Walgreens Specialty Pharmacy > Conditions and therapies > Infertility
Infertility
PrintInfertility is the inability to conceive after one year of unprotected heterosexual intercourse or the inability to carry a pregnancy to term. Infertility may be caused by male factors, female factors, or a combination of both. A diagnosis of infertility means that becoming pregnant may be a challenge, but is not impossible. If you have been trying to conceive for a year or more, you may need to have an infertility evaluation. If you are a woman age 30 or older, who has had unprotected intercourse for six months without getting pregnant, you should have an infertility evaluation. You should also consider seeing your doctor earlier if you have irregular menstrual cycles, pain during intercourse, or if you or your partner has a known fertility problem.
Select any question to learn more about infertility below:
How common is infertility?
What causes infertility?
What are the risk factors associated with infertility?
How is infertility diagnosed?
How is infertility treated?
What are the complications of treatment?
What is the cost of infertility treatment?
How can a couple increase the chances of conceiving?
How can a couple cope with infertility?
How can Walgreens Specialty Pharmacy help?
Where can I find more information about infertility?
How common is infertility?
In the United States, approximately one in 10 couples, or 6.1 million men and women of reproductive age, are affected by infertility. Approximately 40 percent of infertility is due to a "male" factor, such as hormonal imbalance or difficulty making sperm. Approximately 40 percent of infertility is due to a "female" factor, such as difficulty ovulating or hormonal imbalance. The remaining 20 percent may be caused by contributing factors from both partners or for reasons that cannot be identified.
What causes infertility?
Successful full-term pregnancy depends on several factors including proper fertilization of the egg, implantation of the egg in the uterus, and maintenance of the pregnancy. Many factors may be responsible for a couple's infertility; however, when the cause cannot be determined, it is referred to as "unexplained" infertility.
The most common reasons for female infertility include ovulation dysfunction, hormonal imbalance, or reproductive system abnormalities. The most common reasons for male infertility include difficulty making healthy sperm, hormonal imbalance, and conditions related to a man’s general health and lifestyle, such as emotional stress, malnutrition, substance abuse, and overexposure to certain environmental elements. In rare cases, infertility may be caused by a genetic disease such as cystic fibrosis. Other causes that can lead to infertility in men and women are the use of certain medications, thyroid problems, cancer and its treatment, HIV/AIDS, kidney disease, and diabetes.
What are the risk factors associated with infertility?
- Age. Age is the strongest predictor of female fertility. A woman's peak fertility occurs when she is in her early 20s. The ability to conceive declines after about age 32 for a woman and about 35 for a man. Older women are more likely to have health problems that may interfere with fertility, such as an increased risk of miscarriage, and chromosomal abnormalities that occur in the eggs.
- Tobacco use. Smoking can increase the risk of infertility in women and may reduce sperm production in men.
- Alcohol consumption. Alcohol use may increase the risk of infertility in both men and women.
- Emotional factors. Depression and stress may have an effect on the hormones that regulate reproduction in both men and women.
- Occupational and environmental exposure. Prolonged exposure to high temperatures (such as hot tubs for men), chemicals, radiation, or heavy electromagnetic or microwave emissions may reduce fertility in both men and women.
- Weight. Body fat levels that are 10 percent to 15 percent above normal can increase the levels of estrogen in the body, affecting the reproductive cycle. Being overweight may be associated with infertility in both men and women. Body fat levels that are 10 percent to 15 percent below normal can stop the reproductive process. Women at risk include those with eating disorders, on very low-calorie or restrictive diets (strict vegetarians may be at risk due to lack of important nutrients), and women who exercise intensely.
- Sexually Transmitted Diseases (STDs). STDs such as gonorrhea, syphilis, or chlamydia can affect the reproductive organs of both men and women.
- Chronic disease. Chronic diseases such as diabetes, thyroid problems, and kidney disease may be associated with infertility.
How is infertility diagnosed?
The first step for both partners is a general physical examination, which may be followed by a blood test to determine levels of hormones present. Your doctor may ask questions regarding your health history, medications, menstrual cycle, and sexual habits. Couples may also undergo postcoital testing to evaluate the interaction of sperm with cervical mucus.
Men may be asked for a specimen of ejaculated semen, which will be analyzed for sperm quantity and the presence of infection or blood. The lab will note any abnormalities in the shape and movement of the sperm.
Women will have a gynecologic exam that may be followed by several other procedures or monitoring:
- Pelvic exam — An examination of a woman's reproductive system, externally and internally, performed to determine if there are cysts, fibroids, or other abnormalities.
- Hysterosalpingography — An X-ray that evaluates the condition of the uterus and fallopian tubes.
- Laparoscopy — A procedure that examines the pelvic cavity and can identify endometriosis, scarring, and blockage or irregularities of the fallopian tubes and uterus.
- Women may be asked to measure their basal body temperature, by taking their temperature every morning to note the 0.4 to 1.0-degree Fahrenheit temperature increase associated with ovulation.
- Women also may be asked to monitor changes in their cervical mucus throughout the menstrual cycle to determine when ovulation is occurring.
