What is this strange disease?  First recall that the endometrium is the lining of the uterus that thickens during ovulation to prepare for the egg.  For reasons that are not entirely known, sometimes this specialized tissue grows outside the uterus and attaches to other organs; this clearly is not desirable.  Mild cases are probably never diagnosed and cause no problems.  Some are of the opinion that up to 70% of those with mild cases will be able to conceive within three years with no treatment; however three years of trying is a long time.

More substantial levels of influence (the medical community has a rating system for the severity of the situation) can cause significant pain, damage and infertility.  One study reported a connection between endometriosis and infertility in 5-15% of cases, but another source placed this as the cause in 25% to 35% of infertile women.

The renegade tissue, growing outside the uterus, behaves like regular endometrium tissue, thickening and falling away during the cycle.  The fact that other parts of the abdomen are not equipped to deal with this, so that can cause other related problems with possible infection, etc.  As irritated portions heal and scar, the disease can actually bind organs together.  It can cause scarring in the fallopian tubes, which can reduce the mobility of the egg.

This can be a slowly progressive disease, gradually expanding within the abdominal cavity.  It can attach to ovaries and affect their ability to create and release healthy eggs.  Endometriosis located around the uterus can cause painful spasms and particularly difficult periods.

It seems that estrogen is involved in allowing or causing the tissue to grow where it is not welcome, so treatments sometimes center on controlling estrogen.  Too much estrogen can cause other complications that result in infertility as well.

It would be convenient if there were symptoms that made it easier to link endometriosis and infertility, but such is not really the case.  Some of the symptoms for this disease can also be related to other conditions, so if is sometimes mis-diagnosed.  However, some clues are (unusually) painful menstrual periods, abnormal bleeding and pain during sexual relations.  Chronic pain in the pelvic region, backache and leg pain, nausea, high blood pressure, diarrhea and other seemingly unrelated symptoms can actually be pointing to endometriosis.  Sometimes it is diagnosed as appendicitis, ovarian cysts and pelvic inflammatory disease (PID, another cause of infertility).

Treatments can vary widely, from hormone treatment to specialized drugs to surgery to remove the tissue.  A visit to a specialist can help avoid the possibility of years of an incorrect diagnosis and improper treatment.  The treatment may differ for women who want to become pregnant compared to those who no longer plan to have children.  It is important to deal with the effects of endometriosis and infertility, but this condition should be treated even if pregnancy is not the issue.

The disease can reoccur even after treatment.  And it is important to obtain a proper diagnosis in the first place.  The actual course of action will be decided by the specialist depending on several factors, including personal history and health and the stage of severity.

It might be tempting to assume that most of the trouble is with the woman.  Given that the female reproductive system is more extensive than that of the male, there does seem to be a larger number of medical terms describing female problems.  However, more than one study has found that the actual numbers of cases of infertility attributed to men and women are not far apart.  A UK study reported male factors and female factors each at 32.5%.  Cases that had multiple male and female influences were 10.8%.  Unexplained cases made up 23.1% of the total.  The remaining 1% or so involved “other factors” whatever that means.

Since there are fewer entries on the list of male reasons for infertility, we start with that.  At the top of the list is low sperm count or sperm that aren’t healthy and are not sufficiently mobile.  The environment in which the sperm are created is important; stress, improper diet, smoking, obesity and sexually transmitted diseases can all contribute to circumstances where the body is unable to create a sufficient number of healthy sperm.  There is perhaps little reason to spend a lot of money on infertility treatments if the man is unwilling to first take a good look at improving his health in these areas.

Other reasons for male infertility problems are if the testicles have not descended properly and if there is a varicocele, which is basically varicose veins in the testicles.  The veins down there are supposed to send blood back up to the heart; little one-way valves make sure the blood goes in the right direction.  However if they malfunction the circulatory system gets messed up and the ability to produce healthy sperm is diminished.  There are various ways to treat this, with varying levels of success, depending on the nature of the problem.

