Infertility: Should I Have Treatment?
Infertility: Should I Have Treatment?Skip to the navigationYou may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Infertility: Should I Have Treatment?Get the factsYour options- Try infertility treatment.
- Don't try treatment. Keep trying to get pregnant on your own,
or think about other options for parenting.
Key points to remember- Infertility treatments can increase your
chances of getting pregnant.
- Treatment can be stressful, costly,
and painful. If you decide to have treatment, set your limits before you start.
Talk with your partner about how long you want to try to have a baby with
medical help. Decide how much money you can afford to spend.
- Infertility treatment doesn't guarantee that you will have a
baby.
- Treatment increases your chances of having more than one baby
at a time (multiple pregnancy). Be sure to discuss the risks with
your doctor.
- In 10 out of 100 couples who are tested for
infertility, no cause is found.footnote 1 Of these 10 couples, even without treatment, about 3 will get
pregnant within 3 years and about 5 will get pregnant within 7 years.footnote 2
FAQs You may be
infertile if you have not been able to get pregnant
after trying for at least 1 year. A woman's fertility drops from
her mid-30s into her 40s because of the natural
aging of the egg supply. A man's fertility is not affected as much by age.
As a woman's eggs get older, the
risk of miscarriage increases. In
about 35 out of 100 couples, testing finds a male fertility problem, such as a
problem with sperm production or ejaculation.footnote 1 In about 50 out of 100
couples, testing finds a female fertility problem with
ovulation,
fallopian tube function, or other pelvic
problems.footnote 1 Some couples find that both partners have a fertility
problem. In 10 out of 100 couples, no cause is found.footnote 1 Of these 10 couples, even without treatment, about 3 will get
pregnant within 3 years and about 5 will get pregnant within 7 years.footnote 2 It can be stressful for you and your partner to
find out the reason for infertility. Knowing where the problem is may create
feelings of guilt and blame and may put strain on your relationship. Not being
able to find any cause can also create stress. You may want to talk with a
counselor or join an infertility support group before you make your decision.
Talking with other people can help you feel less alone. Infertility treatment usually starts with making sure you are having sex
during your
6-day fertile window, which is your day of ovulation and the 5 days before it. This is called
fertility awareness. If that doesn't work, then you
may choose surgical, hormonal, or
assisted reproductive technology (ART) treatment to
help you get pregnant. Some of these treatments can be stressful, costly, and
painful. Depending on what is causing the problem, couples can:
- Take medicine, such
as clomiphene,
gonadotropins, or gonadotropin-releasing hormone (GnRH), that helps a woman ovulate. A man can
take
medicines to increase sperm count.
- Have a procedure that puts sperm directly inside the
woman (insemination).
- Have surgery
that corrects a problem
caused by
endometriosis or blocked
fallopian tubes.
- Try in vitro fertilization (IVF). During an IVF, eggs and
sperm are mixed in a lab so the sperm can fertilize the eggs. Then the doctor
puts one or more fertilized eggs into the woman's uterus.
The
success of IVF depends on your age and your doctor's skill and experience. For
women, the older you are, the less likely it is that IVF will work unless you
use donor eggs. Also, the cause of your infertility can affect the success of
IVF. What else do you need to know about fertility treatments?Keep in mind that some infertility problems are more
easily treated than others. In general, as a woman ages, especially after age
35, her chances of getting pregnant decrease and her risk of miscarriage
increases. Treatment for fertility problems can be stressful,
costly, and hard on your body. Before you start testing, make some decisions
about what you want to do. You may change your mind later, but it's a good idea
to start with a plan. - Learn all you can about the tests and
treatments, and decide which you want to try. For example, some couples agree
to try medicines but don't want surgery or other treatments.
- Find
out how much the treatments cost and whether your insurance will pay for them.
If you don't have insurance, decide what you can afford.
