Infertility

Infertility is defined as occurring in a woman who is under 35 who has failed to conceive after having sex around the time of ovulation every month for 12 months, according to fertility expert Dr. Daniel E. Stein, medical director of the IVF program at the Continuum Reproductive Center at St. Luke's Regional Hospital in New York City. For a woman who is over 35, Stein recommends a fertility specialist evaluate her after she tries for six months.

4 Causes of Infertility, from Dr. Daniel Stein

Bad Timing:
It may simply be a problem of bad timing. If you're not having sex frequently enough at the right time of the month, you may have trouble getting pregnant. All you may need is a doctor to help you pinpoint the best time to try.
Irregular Ovulation:
You may ovulate irregularly because of age or hormonal imbalances.
Low Sperm Count:
Your partner may have low sperm count.
An Anatomical Problem:
You may have a more serious fertility problem like damaged or blocked fallopian tubes. In this case, you may not be able to get pregnant without in vitro fertilization.

Although many believe infertility is mostly a woman's problem, male infertility is just as likely, according to Kim Hahn, founder and editor-in-chief of Conceive magazine. Hahn says it's about a 50-50 split. When a couple begins trying to conceive, both should have full reproductive screenings to look for any irregularities.

What Moms Can Do about Infertility

Increases in the use of fertility drugs have caused a surge of multiple births in the last two decades, specialists say. Many aging and childless couples are demanding aggressive fertility therapies more likely to produce multiple births. About three million infants have been born worldwide using IVF or other reproductive technologies.

Dr. Daniel E. Stein, medical director of the IVF program at the Continuum Reproductive Center at St. Luke's Regional Hospital in New York City says about IVF, "Costs vary from center to center across the country. Success rates vary because every woman's situation is different. And some insurance policies cover the procedure while others do not. Some centers take insurance and others don't."

Here is the breakdown on IVF (in vitro fertilization):

Cost: Expect to pay anywhere between $7,000 and $13,000 for one IVF cycle. Why such a range? The cost varies depending upon where you are and which center you choose. A boutique center in the well-heeled Upper East Side of Manhattan may cost much more than a center in Tucson, Arizona, but the quality of service might be comparable. Remember, a more expensive center does not necessarily provide a better service.
Success rate: Success rates are notoriously inaccurate and are often manipulated. A patient should not use success rates as a measure of a center's quality. Even the American Society of Reproductive Medicine and the Society for Assisted Reproductive Technology strongly caution patients to not use success rates as a means of comparing centers. The success of IVF depends mostly on the age of the woman and the reason for the infertility.
The skinny on insurance: Several insurance companies cover IVF, but not all centers accept insurance. Whether a center accepts or doesn't accept insurance doesn't say anything about the quality of the center.

Another common and more economical technique is self-insemination -- often referred to as the "turkey baster" method. "The 'turkey baster' method is a colloquial term used to describe self-insemination. It refers to a woman who uses donor sperm or her partner's sperm and injects it into her vagina with a needle-less syringe. It is not terribly effective and it is not a recommended form of insemination," says Dr. Stein.

There is a therapy called intrauterine insemination in which semen is prepared in a special manner to allow it to be injected through the cervix into the uterine cavity. That's what doctors would do in cases where the only problem is an absence of sperm.

For women who have miscarried and are concerned about the likelihood of losing again, Dr. Stein says, "It depends on the cause of the miscarriages and it depends on the age of the woman. Having a single miscarriage is very common and does not indicate that there's a significant problem in any way. Once a woman has had two miscarriages, it is time that an evaluation be performed by a specialist. Being evaluated doesn't mean you have a problem; it just means you're being evaluated."