Finally there can be plumbing problems in the tubing through which the sperm must travel on their mission.  Thus, there may be an ample number of healthy sperm to begin with, but not enough find their way to the finish line.

The most likely reasons for infertility in women relate to the ovulation process.  Luteal phase defect (LPD) means that, for a variety of reasons, the duration of the ovulation process is shortened.  Those reasons can include hormone imbalances, obesity, prolonged use of oral contraceptives and stress.

Pelvic inflammatory disease (PID) is another potential source of trouble.  Blocked fallopian tubes, endometriosis (which can cause blocked tubes), uterine fibroids and PCOS.

Weight can be an issue, although perhaps not as often as one might think.  It may be a major factor less than 10% of the time, but if you are in that 10% it is worth attention.  There are two reasons for infertility related to obesity.  First it turns out that fat cells produce estrogen, which in excess can shorten the luteal phase and/or sabotage the ovulation process.  Also, the same hormonal/chemical influences that can cause excess weight can also cause PCOS, a major hurdle to pregnancy.

Some of the same causes of male infertility can affect women as well, such as alcohol, smoking, stress, sexually transmitted diseases and bad diet.

The healthy diet and bad habits can be worked on before spending a lot of money on sophisticated infertility treatments, but we recommend consulting a doctor if in doubt.

Or maybe you are living a very stressful lifestyle as a result of work, living situation or whatever.  Could that stress be preventing you from success?  And if so, knowing it adds even more stress to your already stress-filled life.  These interwoven factors are all tied into a phenomenon known as infertility stress that affects both men and women.

It goes without saying that infertility is a very significant crisis, one that centers around one of life’s most deep-seated desires.  It is one of the most stressful issues ever to confront a couple, and it is not unreasonable to have a very emotional response.  Those emotions may well include a sense of isolation, with the feeling that nobody else has ever had the problem.  It can also cause feelings of inadequacy and even guilt, especially in the person in whom the infertility condition is found.  So it is these associated emotions, along with the simple concern that they may never be able to become pregnant, that inflame the stress.

That stress can have a direct effect on your health, depending on its severity and duration.  In this modern world, a certain level of stress is unavoidable.  But relentless stress causes the body to take certain defensive measures that work against an environment where conception and safe pregnancy can occur.

We might consider there to be two main types of stress.  First is acute stress—short term conditions brought about by a specific situation.  The body may release adrenalin and other substances that prepare for a fight or flight from danger, for example.  The other kind of stress is chronic, lasting over many days, weeks or months.  Here again the body is releasing hormones and other chemicals to help the brain and body cope with the trouble.

Infertility stress, especially chronic or repeated events involving acute stress, can have a number of negative results on health in general, and on fertility in particular.  Excessive stress affects women by disrupting the communications between the brain and various other organs responsible for creating hormones, eggs and other essential ingredients in a successful conception.  The potential hormone imbalance is a big deal, as that can mess up the whole ovulation cycle, among other effects.

Stress can cause trouble for the cardiovascular system in both men and women, which may not influence pregnancy but certainly cannot be good in the long run.  It can be distracting and reduce the sex drive and make it less attractive in the home for the couple to desire intimate relations.  No intimate relations and no baby!

Infertility stress can impact the sperm count by affecting hormones in the man.  The sperm health and mobility are also at risk.

Taken together, all of the above influences mean that stress is bad news for couples trying to get pregnant.  It is therefore worthwhile to stop and take a look at lifestyle choices, work stress and anxiety over a delay in achieving conception.  There are treatments for reducing stress levels.

Some natural treatments can be effective, including acupuncture and herbs.  These serve to relieve infertility stress by affecting the autonomic and parasympathetic nervous systems to reduce muscle tension, increase a sense of relaxation and release of mental agitation.  Meditation techniques like yoga can help reduce stress levels as can professional and group counseling.  Do not ignore the importance of stress on the fertility battle, both as a source of infertility and a result of it.