Treatments for infertility can increase your chance of
getting pregnant. But they also increase your chance of having more than one
baby at a time (multiple pregnancy). Be sure to discuss this risk with
your doctor. There may be a higher risk of birth defects for babies conceived by certain assisted reproductive techniques. Talk with your doctor about these possible risks. Even though many fertility clinics give information
about how many babies have been conceived, those numbers can be misleading.
They may not include how many pregnancies miscarry. Treatment for infertility
doesn't guarantee that you will have a baby. Your doctor may recommend treatment if: - You have a known problem that can be fixed with infertility
treatment.
- You have unexplained infertility, and your doctor has
proposed a treatment that can increase your chances of having a healthy
pregnancy.
Compare your options | |
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What is usually involved? |
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What are the benefits? |
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What are the risks and side effects? |
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Have fertility treatment
Have fertility treatment
- You take medicines,
have surgery, try
insemination, or have
in vitro fertilization (IVF) to help you get
pregnant.
- With most infertility treatments (except surgery), you won't have
to stay overnight in the hospital and you will recover quickly.
- If you have surgery, you may stay in the hospital for 2 to 4
days. Depending on the type of surgery you have, your recovery may take a few
days to several weeks.
- Depending on the cause
of your infertility, medicines and other treatment can increase your chances of
getting pregnant.
- You may
not get pregnant. Your chances of pregnancy with IVF depend on how good your
eggs are. (Donor eggs may improve your chances).
- Treatment can be
stressful, costly, and painful. It can take months or years.
- Treatments can increase your chances of having more than one baby
at a time.
- There may be a higher risk of birth defects for babies conceived by certain assisted reproductive techniques.
- Medicines to stimulate ovulation (clomiphene) or
increase sperm (gonadotropin) have side effects. Some studies have
found an increased risk of miscarriage when either of these drugs is used.
Don't have treatment
Don't have treatment
- You keep trying to conceive
on your own, having sex just before
ovulation to increase your chances of getting
pregnant.
- You consider other options for parenting, such as adoption or
raising a foster child.
- You avoid the cost, stress,
and risks of infertility treatments.
- You may not
get pregnant without treatment.
We have
been trying for awhile to have a baby on our own. Now that we've had some
tests, our doctor has recommended treatments that will give us a better chance.
We are much more hopeful now. We feel very good about the clinic where we will
have the treatments done, and their live birth rates are above the national
average. We can't afford some of the expensive ART
treatments. We have one child, and we need to think about his future needs,
like college. I don't know where we would get $10,000 or maybe even $15,000 for
treatment, since our insurance doesn't cover the costs. Luckily, some of the
more successful treatment options for our problem are covered by our insurance.
We feel fortunate about that. George, age 45, and Bonita, age
40 We have had every possible test to try to
find out why we can't get pregnant. There doesn't seem to be anything wrong.
After almost 2 years, we don't have a baby yet. We know there is still a chance
that we will get pregnant, and that gives us hope. Knowing that there isn't
anything wrong, at least anything that the doctors can find, helps some. We've
heard about the side effects of treatment, and the stress involved, and we just
aren't sure that we want to put ourselves through that. We are going to try for
a few more months, and then consider our treatment options. My husband
has sperm problems, so our least costly option is to use donor sperm. We are
trying to decide if we want to spend the money for treatment or use it to
adopt. It's a hard decision. Each of us feels differently about having a child
that isn't biologically related to us, so we are talking about it a lot. We
feel lucky because at least we have some options and enough time to consider
them before we finally decide what's best for us. I feel so
guilty for having waited so long to try to have a baby. I can't help wondering
if something I did when I was in my 20s is the reason why I can't get pregnant
now. My husband really wants kids, and I feel like I'm letting him down and
that he is disappointed in me. My husband has started talking about taking a
break from all of this treatment. He said he doesn't like what this is doing to
me emotionally and physically and thinks that a break might help. I worry that
if we take a break I will feel like I am being lazy and just expecting to get
pregnant without putting any work into it. But maybe it would be best, even for
a couple of months. Every month just seems so precious! What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have infertility treatment Reasons not to have infertility treatment Having a biological child is very important to me. I need to think about how important having a biological child is to me. More important Equally important More important I'm not concerned about the cost of infertility treatment. I'm worried about how I will pay for treatment. More important Equally important More important I think I can handle the emotional stress of treatment. I'm not sure I can handle the stress of treatment. More important Equally important More important I accept that I may not get pregnant even with treatment. I don't want to have treatment if I might not get pregnant. More important Equally important More important My other important reasons: My other important reasons: More important Equally important More important Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having infertility treatment NOT having infertility treatment Leaning toward Undecided Leaning toward What else do you need to make your decision?1.