How is infertility treated?
Treatment of infertility may depend on several factors including the age of the female, duration of infertility, contributing factors to infertility, risks of treatment, and the cost of therapy. Infertility treatment consists of two main categories: restoring or bringing about fertility and assisted reproductive technology (ART).
To restore or bring about fertility, couples may be instructed to have intercourse more often or on a scheduled basis. They may require treatment for sexual problems such as impotence, premature ejaculation, or problems associated with the reproductive organs. Women may be required to measure basal body temperature and use ovulation kits to help determine when ovulation is occurring.
Fertility drugs can be taken by women to help regulate or induce ovulation. Commonly used fertility drugs include: Clomid®, Follistim AQ®, Gonal-f™, Bravelle®, Luveris®, Menopur®, Repronex®, Novarel™, Ovidrel®, Lupron®, Cetrotide®, ganirelix acetate, Crinone™, and progesterone in oil. These drugs may be administered orally, vaginally, or through injection.
ART refers to all infertility treatment techniques that involve the handling of both sperm and eggs. In ART procedures, one or more embryos are transferred to the uterus to increase the chances of pregnancy. This procedure accounts for more than 70,000 babies born in the United States every year.
In vitro fertilization (IVF) is a type of ART. In this treatment, a woman receives drugs (such as those listed above) to stimulate the development of several eggs. After they are developed, the eggs are surgically removed from the ovaries and fertilized with sperm outside the body in a lab. After fertilization has occurred, the fertilized eggs (embryos) are transferred into the uterus. The woman may receive more drug treatments to help maintain her pregnancy.
Some infertility medications need to be prepared and self-injected at home. It is very important that you are confident in your ability to inject yourself with medication or that you are able to have someone give you the injections as directed by your doctor. If you are not comfortable giving or receiving your injectable medication, please call your doctor or pharmacist for help in this area. Also contact your doctor or pharmacist if you have any questions on how to correctly prepare your medication.
What are the complications of treatment?
- ART: Multiple pregnancies are the most common complication of ART. The number of embryos kept and matured to birth is a decision made by the couple. There is also a risk of bleeding or infection with ART.
- Drug treatment: Multiple pregnancies may occur with drug treatment. Many medications are associated with ovarian hyperstimulation syndrome (OHSS), which occurs when a woman’s ovaries are over stimulated. The ovaries may become enlarged and cause discomfort, and can lead to serious medical complications. Symptoms of OHSS include excessive fluid retention and severe abdominal discomfort.
What is the cost of infertility treatment?
The cost of infertility medications can range from $30 to $4,000 per treatment cycle. The average cost of an IVF cycle in the United States is approximately $12,400. With IVF, the procedure may need to be repeated if pregnancy is not achieved, which would increase cost of therapy. Your insurance company may cover the cost of treatment; however, the degree of services covered depends on where you live and the type of insurance plan you have.
How can a couple increase the chances of conceiving?
A couple can increase the chances of conceiving in a number of ways. Both men and women should exercise moderately, avoid body weight extremes, and avoid high levels of stress. Men and women should also avoid tobacco, alcohol, and illicit drug use. Patients with chronic disease should be seen by their doctor to be treated appropriately. Since infertility is often caused by sexually transmitted diseases such as chlamydia and gonorrhea, practicing safe sex behaviors may minimize the risk of infertility.
How can a couple cope with infertility?
It can be very difficult for many couples to cope with infertility. Since the emotional burden of infertility can be overwhelming, making plans for how to cope can help. Set limits and decide together how many and what kinds of procedures are emotionally and financially feasible. Join a support group or seek counseling services for help before and after treatment to ease the emotional stress. You can manage emotional stress by practicing relaxation techniques, talking about your feelings with others, and seeking support from family and friends.
How can Walgreens Specialty Pharmacy help?
It is important to find a pharmacy that understands the complexities of medications used in infertility treatment. Specially trained Walgreens pharmacists join your treatment team, working together with your doctor and other healthcare providers, to support their services and help ensure that you receive the best results from your infertility therapy.
Where can I find more information about infertility?
The American Fertility Association
305 Madison Avenue Suite 449
New York, NY 10165
888-917-3777
www.theafa.org
National Women's Health Information Center
8270 Willow Oaks Corporate Drive
Fairfax, VA 22031
800-994-9662 or TTY 888-220-5446
www.4woman.gov
American Society for Reproductive Medicine (ASRM)
1209 Montgomery Highway
Birmingham, Alabama 35216-2809
205-978-5000
www.asrm.org
Resolve: The National Infertility Association
7910 Woodmont Ave., Suite 1350
Bethesda, MA 20814
888-623-0744
www.resolve.org
For more information, call 800-876-4545, or email us at schrafts@walgreens.com
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Information provided here does not constitute professional medical advice. Although it is intended to be accurate, neither Walgreen Co., its subsidiaries or affiliates, nor any other party assumes liability for loss or damage due to reliance on this material. If you have a medical question, consult your medical professional.