With this in mind it is worthwhile to have a better understanding of the hormone and its effect on the infertility problem.  We will finish by looking at a few ways modern medicine helps deal with low progesterone levels.

Progesterone is one of the most important hormones in a woman’s body.  It is produced by one or more of the egg follicles in the ovary after ovulation.  The entire menstrual cycle depends on this substance for regulation.  It prepares the uterus for conception and causes the endometrial lining to thicken up as preparation for the arrival of the egg.  Not enough and there is not a proper thickening of the wall.  The hormone also conveniently causes the basal temperature to go up slightly during ovulation; this is a telltale sign.

If the egg is not fertilized, the source of progesterone disappears after several days.  The drop in the hormone means the uterus cannot maintain the extra thickness, and the lining soon makes its exit in the last act of the menstrual cycle.

Low levels of this hormone can result in a shortened “luteal phase,” that portion of the cycle during which ovulation occurs, among other things.  This phase typically runs between 10 and 16 days, although the time period within this phase when things are ripe for conception is only a couple of days after ovulation.  If the luteal phase is too short there’s not enough time for the choreography to run its natural course.  The result:  no pregnancy.

If the egg is fertilized, progesterone levels continue at higher levels, providing protection for the multiplying and growing new human.  If the levels somehow drop too much during pregnancy there is the possibility of a miscarriage.   By the way, this hormone performs other functions; it is quite a workhorse.

This is, of course, an extreme simplification of the complex process.  But progesterone is one of a few hormones that must be present at the right time and in the right amounts.  Fortunately it is possible to diagnose progesterone infertility and often the addition of a natural or synthetic boost of the hormone can set things right.  Sometimes the problem is actually caused by there being too much estrogen in the system, and that requires its own plan of attack by the fertility specialist.

Progesterone therapy has been shown to be very effective in many cases, with the treatment starting two or three days after ovulation occurs (remember that a lack of progesterone soon causes things to dry up too soon and we want to prevent that).  The hormone is available in oral form, as an injection or as a cream, depending on how the specialist wants to handle it.  It may be that synthetic progesterone has fewer side effects than the natural version; again your doctor will have opinions on that.  The timing is important; if introduced too soon it can prevent ovulation from taking place for example.

Studies have found this therapy can achieve a success rate of over 70% if the source of infertility has been fully determined.  That’s pretty encouraging.  Of course there can be other causes for a shortened luteal phase.  But progesterone infertility is one of the more manageable varieties of the problem, where proper diagnosis and non-invasive treatment can help the patient become pregnant relatively quickly.  Hopefully this explanation will help you ask better questions when you meet with your infertility specialist.

However, experts warn that the emotional aspects make it very hard to reach sound decisions about money.  It is worthwhile to examine the likely actual costs associated with diagnosis and treatement, along with a brief discussion of possible ways to manage and minimize the costs.

Typical Infertility Cost Ranges

The range in infertility cost to a couple can range from a couple hundred dollars for herbal supplements and test kits, to tens of thousands of dollars for major medical procedures (possibly repeated numerous times).  To be more specific, simple tests for hormones or sperm activity might run up to $100 to $200.  An ultrasound can run a couple hundred dollars–this assumes the tests are done in a doctor’s office and not a clinic or hospital.  More invasive tests like biopsies and diagnostic laparoscopy can run from say $400 to $2,000, maybe less.  Some tests may be performed more than once during the course of the whole treatment.

Medication can run from less than $100 to several hundred dollars (one source had Clomid at $750 per cycle).  Procedures to tream male infertility can run upwards of $2,000 to $3,000.  But the big dollars apply to the more advanced ART procedures, which can run thousands of dollars per monthly cycle.  Consultations and other items can add considerably.  Total infertility costs often average $16,000 to $20,000 at a minimum, and can grow a great deal from there since pregnancy can take some time even with medical help.

