Treating
Infertility
This may help pinpoint the cause or causes of infertility.
Infertility often can be treated with lifestyle changes,
medication, surgery, or assisted reproductive technologies.
Infertility may be caused by a problem with the woman,
the man, the couple, or their lifestyle. Infertility
may be caused by more than one factor. Medical treatment
may be needed to help you become pregnant. Medication
may be given, surgery may be needed, or assisted reproductive
technologies may be used. If the woman does not ovulate,
she may be given certain medications to cause (induce)
ovulation to occur. Assisted reproductive technology
(ART) includes treatments that involve a lab treating
and using human eggs and sperm or embryos to help
an infertile couple conceive a child. Insemination-placing
sperm in a woman's vagina by means other than sex-is
an option to treat infertility in the couple. With
in vitro fertilization (IVF), eggs from the woman
and sperm from a man are fertilized outside the body
in a lab.
Evaluating
Infertility
Couples may be infertile if they have not been able
to conceive after 12 months of having sex without
the use of birth control. If you and your partner
are trying to have a child and can't, you may want
to have an infertility evaluation. Based on the results
of these tests, treatment may be needed. If you have
not been able to conceive after 12 months of having
sex without the use of birth control, you may want
to think about having an infertility evaluation. For
healthy, young couples, the odds are about 20% that
a woman will conceive (become pregnant) during any
one menstrual cycle. In an average 28-day menstrual
cycle, ovulation occurs about 14 days after the first
day of your last period. Other tests, such as a Pap
test and blood tests, may be done. This test measures
luteinizing hormone (LH), a hormone that causes ovulation
to occur. After a woman ovulates, the ovaries produce
the hormone progesterone. A blood test taken in the
second half of the menstrual cycle can measure progesterone
to show if ovulation has occurred.
Planning
Your Pregnancy
Good care and a healthy lifestyle before and during
pregnancy increase the odds that you'll end your 40-week
journey (and begin a whole new one) with a healthy
baby in your arms. Also, if you are prepared, it will
help your body handle the stress of pregnancy, labor,
and delivery. If you're planning to become pregnant
and have already planned a pre-pregnancy checkup,
good for you-it's a smart move. As a part of this
visit, your doctor will ask about your medical and
family history, medications you take, any past pregnancies
you've had, and your diet and lifestyle. Your answers
will help your doctor decide whether you need special
care during pregnancy. Some women have medical conditions-such
as diabetes, high blood pressure, and seizure disorders-that
can cause problems during pregnancy. Be sure to let
your doctor know if a past pregnancy was complicated
by diabetes, high blood pressure, premature labor,
preterm birth, or birth defects. Folic acid, taken
before pregnancy and for the first 3 months of pregnancy,
can reduce the risk of neural tube defects. Three
types of providers offer medical care for pregnancy
and birth: obstetrician-gynecologists (ob-gyns), family
practitioners, and certified nurse-midwives (CNMs).
Labor and delivery nurses help care for women and
their babies during labor, delivery, and right after
birth.
Endometriosis
Sometimes, tissue like that which normally lines the
inside of the uterus grows elsewhere in the body.
Endometriosis can cause pain before and during the
menstrual period. For some women, the pain is mild.
Severe endometriosis also may lead to infertility.
Endometriosis can cause pain and infertility. Endometrial
tissue outside the uterus responds to changes in hormones.
Severe endometriosis also may cause infertility. If
other causes of pelvic pain can be ruled out, your
doctor may treat endometriosis without doing any further
exams or surgery. Although treatments may relieve
pain and infertility for a time, symptoms may come
back after treatment. Endometriosis: A condition in
which tissue similar to that normally lining the uterus
is found outside of the uterus, usually on the ovaries,
fallopian tubes, and other pelvic structures.
Laparoscopy
To diagnose certain problems, a doctor needs to look
directly into the abdomen and at the reproductive
organs. The word laparoscopy comes from the Greek
words that mean "look into the abdomen. It is also
used to check for ectopic pregnancy, causes of pelvic
pain, and masses. Besides using the laparoscope to
look into the abdomen to diagnose a problem, your
doctor can use it for treatment as well. For some
procedures, laparoscopy has replaced the need for
laparotomy. Laparotomy involves opening the abdomen
to operate on reproductive organs. Laparoscopy is
often used to diagnose causes of abdominal pain. If
the doctor finds that he or she can treat the condition
during the procedure, diagnostic laparoscopy can turn
into operative laparoscopy. When a woman has pain
in her lower abdomen during early pregnancy, the doctor
may suspect an ectopic pregnancy. Laparoscopy: A surgical
procedure in which a slender, light-transmitting instrument,
the laparoscope, is used to view the pelvic organs
or perform surgery.
