Thinking about fertility treatment
Have you been trying to get pregnant for a long time? Are you beginning to wonder if you can get pregnant? You're not alone. Many women need special medical treatment to help them get pregnant. This kind of treatment is called fertility treatment.
If you’ve been trying to get pregnant for 3 or 4 months, keep trying. It may just take more time, even longer than you think it should. You may want to think about fertility treatment if:
- You’re younger than 35 and have been trying to get pregnant for at least a year.
- You’re 35 or older and have been trying to get pregnant for at least 6 months.
Talk to your health care provider if you think you may need fertility treatment.
Here are the top things you need to know about fertility treatment:
- There are many kinds of fertility treatment that can help women get pregnant. Talk to your provider to find out if one is right for you.
- Fertility treatment can cause complications, like getting pregnant with twins or more, having premature birth and having a baby with birth defects.
- If you need fertility treatment, there are ways to help you get pregnant with just one baby. This can help reduce the risk of pregnancy complications.
- Things like smoking and weight can affect your fertility. Making certain changes in your life may help you get pregnant without fertility treatment.
How can you find out if you need fertility treatment?
If you think you and your partner may need treatment to help you get pregnant, here’s what you can do:
- Talk to your health care provider. You can see a prenatal care provider, like an obstetrician or a midwife, who takes care of pregnant women. Or you can see a fertility specialist (also called a reproductive endocrinologist). This is a doctor who’s an expert in helping women get pregnant.
- Tell your provider about your family health history. This is a record of any health conditions and treatments that you, your partner and everyone in your families have had. Be sure to tell your provider if you’ve been pregnant before and about any children you’ve had.
- Make changes in your life that may help you get pregnant without treatment. For example, things like smoking, being over- or underweight and taking certain medicines can affect your fertility and make it harder for you to get pregnant. Even using a hot tub can affect fertility! You may be able to make changes in your life without fertility treatment that can improve your chances of getting pregnant.
- Keep track of your periods to find out when you ovulate. Ovulation is when your ovary releases an egg into your fallopian tubes. The egg then travels down the tubes to your uterus. If you have sex and the egg gets fertilized by sperm, you’re pregnant. To find out when you ovulate, write down when your period starts each month and how long it lasts. Or use our online ovulation calendar. Knowing when you ovulate helps you know the best times of the month to have sex with your partner to try and get pregnant.
Your provider may give you and your partner medical tests to find out if you may need treatment. For example, your provider may:
- Want your partner to get his sperm tested to make sure it’s healthy. This is called a semen analysis. Your provider can tell him where to get this test.
- Give you some tests to make sure there are no problems with your fallopian tubes or uterus. If your tubes are blocked or if there are problems with your uterus, you may have trouble getting pregnant. You may be able to get treatment to fix these problems.
After these tests, you, your partner and your provider can decide about fertility treatment.
What problems can fertility treatment cause?
Fertility treatment does help many women get pregnant. But it can cause certain problems, too. The most serious problem is that treatment can cause you to get pregnant with multiples. Some fertility treatments may cause you to release many eggs at the same time. Each of these eggs can become fertilized by sperm, which can make you pregnant with more than one baby.
Being pregnant with multiples can cause serious problems for you and your baby. The March of Dimes believes that if you’re getting fertility treatment, it’s important to try to get pregnant with just one baby. Talk to your provider about ways to help lower your chances of getting pregnant with multiples.
Even if you get pregnant with just one baby, some fertility treatments make your baby more likely to have problems than a baby born without fertility treatment. These include premature birth, low birthweight and birth defects. Talk to your provider about the risks of fertility treatment so you and your partner have all the information you need to decide if treatment is right for you.
What kinds of fertility treatment are there?
There are several kinds of fertility treatment. You, your partner and your provider can decide which treatment gives you the best chance of getting pregnant and having a healthy pregnancy. Common treatments include:
- Surgery to repair parts of your or your partner’s reproductive system. For example, you may need surgery on your Fallopian tubes to help your eggs travel from your ovaries to your uterus.
- Controlled ovarian stimulation (also called COS)
- In vitro fertilization (also called IVF)
You can find out about other kinds of fertility treatments at resolve.org.
What is controlled ovarian stimulation?
Controlled ovarian stimulation (also called COS) is a kind of fertility treatment. It uses certain medicines to help your body ovulate and make healthier eggs. It’s really important that you take these medicines the right way and for the right amount of time so that you don’t make too many eggs. The medicines include:
- Clomiphine citrate (also called clomiphene, Clomid® or Serophene®). This medicine comes as a pill. It’s the most common medicine used to help women ovulate. You may have side effects from the medicine, like feeling sick to your stomach, feeling moody and having hot flashes and sore breasts.
- Gonadotropins. You get this medicine in shots. Side effects include feeling bloated or having pain in your lower belly.