Infertility Cost Strategies

The costs mentioned above can break a family financially.  Some insurance plans offer at least partial coverage; read your policy carefully.  A Healthcare Flexible Spending Account (FSA) may let you declare the costs for infertility treatment as deductible expenses (confirm with your tax professional).  It is possible to obtain various types of specialty infertility insurance; this is best obtained before you learn you have an infertility problem.

Dealing with infertility is stressful enough without the financial burden; using credit cards to pay for procedures and consultations at a high interest rate can really make things worse.  To cover costs, some families without insurance sell off the boat, downsize the house or swap the expensive automobile for a cheaper model.  Some obtain a loan against their home.
It is important to be realistic about what the potential infertility costs could run.  Therefore, finding out exactly what the issue is can be very important.  In other words, focus on a reliable diagnosis.  That might mean going to a very experienced infertility specialist as soon as possible, rather than trying to figure it out with the family GP. One source indicates that finding the specialist early tends to increase the probability of success and reduces overall costs, on average.

In some cases the exact cause of infertility is unknown; in fact it may be unclear as to whether infertility is really a problem or if more time is needed.  If in doubt and if the budget is very tight, using natural treatments, monitoring temperatures and patience may bring success at an affordable cost.  But it may take time also; there is the tension of wanting success and having to pay for it.

Infertility cost is clearly a stressful concern for most couples faced with this challenge.  Preparing financially for potential problems years before trying to get pregnant, including acquiring insurance perhaps a year in advance, certainly makes sense.  In any event, having a good understanding of the whole subject before visiting the doctor will be worthwile.

One of the primary sources of infertility problems in women is Polycystic Ovarian Syndrome or PCOS.  Although perhaps not completely understood, it appears to be closely related to excessive production of insulin by the body.  In some cases the response is for the woman to produce unusually high levels of male hormones, or androgens.  A woman with PCOS is typically insensitive to insulin and that can actually lead to diabetes.  This emphasizes the importance of a correct balance of hormones.

Let’s look a bit closer at what happens when PCOS jams up the works.  In the course of the monthly cycle a number of follicles develop inside the ovaries.  There is an egg that grows inside each follicle.  As the menstrual cycle proceeds, a single follicle will stay, to release its egg during the ovulation process.  Basically, after the egg is sufficiently developed levels of LH increase significantly.  That causes the egg to break loose; and voila, there is ovulation!

Women dealing with PCOS normally don’t create a sufficient amount of the female hormones needed to jump start the ovulation process.  That means that the follicles do not create the expected eggs.  Consequently some of the stunted follicles turn into cysts.  An ultrasound may show a group of cysts like pearls or little islands; they are underachieving follicles.  There will be numerous cysts on the outside of the ovaries.

One of the prime symptoms that a woman has PCOS is when the period is irregular or absent altogether.  When ovulation does not take place during the monthly cycle, there is little or no progesterone created and that is what causes the lining of the uterus to thicken in anticipation of a fertilized egg.  No progesterone and no symptoms of a period.

Polycystic Ovarian Syndrome can become more pronounced as a woman ages; this is one of the reasons that it becomes harder to get pregnant with age.  It does not have to be the case that there is no period; an irregular period can also be involved.

Experts have estimated that PCOS affects somewhere around 5% to 10% of women in the likely child-bearing years.  There is a good chance that they don’t even know they suffer from this condition; actually only around 20% or so of those with the affliction have been diagnosed.  It is possible for certain fortunate women to conceive even if the periods are irregular; applying a technique that we discuss in the featured book “Secrets of Infertility Relief” might be helpful in this situation, depending on the advice of your doctor.

Another clue that PCOS may be present is if you see changes in hair growth.  Specifically, increased hair growth on the face, chest or on the back.  Also, if your hair starts to thin unexpectedly, you gain weight for no particular reason or develop acne.  Excessive insulin levels or pelvic pain could be other signs.  But for some the irregular period is the only clue.  Obviously if these signs are evident, a visit to the doctor is called for right away.

