. Age is starting to be a concern at age 35 for women trying to conceive.
  • Male factor infertility. Male factor infertility can have a range of causes, including hormonal imbalances, poor semen quality, diabetes, certain medications, blocked tubes in the testes, varicose veins or previous sexually transmitted infections (STIs).
  • Endometriosis. Fertility issues are a significant complication of endometriosis.
  • Ovulation problems or dysfunction. Polycystic ovary syndrome (PCOS) is the most common cause of ovulation problems.

Many of his clients have had a history of miscarriages, and for some, the cause of their fertility problems remains unexplained.

“About 30 percent of the time, there’s no obvious reason for infertility,” Brown says. “Sperm analysis looks good, ovulation occurs, and couples are looking for an explanation.”

It depends on what your doctor believes is behind your fertility concerns.

“Fertility treatment includes a wide range of options,” says Turocy, “from the less invasive options, such as timely intercourse where we help determine the best time for a couple to have intercourse at home, to more invasive options, such as in vitro fertilization where an egg and sperm are combined outside the body in the laboratory. ”

For example, some conditions, such as PCOS, can be managed with medications such as metformin and clomiphene, while others, he says, can be treated with simple surgeries.

“For families experiencing unexplained infertility, medication, intrauterine insemination, and in vitro fertilization can help you conceive,” says Brown. ”[And] for male infertility, we will often approach it with intrauterine insemination or IVF with ICSI (where a single sperm is injected right into the ovum).

It depends on what you are being treated for and your insurance coverage.

“Often, cheap medicine or simple surgery covered by insurance, depending on your condition, will correct many problems,” says Brown.

From there, the costs differ, say both Turocy and Brown. Here are some average US national costs they shared:

  • Ovulation-induction oral medication: $ 10- $ 100
  • New patient appointment: $ 200- $ 500
  • A single IVF cycle: $ 15,000– $ 30,000
  • IVF hormonal medication: $ 3,000– $ 5,000
  • Egg freezing cycle: $ 8000– $ 15,000
  • Intrauterine insemination (IUI) treatment: $ 2,500– $ 4,000
  • Storage of eggs, embryos or sperm: $ 500- $ 1,000 per year

You may also incur some additional costs, including:

Does insurance cover fertility treatment?

It depends on where you live.

“Only in the United States 19 state mandate insurance coverage for fertility treatments, ”says Brown.

Thus, he continues, “The cost of reproductive medical treatments, and specifically the lack of insurance coverage for infertility medical treatments, is a major obstacle to family building.”

“It’s only been 40 years since IVF came to the US, and now the problem is not accessibility – it’s affordability,” says Brown.

Their prospects are hopeful, Brown says.

“Never lose heart [because] “Most infertility cases – 85 to 90 percent – are treated with conventional medical therapies, such as medication or surgery,” he says.

“In vitro fertilization and similar treatments account for less than 3 percent of infertility services and are not necessary for everyone,” Brown adds.

If you need IVF, your chances of conception depend on several factors, including your age and egg quality.

“Broadly speaking, women under the age of 35 are typically the best prognosis patients,” says Turocy, “but even women in their mid to late 40s can achieve success by using donated eggs.”

For example, according to the CDCin women under 35, the percentage of live births per egg retrieval is 54.5 percent, but it decreases to 4.2 percent in women older than 43.

“I encourage all women who are struggling to conceive or want to preserve their fertility for the future to talk to a fertility specialist who can help them understand their individualized chances of success,” says Turocy.

It can be difficult to know what to ask when you meet a fertility expert and how to know if this doctor is a good fit for you and your partner.

Turocy gives advice:

“Infertility can be frightening and complex, so it’s important to ask questions, especially if you do not understand something,” she says. “Make sure your doctor can explain things in terms you can understand so that you feel empowered to make informed and confident decisions.”

“Ask your doctor at the first visit what possible problems they think may be going on based on your history and what type of tests they recommend to help make a diagnosis,” Turocy adds.

On one thing people need to know about fertility issues, Brown says, “When it comes to fertility, especially related to age, it’s all about conservation.”

Therefore, fertility preservation, such as egg and embryo freezing, may be a good idea, especially for women who know they are not going to get pregnant before 38, he says.

“I would strongly encourage them to consider freezing their eggs,” Brown says. “It’s essential to have a detailed discussion about any plans to get pregnant, and it’s never too early to start having that conversation.”

Infertility can be frightening and stressful – but the good news is that there are doctors and clinics available to help you go over your options and discuss possible treatments that may work for you.

IVF is a powerful tool that can be very effective for some couples, but may not be necessary for all.

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