How sure do you feel right now about your decision? Not sure at all Somewhat sure Very sure Your SummaryHere's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. Next stepsWhich way you're leaningHow sure you areYour commentsKey concepts that you understoodKey concepts that may need reviewCredits | Author | Healthwise Staff |
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| Primary Medical Reviewer | Sarah Marshall, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology |
|---|
References Citations - Fritz MA, Speroff L (2011). Female infertility. In Clinical Gynecologic Endocrinology and Infertility, 8th ed., pp. 1137-1190. Philadelphia: Lippincott Williams and Wilkins.
- Lobo RA (2012). Infertility: Etiology, diagnostic evaluation, management, prognosis. In GM Lentz et al., eds., Comprehensive Gynecology, 6th ed., pp. 869-895. Philadelphia: Mosby.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Infertility: Should I Have Treatment?Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. - Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the FactsYour options- Try infertility treatment.
- Don't try treatment. Keep trying to get pregnant on your own,
or think about other options for parenting.
Key points to remember- Infertility treatments can increase your
chances of getting pregnant.
- Treatment can be stressful, costly,
and painful. If you decide to have treatment, set your limits before you start.
Talk with your partner about how long you want to try to have a baby with
medical help. Decide how much money you can afford to spend.
- Infertility treatment doesn't guarantee that you will have a
baby.
- Treatment increases your chances of having more than one baby
at a time (multiple pregnancy). Be sure to discuss the risks with
your doctor.
- In 10 out of 100 couples who are tested for
infertility, no cause is found.1 Of these 10 couples, even without treatment, about 3 will get
pregnant within 3 years and about 5 will get pregnant within 7 years.2
FAQs What is infertility?You may be
infertile if you have not been able to get pregnant
after trying for at least 1 year. A woman's fertility drops from
her mid-30s into her 40s because of the natural
aging of the egg supply. A man's fertility is not affected as much by age.
As a woman's eggs get older, the
risk of miscarriage increases. What kinds of problems lead to infertility? In
about 35 out of 100 couples, testing finds a male fertility problem, such as a
problem with sperm production or ejaculation.1 In about 50 out of 100
couples, testing finds a female fertility problem with
ovulation,
fallopian tube function, or other pelvic
problems.1 Some couples find that both partners have a fertility
problem. In 10 out of 100 couples, no cause is found.1 Of these 10 couples, even without treatment, about 3 will get
pregnant within 3 years and about 5 will get pregnant within 7 years.2 It can be stressful for you and your partner to
find out the reason for infertility. Knowing where the problem is may create
feelings of guilt and blame and may put strain on your relationship. Not being
able to find any cause can also create stress. You may want to talk with a
counselor or join an infertility support group before you make your decision.
Talking with other people can help you feel less alone. What types of infertility treatment are available? Infertility treatment usually starts with making sure you are having sex
during your
6-day fertile window, which is your day of ovulation and the 5 days before it. This is called
fertility awareness. If that doesn't work, then you
may choose surgical, hormonal, or
assisted reproductive technology (ART) treatment to
help you get pregnant. Some of these treatments can be stressful, costly, and
painful. Depending on what is causing the problem, couples can:
- Take medicine, such
as clomiphene,
gonadotropins, or gonadotropin-releasing hormone (GnRH), that helps a woman ovulate. A man can
take
medicines to increase sperm count.