Solutions

So it is the lack of ovulation that disrupts the ability of the woman to conceive.  Fortunately there are steps that are often effective against PCOS.  Since it is related to hormones, any adjustment to diet and exercise that helps the body balance hormones can be significant.  Losing weight is one way to allow the body to naturally balance its hormone chemistry.

As we noted above, insulin is an important player in this situation.  A doctor may prescribe Metformin, which is a drug that enhances the ability of the body to process insulin.  This treatment is typically used with women who do not have diabetes; it affects the level of insulin in the body but does not do anything to reduce the blood sugar level, a big deal to diabetics.

Another common drug is Clomid, which helped us get pregnant back in 1985 (December 1, I believe).  This drug affects the estrogen receptors in the brain, blocking their sensitivity to that hormone.  The brain is tricked into assuming that estrogen levels are too low.  This results in an increase of FSH and LH in the system and they tend to trigger ovulation.  Clomid reportedly works quite well to induce ovulation.  Around 35% to 40% of users who do ovulate from this approach are actually successful in getting pregnant.

Another more substantial treatment is the use of In-Vitro Maturation (IVM), where the eggs are harvested before becoming mature, early in the cycle.  The eggs are allowed to grow in the lab and then used for fertilization when the time is right.  In-Vitro Fertilization is slightly different in that they remove the eggs after they mature inside the woman.  In either approach, the eggs are fertilized and implanted back in the uterus.  Medications are used with IVF to help the eggs develop.

A Final Word of Encouragement: Although it has been over 20 years and the terms have changed, my wife most likely had some form of PCOS when we were trying to get pregnant.  A prescription for Clomid and the use of the “secret” techniques mentioned above and we were successful in a reasonable amount of time—a  few months at most.  So PCOS can be beat!

As will be evident below, we could also call this page “Signs of Potential Infertility.”

A substantial number of women are affected by infertility to one degree or another, as are a smaller percentage of men.  Many have no idea it is a problem until they are trying to get pregnant, and others show symptoms that are easy to recognize.  This is not surprising, given the variety in different forms of infertility.  The signs differ from one person to the next, and may include the man.

One of the most obvious signs of infertility is if the couple is unsuccessful after vigorously trying for a reasonable period of time.  Since there is a good chance the condition will not show itself in other symptoms, a woman should check in with her physician if a year or more of continuous “trying” is unsuccessful.  By “trying” we mean sexual relations an average of 3 times per week.  It could take longer than a year, so patience is called for even as they pass the 12-month mark; some doctors want you to try upwards of two years.

Signs of Infertility in Women

Among the numerous potential signs of infertility, one of the most obvious is an irregular or unusual menstrual cycle.  On the other hand, an irregular cycle could mean several other things—or nothing much at all.  It might have no relationship to a fertility problem.

Pain in the pelvic region could be a sign of PCOS or Polycystic Ovarian Syndrome, which is covered in some detail on another page.  Unexpected changes in hair, or the appearance of hair in unusual places (chest, face) could indicate a hormone problem that will cause fertility issues.

Although not necessarily a result of infertility, a related phenomenon is weight.  That is excessive weight, or being too thin as the other extreme.  Obesity can be related to hormone problems, which mess with the ovulation process among other things.  A woman who is very thin may lack the necessary nutrients for successful conception.  So giving some thought to one’s weight is worth doing some time before trying to get pregnant.  If unusual weight gain is noticed, that could be related to a hormone imbalance that also ties to infertility.

Abuse of alcohol and other substances also can contribute to infertility, as we discuss in more detail on another page.  They are more causes than signs of infertility.  But if a person finds themselves with these dependencies, there is a distinct chance that fertility problems are looming.  So in that respect they are a sign of things to come.

