In vitro fertilization (IVF) is used to treat couples who cannot become pregnant on their own and who have not had success with conventional medical infertility therapies or surgery.

Infertility is a condition that impairs a couple’s ability to become pregnant. The condition affects about 6.1 million couples in the US, which is about 10% of the reproductive-age population. Infertility affects both men and women. Fortunately, 85% to 95% of cases of infertility can be treated with conventional medical therapies, such as fertility medicines or surgeries to repair reproductive organs.

Natural reproduction requires a complicated chain of events:

  • The man and woman must produce healthy sperm and healthy eggs.
  • The woman’s fallopian tubes must be functioning properly to allow the sperm to reach the egg.
  • The sperm must be healthy so that they can fertilize the egg when they meet.
  • The fertilized egg (embryo) must move down the fallopian tube to implant in the woman's uterus.
  • The embryo must be healthy to sustain the pregnancy.
  • Sufficient hormonal support by the mother must be present.

If one piece of that chain is not functioning properly, infertility can result. You should schedule a visit with your doctor to discuss your fertility if you:

  • Are under age 35 and have not been able to get pregnant after a year of unprotected sex timed to match ovulation
  • Are age 35 or older and have not been able to get pregnant after six months of unprotected sex timed to match ovulation
  • Have reason to believe you or your partner may have fertility problems, even before trying to get pregnant

A fertility consultation generally includes a physical examination of both partners. The exam will include questions about sexual habits to determine whether intercourse is taking place properly for conception. If no cause of infertility is determined, more specific tests are ordered, including:

  • Hormone tests
  • Basal body temperature and ovulation analyses
  • Ultrasound and/or x-rays of the reproductive organs, dye may be injected into the uterus
  • Laparoscopy in women
  • Semen analysis in men

A number of factors contribute to infertility, including uterine fibroids, endometriosis, pelvic inflammatory disease, polycystic ovarian syndrome (PCOS), premature ovarian failure (POF), luteal phase defect (LPD), smoking, alcohol use, extreme underweight or overweight, strenuous exercise, eating disorders, sexually transmitted diseases (STDs), prostate surgery, and testicle injuries or problems.

In addition, advancing age is associated with declining fertility, especially in women. Fertility especially declines in women after age 35. Men, on the other hand, often remain fertile into their 60s and 70s, although advancing age can be associated with problems with the shape and movement of sperm.