Your Infertility Questions Answered Dr. Bradford Bopp, a reproductive endocrinologist at Midwest Fertility Specialists in Carmel, answers some of the most common questions people ask about infertility. How common is infertility? Infertility is more common than most people realize. Because of its taboo nature, which has only recently begun to dissipate, it’s one of those things that many people deal with in silence — but they don’t have to. As much as it may feel like it, if you are struggling to start a family, you are most certainly not alone. A staggering 1 in 8 couples in the United States struggle to conceive. Even once pregnant, miscarriage is also surprisingly common, with about 15-20 percent of confirmed pregnancies ending in a loss — and that number increases with age. How do I know if I am infertile? Conception is a very delicate and complicated process, no matter how young and healthy you are. Even if you have been trying for a few months with no success, this does not necessarily mean that you are infertile. So, how do you know if you are infertilie or just need to give it more time? Unfortunately, there are not many telltale signs that a woman or man has infertility. Some medical conditions, such as polycystic ovarian syndrome (PCOS) or endometriosis in women, or Klinefelter Syndrome or hypothyroidism in men, make infertility much more likely. Risk factors like smoking, excessive drinking, obesity, and family history of infertility can also increase the likelihood of infertility. There is a common misconception that infertility typically lies with the female. In reality, a third of infertility cases are attributed to the female, a third are attributed to the male, and a third involve both partners or are unexplained. Are there natural ways to improve fertility? In some cases, fertility can be improved through lifestyle changes, such as losing weight or quitting smoking. In women, being overweight or obese may impair ovulation and cause hormonal imbalances, as well as increase the likelihood of miscarriage and complications during pregnancy. In men, it may result in reduced semen volume or reduced sperm count, making egg fertilization difficult. There is no magic fertility diet, but eating a healthy, well-balanced diet and staying active will help your body function at its highest level, including your reproductive function. Some supplements also promote healthy reproductive function. This includes folic acid, omega 3s and CoQ10 for women, and CoQ10 and zinc for men. When should we see a doctor? In your reproductive years, whether you are actively trying to get pregnant or not, it is important for women to see their gynecologist annually and for men to get a regular wellness checkup. If you are regularly checking in with a physician on your reproductive and overall health, they can track any concerns, point out potential red flags and help you plan for a healthy future. If you have been trying to conceive with no success, or if you are over 35 and are ready to start trying, it is never a bad idea for both partners to get their fertility tested. This initial workup can help you identify any potential issues as early as possible and get a sense of your chances of getting pregnant naturally. Generally speaking, we recommend that couples in which the woman is younger than 35 try for at least 12 months before seeking medical intervention. Because of the decline in egg quantity and quality with age, that period reduces to six months for women over 35. What are our treatment options? Many factors will play into the treatment plan that your doctor recommends, including your diagnosis (whether we’ve been able to pinpoint the likely cause being in the male or female), age, health history, and your desires for your family. If possible, we begin with the least invasive and lowest cost treatment options and progress as needed, with in vitro fertilization (IVF) often being our last course of treatment. This may mean starting with a tailored fertility medication regimen to help improve the chances of conceiving at home. If this does not produce results, we may move on to intrauterine insemination (IUI), a procedure in which we place sperm directly into the woman’s uterus near the time of ovulation to improve the chance that a sperm will fertilize an egg. If these steps do not result in a successful pregnancy, or if your diagnosis requires us to start with a more intense treatment plan, we may recommend IVF. IVF involves the collection of sperm and eggs from each partner, which are combined in a laboratory to create an embryo. We then transfer an appropriate number of embryos (typically just one to avoid multiples) into the woman’s uterus. In some cases, egg and sperm donors or a gestational carrier (also known as a surrogate) is needed for a couple to achieve and carry a successful pregnancy to term. At Midwest Fertility, we have our own egg donation program with a large donor database to choose from. We also work with several sperm banks and surrogacy agencies to provide a variety of options to our patients. How effective are infertility treatments? Every couple or individual’s infertility journey is unique, based on their specific situation — and so is their chance of conceiving. While not everyone has the ability to walk away with a baby, most patients who pursue treatment can be successful. Some patients get pregnant during their first course of treatment, and some patients must try several different treatment options or attempts to get pregnant. For example, it is possible that more than one cycle of IVF may be necessary before a pregnancy is achieved. The good news is that with each procedure or each round of treatment, we learn more and more and are able to continue to adjust and tailor our approach to improve the chances of success. Technology has also advanced to the point where we have much better predictors of the success of a particular cycle, such as the use of genetic testing to determine the best embryos to use for IVF. With genetic testing, the chances of success with IVF approaches 70% with a single embryo transfer. What advice do you have for people struggling to start a family? Listen to your heart. If you feel that something isn’t right, don’t be afraid to get things checked out. When it comes to your health, knowledge really is power. We have the ability to give you some pretty powerful information. What you decide to do with that information is entirely up to you, but having it is the important part. This also goes for choosing your doctor. There is nothing more important than your family. Put this incredibly important job of growing your family in the hands of a team you trust. If it doesn’t feel right, then it probably isn’t. If you have concerns about your fertility, don’t hesitate to give us a call at 317.571.1637 or visit MidwestFertility.com.