Signs of Infertility in Men

What about the man?  There are some signs of potential infertility with him also.  Men with un-descended testicles may be facing a reduced ability to “contribute” to the process of conception.  Wearing tight underwear or jeans can, over time, also be a factor in infertility in males.  Exposure of the genital area to extreme heat (super hot spa) can likewise result in a reduced sperm count.  Safe to say you don’t want to be taking hot baths or jumping into hot tubs at high temperatures when trying to get pregnant (or if you think you might want to get pregnant).

Some of the signs can be very similar for men and women.  Hormone imbalances that cause weight gain can also reduce the quantity and/or quality of sperm.  So sudden changes in health should be looked at carefully.  Obviously substance abuse can be a big roadblock for both men and women in that they tend to mess up the overall health and thus the ability to produce adequate sperm or eggs.  If you find yourself to be a big drinker, that is a sign that trouble may be brewing.

Final Thoughts

Obviously observing any of these signs does not automatically mean that there is an infertility problem.  Some apparent signs of infertility may amount to nothing; if the symptoms are dramatic or could be indicators of some other serious condition it is clearly time to visit the doctor.  In fact, if in doubt have it checked out.  Otherwise, being patient and persisting with your efforts will often pay off over time.  As we’ve observed, sometimes patience is the best cure to what may seem like indications of infertility.

The manipulation of the specialized needles helps to release endorphins; these serve to block pain and introduce an overall feeling of well-being.  Another result is the release of helpful substances known as neurohormones and neurotransmitters.  These are important in the natural healing process.

The treatment can serve to stabilize the nervous system and improve the balance of hormones that are so important to reproduction.  So, although acupuncture is unconventional when compared  to western medicine, it is based on solid science.  And hundreds of millions of satisfied patients must know something.

You could think of acupuncture a bit like physical therapy, where the process allows the body to experience natural healing over time.  As a rule, it is advisable to start modestly and proceed carefully to higher levels of therapy.  When preparing for IVF the specialist may prescribe that the woman receive three to four months of treatment before proceeding with the medical procedure.

Acupuncture is clearly valuable as a means to reduce stress from any number of sources; concerns over fertility and the discomfort related to the medical visits and procedures represent a dramatic source of stress.  So this ancient art can not only help the body deal better with the stress, but it also helps give the body its best chance of achieving success.  Given the multiple benefits realized through acupuncture, a couple dealing with infertility would be wise to at least consider it as a low-risk option.

Speaking of risks, the pairing of acupuncture and infertility treatments is quite safe.  Certainly the process itself is typically (virtually) painless and bloodless, with the occasional minor exception.  One concern would be if the treatment involved stimulating the wrong acupuncture points, thus causing a miscarriage in a pregnant woman.  This is the reason that it is essential to use a specialist with great experience in treating fertility problems; check this out in advance.

By the way, and assuming you are successful in getting pregnant, it may be worthwhile to consider a technique known as electro-acupuncture as an alternative to conventional painkillers in labor.  It might shorten the hospitalization period slightly, which reduces costs and sends Mom home earlier.

Research suggests that acupuncture and infertility treatments of a more conventional nature can work together to improve substantially the body’s ability to become pregnant.  We do not find support for this ancient art as a substitute for mainstream medicine and, as always, consult a doctor before moving forward with any treatment for infertility.

Elsewhere we’ve discussed the numerous methods to treat infertility.  Some are quite inexpensive and others are very costly.  The testing alone can cost thousands of dollars.  If you embark on a program with a specialist, it may involve ongoing testing and visits, which can add up tremendously.  Some assisted reproductive procedures can cost over $4,000, with the potential for in-vitro fertilization to be much higher still.  You could be looking at $10,000 or more by the time you are finished.

These costs are beyond the budget of many couples and they need help.  One potential solution is to purchase one of the forms of infertility insurance presently available.  What are the options for this type of specialty insurance?

