Ask the Expert: Infertility

Dr. Arlene Morales, a Sharp-affiliated reproductive endocrinologist and OBGYN, answers commonly asked questions about infertility.

What is infertility?
It is defined as when a couple has been trying to have a baby together, and if the woman is under age 35, they’ve had no success now for 1 year. If the woman is between the ages of 35 and 40, it is defined as 6 months. And if a woman is over the age of 40, at 3 months. These women are suffering from what is now called infertility and really should seek care from either their OBGYN, or sometimes a subspecialist called a reproductive endocrinologist.

Is age a common factor with infertility?
The majority of infertility in this country is due to not necessarily an aging phenomenon in the woman. One in eight couples in the United States suffer from infertility. It is important though to realize that a woman’s age plays a very critical role in her attempts to conceive.

What is conception?
Conception is defined as having intercourse anywhere from two times a week over that time period without necessarily timing your frequency of intercourse. And exposure of sperm two to three times a week over a six-month or one-year period is sought to be attempts of conception. So it’s important to understand that if you are not using any contraception and you are having intercourse of some kind on a regular basis, those are attempts at conception and those women should be conceiving in that time period.

What can affect a person's fertility?
The weight or the body mass index of both the male and the female are extremely important. Exercise regiments, smoking and alcohol issues should be addressed. Smoking has a huge impact on reproductive ability. Now, it is important to understand that women are born with a certain number of eggs and smoking is probably one of the very few things that we know that decreases those amount of eggs.

How is infertility treated?
The most important answer is you have to have a diagnosis first. You don’t start therapy without an evaluation. It includes some blood tests, it includes on some exams on both partners, a semen analysis and some assessment of the mechanical aspects of the female and their tubes in their uterus.

What does hormone therapy include?
Sometimes therapies include hormonal correction of things like prolactin and thyroid, with very simple and inexpensive medicines. Sometimes therapy includes surgical corrections of some of the mechanical abnormalities. For those who are not able to conceive on these low technologies, there is a variety of high technologies that that we use for therapy such as in vitro fertilization or IVF.

What should I do if I'm having difficulty conceiving?
The most important thing you and your partner can do if you are trying to conceive and after either one year, six months or three months depending on the age of the female you have not conceived is to please seek care. Please get educated about why you are having trouble conceiving and what your treatment options are.

For More Information
To learn more about Sharp's women's health services or to find a Sharp-affiliated doctor, search for a San Diego OBGYN or call 1-800-82-SHARP (1-800-827-4277), Monday through Friday, 8 am to 6 pm. To find general information about women's health, visit Women's Health in Adult Health or read the Women's Health News archive.