Uterine
Fibroids
Uterine fibroids are benign (not cancer) growths in
the uterus. Many women who have fibroids are not aware
of them because the growths can remain small and not
cause symptoms. Fibroids can cause problems because
of their size, number, and location. Like any growth,
fibroids should be checked by a doctor. Uterine fibroids
are growths that develop from the cells that make
up the muscle of the uterus. Fibroids may appear on
stemlike structures or be attached directly to the
inside or outside of the uterus. Fibroids occur more
often in black women than in white women. Fibroids
also may cause infertility. Although it cannot remove
fibroids deep in the walls of the uterus, it often
can control the bleeding these fibroids cause. Fibroids
may cause no symptoms and require no treatment.
Hysterosalpingography
Hysterosalpingography (HSG) is a procedure used to
diagnose certain problems of the uterus and fallopian
tubes. HSG most often is used to see if a woman's
tubes are partly or fully blocked. Blocked tubes are
a common cause of infertility. HSG also is used to
help find the cause of repeated pregnancy loss. HSG
is a way to diagnose problems of the uterus and fallopian
tubes. With HSG, the doctor can check for blockage
or growths inside the uterus and tubes. This may help
your doctor find the cause of infertility or repeated
pregnancy loss (also called repeated miscarriage).
Blockage of one or both fallopian tubes causes about
35% of cases of infertility in women. HSG also is
done to detect growths or scarring inside the uterus
or problems in its size or shape. The fluid slowly
is placed through the thin tube into the uterus and
fallopian tubes.
Gonorrhea,
Chlamydia, and Syphilis
Infection with gonorrhea and chlamydia causes two
of the most common sexually transmitted diseases (STDs).
Syphilis, another STD, occurs less often, but can
be serious if it is not treated. If you think you
may be at risk for gonorrhea, chlamydia, or syphilis,
get tested. Gonorrhea and chlamydia often have no
symptoms. When symptoms do occur, they may show up
2 days to 3 weeks after infection. Pregnant women
also may be offered testing for gonorrhea and chlamydia.
Chlamydia: A sexually transmitted disease that can
cause pelvic inflammatory disease, infertility, and
problems during pregnancy. Gonorrhea: A sexually transmitted
disease that may lead to pelvic inflammatory disease,
infertility, and arthritis. Sexually Transmitted Disease
(STD): A disease that is spread by sexual contact.
Syphilis: A sexually transmitted disease that is caused
by an organism called Treponema pallidum; it may cause
major health problems or death in its later stages.
How
to Prevent Sexually Transmitted Diseases
Sexually transmitted diseases (STDs) are infections
that are spread by sexual contact. Except for colds
and flu, STDs are the most common contagious diseases
in the United States, with about 12 million new cases
of STDs each year. The human immunodeficiency virus
(HIV) is a virus that causes acquired immunodeficiency
syndrome (AIDS). Acquired Immunodeficiency Syndrome
(AIDS): A group of signs and symptoms, usually of
severe infections, occurring in a person whose immune
system has been damaged by infection with human immunodeficiency
virus (HIV). Chlamydia: A sexually transmitted disease
that can cause pelvic inflammatory disease, infertility,
and problems during pregnancy. Genital Herpes: A sexually
transmitted disease caused by a virus that produces
painful, highly infectious sores on or around the
sex organs. Gonorrhea: A sexually transmitted disease
that may lead to pelvic inflammatory disease, infertility,
and arthritis. Human Immunodeficiency Virus (HIV):
A virus that attacks certain cells of the body's immune
system and causes acquired immunodeficiency syndrome
(AIDS). Human Papillomavirus (HPV): A sexually transmitted
virus that can cause small growths, called condylomas
or genital warts, on or around the genitals. Syphilis:
A sexually transmitted disease that can cause few
initial symptoms, but may lead to major health problems
or death in its later stages.
Pelvic
Inflammatory Disease
Pelvic inflammatory disease (PID) is a broad term
used to refer to infection of the uterus, fallopian
tubes, or ovaries. About 1 million women are treated
for PID in the United States each year. About 1 in
7 women are treated for PID at some point in their
lives. PID often can be treated with success, but
the infection still may damage a womanÃs reproductive
organs and cause long-term problems. PID most often
affects sexually active women during their childbearing
years. Most cases of PID are thought to stem from
sexually transmitted diseases (STDs). Without treatment,
the same organisms that cause these diseases can also
cause PID. PID may cause severe symptoms, minor symptoms,
or no symptoms at all. Chlamydial Infection: A sexually
transmitted disease that can cause pelvic inflammatory
disease, infertility, and problems during pregnancy.
Gonorrhea: A sexually transmitted disease that may
produce no symptoms in women but can lead to pelvic
inflammatory disease, infertility, and arthritis.