Add to Regular Health Insurance Policy

Some health insurance companies offer supplemental coverage for possible infertility, and some employers cover this for employees.  For a relatively small premium the couple acquires protection in the event they find out about a fertility problem.  The coverage will handle some or all of the costs of a wide variety of diagnostic and treatment alternatives.  These may include fertility tests, artificial insemination and treatment of other health issues that are affecting the ability to conceive.  The insurance company may want you to start the process with the least expensive steps, and there are limits to how long they will cover the costs for ongoing treatment.

The best pricing comes when the insurance is purchased before there is any hint of infertility; in fact it may be unavailable for couples with pre-existing conditions.  The reason it is so inexpensive is that the probability that any one customer will have the problem is small.  Once the doctor has diagnosed infertility, this option becomes less viable (or much more expensive), but still worth investigating.

Refund Program

This is an interesting approach to the problem.  The couple must pay up front for the cost of the treatment, but if they are still unable to conceive successfully after a predetermined period of time the insurance company refunds between 70% and 100% of the amounts paid.

Financing

This is not really insurance, but a specialty loan program to help spread out the costs.  Some such loans do not require full payback if the couple are unsuccessful.  In this way it is similar to a refund program.

Conclusions

In these days of upheaval in the health insurance industry it would be wise to seek the help of a specialist.  Not everybody can obtain this specialty coverage; it will depend on your specific existing insurance company.  There may be age limits (maximum age of say 40 years) and the requirement that the buyers are existing customers.  The insurance company could require that the couple be trying to get pregnant for over a year before considering it an insurable situation.  Other restrictions and terms will undoubtedly apply, so be careful before purchasing any policy.

Infertility insurance is not an instant answer to the high costs of treatment, but it is worthy of some investigation.  There are plenty of costs associated with the joys of new parenthood and it would be a shame to burn through the family savings in the effort to start a family.

There are about 7.3 million women in this country alone between the ages of 15 and 44 who have an impaired ability to have children.  Many of these women don’t even know that they have a problem until they try to start a family.  Some women have gotten pregnant with issues like polycystic ovarian syndrome and the diagnosis didn’t come until after they had kids.  But, most often this is not the case.  There are many other couples who have gone through fertility treatments.

Often when seeing the happy couples with their babies, infertile couples do not contemplate whether that parent had to receive some sort of infertility treatment in order to conceive.  In 2002 11.9% or 7.3 million women between the ages of 15 and 44 years of age have received some sort of infertility services.  6.1% have received professional advice.  5.5% of women have received some sort of medical help to prevent a miscarriage.  4.8% have undergone a fertility test.  3.8% of women have received ovulation drugs.  And 1.1% of women have received artificial insemination.  11.8% of women between the ages of 15 and 44 years of age have impaired fecundity which means they not only have problems getting pregnant, they have problems carrying a baby to term.

It is commonly known that as women age their ability to become pregnant decreases with the loss of their eggs.  In fact, the percent of childless women who have ever received any infertility service between the ages of 35 and 39 years of age is 15.2%.  Childless women who have received any infertility service between the ages of 30 and 34 years of ages was 17.3% and women between the ages of 15 and 29 was only 2.9%.

The percent of married childless women between the ages of 15 and 44 years of age are infertile by the following ages.  27.4% of women are infertile by the ages of 40 and 44.  22.6% of women are infertile by 35 and 39 years of age.  16.9% of women are infertile by the ages of 30 and 34. And 11% of married women are infertile by the ages of 15 and 29.

But just because there are problems getting or maintaining a pregnancy, that does not mean that it is impossible.  At age 31, the percentage of live births after undergoing in vitro fertilization (IVF) which is a very affective fertility treatment was about 38%.  By age 39, the percentage of live births was around 22%.   But after age 43, the percentage of live births drops to less than 10%.  Women have also used an egg donor.  Even though IVF success was less than 10% at age 40 using the mother’s own eggs, women who used an egg donor from a much younger women had a success rate of about 45%.  It is an even better rate than women using their own eggs in their early 30s.