If you’ve been trying to conceive for a while and you are still not getting pregnant, you may be asking yourself, “Am I infertile?” The word “infertility” can be daunting but we hope to help clarify why infertility isn’t as black and white as you may think and why you are more than the medical condition of infertility.
Before You Ask, “Am I Infertile?”, Let’s Define InfertilityAccording to Resolve: The National Infertility Association, “Infertility, is a disease characterized by the failure to establish a clinical pregnancy after 12 months of regular, unprotected sexual intercourse or due to an impairment of a person’s capacity to reproduce either as an individual or with his/her partner.” This means if the female partner is under the age of 35, and the couple has been actively trying to conceive for at least one year; or if the female partner is over the age of 35 and the couple has been actively trying to conceive for at least six months without success, they should seek the help of a fertility specialist known as a reproductive endocrinologist. If you look carefully at that paragraph above and reread it, you’ll notice the word, “disease”. This should be an encouraging answer to the question, “Am I infertile?” because infertility is exactly that: a medical issue like any other. You’ll also note that in the above definition, no medical intervention has taken place yet. That means with testing, diagnosis and treatment there is still hope. Explanations for why you are not getting pregnant may be uncovered and options for treatment could exist.
Asking a Fertility Specialist, “Am I Infertile?”If you fit into the criteria outlined in Resolve’s definition of infertility above and have been quietly wondering, “Am I infertile?”, your best first step is to make an appointment to get a fertility work-up with a specialist. A reproductive endocrinologist can run blood work to check your hormones and perform a transvaginal sonogram to check your ovaries and uterus. They would also look into any relevant family history (if your mother or sisters have any fertility issues), your own health history (if you have regular periods, if you smoke, etc.) and review your family goals. The blood work, hormone levels, and consultation will provide the doctor a sense of how many eggs you have in your ovarian reserve and a general idea of your reproductive health and ovulation function. Also, they may recommend having your male partner come in for a semen analysis if one hasn’t been done already. They will also review his family and health history and will most likely perform blood work as well. If they find any concerns such as polycystic ovarian syndrome, or endometriosis, or a sperm quality problem, they will offer a treatment plan. It’s possible that with a diagnosis and proper treatment you will not need any additional fertility assistance.
What If Infertility Treatment is Recommended?While this may sound strange, if your doctor is recommending trying assisted reproductive technology to help you have family, then they believe that there is a protocol that can bring you one step closer to becoming a parent. It’s also a comfort to know that should your doctor find any fertility concerns, you have many different options available to you such as:
- Intrauterine insemination (IUI): This is when a catheter is used to “bypass” the cervix and insert sperm into a woman’s uterus when she is ovulating.
- In vitro fertilization (IVF): When IVF is performed, a woman’s eggs are extracted and combined with your partner (or donor’s) sperm in a laboratory. The resulting embryos are then transferred to the woman’s uterus.
- Preimplantation Genetic Diagnosis (PGT-M, formerly called PGD): This includes conditions like cystic fibrosis, Tay-Sachs disease, spinal muscular atrophy (SMA) or sickle cell to name a few. PGT-M can test an embryo for such conditions, which can increase your chance of having a baby born free of a genetic disease.
- Preimplantation Genetic Test for Aneuplody (PGT-A, formerly known as PGS): PGT-A is an optional test for all individuals undergoing IVF, who want the extra security of identifying the correct number of chromosomes in embryos, in hopes of improving IVF outcome.
- ERA test: This test can assist in avoiding implantation failure by determining the best day to transfer your embryo which may increase the chance of pregnancy.
- Donor egg or embryo: If you’re unable to conceive with your own eggs or if you’re a same sex male couple, you can have IVF treatment using eggs donated by a woman. The donor egg is combined with your partner’s sperm, and the resulting embryo is transferred to the intended mother or gestational surrogates’ uterus. This procedure can also be done with a donated embryo or donated sperm.