- Have a procedure that puts sperm directly inside the
woman (insemination).
- Have surgery
that corrects a problem
caused by
endometriosis or blocked
fallopian tubes.
- Try in vitro fertilization (IVF). During an IVF, eggs and
sperm are mixed in a lab so the sperm can fertilize the eggs. Then the doctor
puts one or more fertilized eggs into the woman's uterus.
The
success of IVF depends on your age and your doctor's skill and experience. For
women, the older you are, the less likely it is that IVF will work unless you
use donor eggs. Also, the cause of your infertility can affect the success of
IVF. What else do you need to know about fertility treatments?Keep in mind that some infertility problems are more
easily treated than others. In general, as a woman ages, especially after age
35, her chances of getting pregnant decrease and her risk of miscarriage
increases. Treatment for fertility problems can be stressful,
costly, and hard on your body. Before you start testing, make some decisions
about what you want to do. You may change your mind later, but it's a good idea
to start with a plan. - Learn all you can about the tests and
treatments, and decide which you want to try. For example, some couples agree
to try medicines but don't want surgery or other treatments.
- Find
out how much the treatments cost and whether your insurance will pay for them.
If you don't have insurance, decide what you can afford.
Treatments for infertility can increase your chance of
getting pregnant. But they also increase your chance of having more than one
baby at a time (multiple pregnancy). Be sure to discuss this risk with
your doctor. There may be a higher risk of birth defects for babies conceived by certain assisted reproductive techniques. Talk with your doctor about these possible risks. Even though many fertility clinics give information
about how many babies have been conceived, those numbers can be misleading.
They may not include how many pregnancies miscarry. Treatment for infertility
doesn't guarantee that you will have a baby. Why might your doctor recommend infertility treatment?Your doctor may recommend treatment if: - You have a known problem that can be fixed with infertility
treatment.
- You have unexplained infertility, and your doctor has
proposed a treatment that can increase your chances of having a healthy
pregnancy.
2. Compare your options| | Have fertility treatment
| Don't have treatment
|
|---|
| What is usually involved? | - You take medicines,
have surgery, try
insemination, or have
in vitro fertilization (IVF) to help you get
pregnant.
- With most infertility treatments (except surgery), you won't have
to stay overnight in the hospital and you will recover quickly.
- If you have surgery, you may stay in the hospital for 2 to 4
days. Depending on the type of surgery you have, your recovery may take a few
days to several weeks.
| - You keep trying to conceive
on your own, having sex just before
ovulation to increase your chances of getting
pregnant.
- You consider other options for parenting, such as adoption or
raising a foster child.
|
|---|
| What are the benefits? | - Depending on the cause
of your infertility, medicines and other treatment can increase your chances of
getting pregnant.
| - You avoid the cost, stress,
and risks of infertility treatments.
|
|---|
| What are the risks and side effects? | - You may
not get pregnant. Your chances of pregnancy with IVF depend on how good your
eggs are. (Donor eggs may improve your chances).
- Treatment can be
stressful, costly, and painful. It can take months or years.
- Treatments can increase your chances of having more than one baby
at a time.
- There may be a higher risk of birth defects for babies conceived by certain assisted reproductive techniques.
- Medicines to stimulate ovulation (clomiphene) or
increase sperm (gonadotropin) have side effects. Some studies have
found an increased risk of miscarriage when either of these drugs is used.
| - You may not
get pregnant without treatment.
