There are few events in our lives that are more heartfelt, cherished and deeply envisioned than having children. The decision of when to start your family is subject to conditions within and outside of our control: who, when and if we meet our life partner, our job, feeling economically ready, feeling emotionally ready, our health, our age and other family obligations that defer our personal efforts to have children.
Women and men often spend much of their early reproductive years avoiding pregnancy. Then, when they are ready to start their family and have a baby, it is reasonable to expect conceiving successfully by natural means within 3 to 4 months—and to share enjoyment in the effort. By 6 months of effort to conceive without success, we often begin to wonder and worry if there may be a fertility issue.
Michigan Reproductive Medicine is proud of the fact we have helped so many of our infertility patients through their journey to successfully having a child with a gentle, calming approach raising your awareness of the causes and solutions to your fertility issue. The first step is gaining a balanced perspective about infertility issues.
During a couple’s initial consultation, we will often say, “we’re detectives on a fact-finding mission.”
Here are Some Important Facts on Fertility Issues
- Infertility has been popularly defined as the inability to conceive for 1 year. The definition has been refined considering the age of the female partner as the inability to conceive within 6 months for women age 35 years and older. In general, couples should consider consulting their physician about an infertility evaluation at 6 months or 1 year depending on the age of the female partner.
- For most couples, the likelihood of becoming pregnant any given month of unprotected intercourse is about 25%, increasing to 85-90% after one year. Unfortunately, the remaining 10-15% of couples have yet to become pregnant at the end of one year.
- Normal fertility requires reliable ovulation of a normal egg, a normal uterus, open fallopian tubes, normal sperm and well timed sexual intercourse at the time of ovulation.
- There are many circumstances requiring a sense of urgency and a need to override the 6-month or 1 year waiting guidelines. In these situations, patients may need to consult with a Reproductive Endocrinology and Infertility specialist as soon as possible.
Some examples include the following:
- Very advanced female reproductive age of 40 years or older.
- Family history of early menopause.
- You have uterine problems, sperm problems, or a condition that is already known to impair ovulation or egg transport.
- You are treated for a non-fertility related condition for which there is a narrow window of time within which you can become pregnant and have a baby.
- You wish to avoid passing a genetic disorder on to your child known to exist in your family by having your embryos tested prior to one being placed in your uterus: pre-implantation genetic diagnosis.
An Evaluation for Infertility Issues Focuses on 5 Main Areas
- Egg: ovarian reserve testing and ovulation.
- Sperm: assessment by semen analysis of sperm concentration, movement and shape.
- Egg and embryo transport through the fallopian tube: assessment by either a saline sonohysterogram with 3D ultrasound imaging or hysterosalpingogram.
- Uterus or what our physicians often terms the “9-month rental unit”: assessed by saline sonohysterogram with 3D ultrasound imaging or hysterosalpingogram.
- Preconception screening
- Rubella immunity for female partner
- Genetic mutation carrier screening for at least one partner which includes cystic fibrosis, spinal muscular atrophy, fragile X syndrome, or other tests related to ethnic background.
There can be one or more than one abnormality contributing to a couple experiencing infertility. In general, infertility is diagnosed as an exclusive female problem in 35% of couples, an exclusive male problem in 35% of couples, a combined problem in 20% of couples and unexplained in 10% of couples.
Unexplained infertility does not mean there is not a problem, but rather, our current tests are not sophisticated enough to identify the problem. Issues such as abnormal egg structure, abnormal embryo development and abnormal genetic composition of an embryo may only be assessed and identified during treatment of In-Vitro Fertilization and pre-implantation genetic testing by 24 chromosome analysis, also referred to as comprehensive chromosome screening.
By providing the most current diagnostic procedures and effective medical and surgical infertility treatments, Michigan Reproductive Medicine provides real hope for couples with fertility issues. Our physicians will customize your treatment according to your specific circumstances. All diagnostic testing and treatments are provided at our facility.
Please make an appointment with one of MRM’s fertility expert physicians to evaluate the best treatment options available for treating your infertility issues.