If you’re getting COS, have sex a few days before and the day that you ovulate. The more often you have sex during this time, the more likely you are to get pregnant. Your provider may recommend that along with COS you also have a treatment called intrauterine insemination (also called IUI). In IUI, your provider places sperm inside your uterus when you ovulate.
What is in vitro fertilization?
In vitro fertilization (also called IVF) is a kind of fertility treatment called assisted reproductive technology (also called ART). ART is any kind of fertility treatment where both the egg and sperm are handled in a lab.
IVF is the most common kind of ART. In IVF, an egg and sperm are combined in a lab to create an embryo (fertilized egg) which is then put into your uterus. You may need IVF if:
- Your fallopian tubes are damaged and can’t be fixed by surgery.
- You have endometriosis. This is when tissue from the uterus grows somewhere outside the uterus.
- You have premature ovarian failure. This is when you stop ovulating and getting your period before you’re 35 years old.
- Your partner has fertility problems.
The March of Dimes recommends that most women on IVF have just one embryo placed in the uterus. This is called single embryo transfer (also called SET). For women who’ve had certain health conditions, like chemotherapy to treat cancer, the March of Dimes supports having two embryos placed in the uterus. This is called double embryo transfer (also called DET). If your specialist recommends IVF, ask about the number of embryos to transfer to get the best results from your treatment.
For more information
Multiple Pregnancy and Birth: Considering Fertility Treatments(PDF, 235KB)
American Fertility Association
American Society for Reproductive Medicine's ReproductiveFacts.org
Centers for Disease Control and Prevention (CDC)
CDC Show Your Love Campaign
RESOLVE: The National Infertility Association
Society for Assisted Reproductive Technology
Last reviewed May 2015
Frequently Asked Questions
How do you know you're pregnant?
Knowing the signs of pregnancy can help you tell if you’re pregnant. Here are some signs that you might be pregnant:
If you have any of these pregnancy signs and think you may be pregnant, go to your health care provider. The sooner you know you're pregnant, the sooner you can begin prenatal checkups and start taking good care of yourself and your growing baby.
How soon can I take a pregnancy test?
Home pregnancy tests are usually more accurate when your period is late - about 2 weeks after conception (getting pregnant). If they're done too early, they may say that you're not pregnant when you really are. This is called a false negative. That's why it’s best to take a home pregnancy test when your period is late. Carefully follow the test's instructions. Tests done at a lab or at your health care provider's office are more accurate.
I’m late for my period but my pregnancy test is negative. Why?
If you've taken a home pregnancy test and it's negative (shows that you're not pregnant), you may want to take a blood pregnancy test at your health care provider's office. A blood pregnancy test is more sensitive than a home pregnancy test that checks your urine. The blood pregnancy test can tell a pregnancy very early on.
Pregnancy tests work by looking for the hormone called human chorionic gonadotropin (hCG), a hormone that a woman's body makes during pregnancy. If both a blood and urine test come back negative and you still have a missed period, talk with your health care provider. Things like stress, eating habits, illness or infection can cause changes in your menstrual cycle.
I’ve been trying to get pregnant for 3 months. What’s wrong?
Pregnancy may not occur right away, so there is no need to worry. For most couples, it may take up to 1 year to conceive. If you’ve been trying to get pregnant for more than a year, or 6 months if you're over 35, it may be time to talk with your health care provider. You and your partner can get tests to find out why you are not getting pregnant
Is it possible to ovulate without having a period?
Ovulation is when a woman's ovary releases an egg. This egg travels down into the fallopian tube. If you had sex without using birth control, sperm will swim up to meet your egg so that your egg can be fertilized. If no fertilization occurs, and after about two weeks, your body sheds the unfertilized egg, the uterine lining and blood and tissue that would have nurtured a fertilized egg. This is known as menstruation (your period).
You ovulate before you menstruate. But if you don't get your period, it doesn't necessarily mean that you haven't ovulated. For example, some women have irregular cycles. Even if you're very regular, once in a while your cycle may change. Therefore, it's hard to pinpoint exactly when you ovulate. If you don't get your period, you may want to take a pregnancy test.
What is the best time to get pregnant?
The best time to get pregnant is a few days before ovulation or the day of ovulation. This is because a man's sperm can live up to 72 hours after intercourse and a woman's egg is fertile for 12 to 24 hours after its release. If your periods are regular, use an ovulation calculator. If your periods are irregular, use one of the following. Talk to your health care provider to learn more about the most effective way to use these.
- Purchase a basal body thermometer. Use it to take your temperature before you get out of bed every day. Your temperature goes up by 1 degree when you ovulate.
- Check the mucus in your vagina. It may become thinner, more slippery, clearer and more plentiful just before ovulation.
- Purchase an ovulation prediction kit. Use it to test your urine for a substance called luteinizing hormone (LH). LH increases each month during ovulation.
Have intercourse as close as possible to ovulation to improve your chance of getting pregnant.