Fertility

Conditions and Treatments

Both the need and desire to have children are very basic. Most people plan to have children at some point in their lives, and many assume that when they are ready they will be able to conceive without trouble.

For most couples, the likelihood of becoming pregnant after one month of unprotected intercourse is approximately 25 percent, increasing to 85 to 90 percent after one year. Unfortunately, approximately 10 to 15 percent of American couples who want children are infertile.

However, European researchers reported recently that fertility already starts to wane in women starting about age 27. UCSF gynecologist Dr. Felicia Stewart told the San Francisco Chronicle that the study offers one more reason for sexually active young people to "protect their fertility future," by maintaining good overall health and, in order to avoid fertility-damaging infections, using condoms and "choosing partners wisely."

Infertility is NOT a sexual disorder. Rather it is a condition of the reproductive system that can be caused by a number of factors in both men and women.

• A couple under age 35 should undergo a fertility evaluation if conception does not occur after a year of attempts. Couples over 35 should pursue a fertility evaluation after attempting for six months. A woman using artificial insemination should ask her physician about an infertility evaluation after six months.

• The actual diagnosis of infertility is an important predictor of pregnancy success and the ultimate guide to treatment. In general, infertility is diagnosed as a female problem in 35 percent of cases, a male problem in 35 percent, a combined problem in 20 percent, and unexplained in 10 percent. It is important that both partners be tested to carefully assess the extent of the fertility problems.

• There are many options available to help women and men address infertility. Medications and surgery are the traditional approaches to correcting infertility. Modern technology has created a new group of fertility solutions called assisted reproductive technologies or ARTs, in which a portion of the conception process may occur outside the body. The most common ART is in vitro fertilization (IVF) but a variety of others have been developed to address specific fertility problems.

• In addition to the procedures offered by the UCSF Fertility Group, options such as adoption and foster parenthood also can be considered.

Reviewed by health care specialists at UCSF Medical Center.
Last updated May 8, 2007