Interview Transcript contributed by
Dr. Kirtly Jones
Utah Center for Reproductive Medicine, a participating provider in the WINFertility Network
Infertility affects 12 percent of women in the United States. This equates to 7.3 million women between the ages of 15-44 every year having difficulty getting pregnant. It is a problem that faces both women and men, and can be very distressing. Dr. Kirtly Jones discusses what can cause infertility and how doctors can help if you’re having trouble conceiving.
Dr. Jones: Getting pregnant. You would think it would be so easy. And for some folks it is, but for some folks it isn’t. This is Dr. Kirtly Jones from Obstetrics and Gynecology at University of Utah Health Care. And we are talking about frequently asked questions about infertility on The Scope.
Announcer: Covering all aspects of women’s health. This is the Seven Domains of Women’s Health with Dr. Kirtly Jones on The Scope.
Dr. Jones: So what is infertility? Infertility is most commonly defined as the inability to get pregnant within one year of trying. So what is trying? Well trying is having intercourse two to three times a week at least during the ovulation week.
It seems like everyone I know is getting pregnant except me. Is this common? Yes, it’s common. About 12% of women, 7.3 million in the United States aged 15, although who is trying at 15? To 44 have difficulty getting pregnant or carrying a baby to term in 2002 according to the National Center for Health Statistics.
If I can get pregnant but I keep on having miscarriages is that infertility? Yes, we consider women to be infertile who are trying to get pregnant but have miscarriages. Women who have had three miscarriages in a row should talk to a specialist in recurrent miscarriages.
Is infertility just a women’s problem? No. Infertility is not just a women’s problem. In about one-third of cases of infertility is due to female factors. In about another third it’s due to male factors. The remaining causes are a mixture of male and female. Or sometimes we just can’t figure it out.
Due we have to wait a year before we get help? If you’re under 35 years old and you have regular periods and have no history of surgery on your uterus, or ovaries or tubes and if your male partner has no known problems, you should try a year. Of course, if you come to see us before a year we can start some simple testing.
If you’re over 35 we know it can take a little longer to get pregnant as women are about half as fertile in their late 30s compared to their mid 20s. However, if you wait longer then you are older. So we often say that when a woman is over 35 and attempting pregnancy, she and her partner may want to start some testing after six months.
Also, if your periods are very irregular, more than 45 days apart, you may want to see a doctor from the beginning. Of course, if you know you have a problem, or if you have signification pain with your periods or intercourse, or if you know that your male partner has a problem, don’t wait.
What causes infertility? Well, humans aren’t that fertile to begin with. Most conceptions, egg meets sperm, don’t make a baby. The chances for a young couple getting pregnant in one month of regular intercourse is about 25%. That’s successfully pregnant. Pregnant and having a baby. And that chance goes down with age. Sometimes some problems you’re born with, some problems are caused by aging. Some problems, for men and women, are caused by obesity. And some problems we can’t figure out. Luckily there are fewer and fewer of those.
What can make a man infertile? Well men can have a decrease in sperm count, or function, due to obesity, alcohol, poor diet, inherited or genetic factors. Some environmental factors like bad air quality or health problems. Some men are born with problems in sperm function, that they might know about or might not.
How is infertility treated? Well there are many treatment options. And they should be individually focused on the problems causing the infertility. When you see a doctor for infertility the first steps are to find out about eggs. Are you ovulating? Sperm. Your honey needs a sperm count or a semen analysis. And your tubes. Usually an x-ray, or some way of making sure that the fallopian tubes are open.
Will my insurance pay for tests or treatment? Whoa, that’s difficult to know. Some states have passed laws that require health insurance policies to cover infertility testing and treatment. But many states don’t. Some insurance policies cover infertility treatment and some do not. You’ll need to talk to your insurance provider to find out. But it often isn’t very clear at all. This is one of the most frustrating parts of a heart breaking problem.
Who should we see for our infertility evaluation? For the first diagnostic steps, or evaluating the eggs and sperm your family doc, your nurse practitioner, or your regular OBGYN can get you started. If you have been with them a year, and you aren’t pregnant, or if you’re over 35 you may want to see a fertility specialist called a reproductive endocrinologist. These are people, doctors like me, who are specially trained in male and female infertility.
Sometimes men need to be referred to a urologist who specializes in male infertility. Ideally you will have a special team of reproductive endocrinologists and urologists who work in an IVF center, who can offer you the complete range of options.
When should we stop treatment or quit trying? Well, if couples can use all the options available over 80% will get pregnant. But how far to take treatment, in-vitro fertilization, donor eggs or sperms is a very personal decision. Within a couple there may be differences in how far each person wants to go to try to have a baby and what options to consider. A good fertility center will also have a fertility counselor, a social worker or a psychologist who can help you if you get stuck.
Now these are just a few questions. If you’re seeking evaluation and treatment for infertility bring your own list of questions when you see your doctor so you can be sure to get the answers you need to move ahead. And I hope for success in building the family of your dreams and thanks for joining us on The Scope.
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