Infertility (Difficulty Conceiving)

Infertility is the inability to reproduce. The Cedars-Sinai Fertility and Reproductive Medicine Center knows it affects about 7.3 million women and their partners in the U.S. - about 12 percent of the reproductive-age population. Infertility affects men and women at equal rates. There are many causes of infertility, and 25 percent of infertile couples have multiple contributing factors. The causes of infertility may include androgen-related disorders, endometriosis and uterine fibroids. Infertility can be linked to abnormal ovulation (release of an egg from the ovary) or abnormal development or shape of the uterus.

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Symptoms

Many women who are infertile may exhibit no symptoms.

Symptoms that do present in others may include:

  • Irregular ovulation and abnormal menstrual periods
  • Pelvic pain
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Diagnosis

Before you are treated for infertility, you and your partner must be evaluated by a doctor. Several testing procedures may be performed to identify the cause or causes of infertility. 

Possible procedures include:

  • Blood tests
  • Hysterosalpingogram (HSG)
  • Laparoscopy
  • Magnetic resonance imaging (MRI) scans
  • Medical history
  • Physical examination
  • Semen analysis
  • Ultrasound
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Treatments

Normal fertility requires that the ovary release an egg or ovum, which can be fertilized by the male sperm. After fertilization, the developing embryo must enter the uterus where the endometrium is appropriately developed to allow for the pregnancy to continue. Women with PCOS, endometriosis and other reproductive disorders can often become pregnant, in some cases naturally and in other cases with the help of medications or assisted reproductive technologies. 

For some, surgery can improve the chance of natural conception. For others, infertility therapies, such as ovulation induction or in vitro fertilization, may be more effective.

In many cases, a diagnosis of a reproductive problem does not mean a lifetime of sterility.

If the cause of infertility is with one partner, then that partner can be treated. Since 1985, when we began counting, through the end of 2006, almost 500,000 babies have been born in the United States as a result of reported Assisted Reproductive Technology procedures (IVF, GIFT, ZIFT, and combination procedures). With appropriate treatment, women may become pregnant and deliver healthy babies.

Assisted reproductive technologies include:

  • Artificial insemination: placing sperm in the cervix or uterus without intercourse
  • Donor Site Program: donor eggs are fertilized in vitro (in a dish) with a woman's partner's sperm
  • Intracytoplasmic sperm injection (ICSI): placing one sperm directly into an egg to fertilize it
  • In vitro fertilization (IVF): fertilizing eggs and sperm in a laboratory and placing the fertilized egg (embryo) into the uterus
  • Gamete intrafallopian transfer (GIFT): placing eggs and sperm in the fallopian tube during laparoscopy

Other treatment options include:

  • Ovulation induction: medications are given to cause ovulation to occur and/or stimulate the number of eggs released
  • Surgery: to open fallopian tubes or repair reproductive organs
  • Donor program: obtaining eggs from another woman, which involves an arrangement between the intended parents of the child and a woman who agrees to donate her egg(s) to be artificially inseminated with the sperm of the intended father
  • Surrogacy: the use of another woman's to carry the pregnancy