|
|---|
Personal storiesPersonal stories about infertility treatment decisions
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"We have been trying for awhile to have a baby on our own. Now that we've had some tests, our doctor has recommended treatments that will give us a better chance. We are much more hopeful now. We feel very good about the clinic where we will have the treatments done, and their live birth rates are above the national average." "We can't afford some of the expensive ART treatments. We have one child, and we need to think about his future needs, like college. I don't know where we would get $10,000 or maybe even $15,000 for treatment, since our insurance doesn't cover the costs. Luckily, some of the more successful treatment options for our problem are covered by our insurance. We feel fortunate about that." — George, age 45, and Bonita, age
40 "We have had every possible test to try to find out why we can't get pregnant. There doesn't seem to be anything wrong. After almost 2 years, we don't have a baby yet. We know there is still a chance that we will get pregnant, and that gives us hope. Knowing that there isn't anything wrong, at least anything that the doctors can find, helps some. We've heard about the side effects of treatment, and the stress involved, and we just aren't sure that we want to put ourselves through that. We are going to try for a few more months, and then consider our treatment options." "My husband has sperm problems, so our least costly option is to use donor sperm. We are trying to decide if we want to spend the money for treatment or use it to adopt. It's a hard decision. Each of us feels differently about having a child that isn't biologically related to us, so we are talking about it a lot. We feel lucky because at least we have some options and enough time to consider them before we finally decide what's best for us." "I feel so guilty for having waited so long to try to have a baby. I can't help wondering if something I did when I was in my 20s is the reason why I can't get pregnant now. My husband really wants kids, and I feel like I'm letting him down and that he is disappointed in me. My husband has started talking about taking a break from all of this treatment. He said he doesn't like what this is doing to me emotionally and physically and thinks that a break might help. I worry that if we take a break I will feel like I am being lazy and just expecting to get pregnant without putting any work into it. But maybe it would be best, even for a couple of months. Every month just seems so precious!" 3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have infertility treatment Reasons not to have infertility treatment Having a biological child is very important to me. I need to think about how important having a biological child is to me. More important Equally important More important I'm not concerned about the cost of infertility treatment. I'm worried about how I will pay for treatment. More important Equally important More important I think I can handle the emotional stress of treatment. I'm not sure I can handle the stress of treatment. More important Equally important More important I accept that I may not get pregnant even with treatment. I don't want to have treatment if I might not get pregnant. More important Equally important More important My other important reasons: My other important reasons: More important Equally important More important 4. Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having infertility treatment NOT having infertility treatment Leaning toward Undecided Leaning toward 5. What else do you need to make your decision?
Check the facts
1.
Does having infertility treatment guarantee that you will deliver a baby? You're right. Infertility treatment does not guarantee that you will have a baby. 2.
Can infertility treatment increase your chances of getting pregnant with more than one baby at a time? You're right. Infertility treatments can increase your chances of getting pregnant. But they also increase your chance of having more than one baby at a time. 3.
If you decide to start treatment, is it important to know how far you are willing to go with it before you get started? You're right. If you decide to have treatment, you should define your limits before you start. Talk with your partner about how long you want to use medical help to try to have a baby. Decide what's next1.
Do you understand the options available to you? 2.
Are you clear about which benefits and side effects matter most to you? 3.
Do you have enough support and advice from others to make a choice? Certainty1.
How sure do you feel right now about your decision? Not sure at all Somewhat sure Very sure 2.
Check what you need to do before you make this decision. Credits | By | Healthwise Staff |
|---|
| Primary Medical Reviewer | Sarah Marshall, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology |
|---|
References Citations - Fritz MA, Speroff L (2011). Female infertility. In Clinical Gynecologic Endocrinology and Infertility, 8th ed., pp. 1137-1190. Philadelphia: Lippincott Williams and Wilkins.
- Lobo RA (2012). Infertility: Etiology, diagnostic evaluation, management, prognosis. In GM Lentz et al., eds., Comprehensive Gynecology, 6th ed., pp. 869-895. Philadelphia: Mosby.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.Current as of:
March 16, 2017 Fritz MA, Speroff L (2011). Female infertility. In Clinical Gynecologic Endocrinology and Infertility, 8th ed., pp. 1137-1190. Philadelphia: Lippincott Williams and Wilkins. Lobo RA (2012). Infertility: Etiology, diagnostic evaluation, management, prognosis. In GM Lentz et al., eds., Comprehensive Gynecology, 6th ed., pp. 869-895. Philadelphia: Mosby. Last modified on: 8 September 2017
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