Infertility Q&A

Q: I've been taking the Pill for 10 years. Will that affect my ability to become pregnant when I'm ready?

A: Many women who wait to begin a family may wonder if prior birth control choices negatively affect their fertility. It's not uncommon, for instance, for a woman to take oral contraceptives for 10 years or longer. The birth control pill itself doesn't affect long-term fertility.

However, when you come off the pill, you may have some lingering effects from your last use of it. For example, if you don't complete all the pills in your last pack, the agents in the pill will clear the body in a matter of days, but your menstrual cycle may be affected. In such a case, although you may ovulate, your uterine lining may not be adequately prepared to accept a fertilized egg because progestin was present too early in the cycle, or for too long in that cycle. As a result, you might not get pregnant, or you may miscarry because the uterine lining isn't fully developed. To avoid the risk of miscarriage, health care professionals generally recommend that women who want to get pregnant complete all the pills in a pack before they stop taking the medication, and wait until the third month after stopping for their cycles to become normal.



The only current contraception that deserves mention in terms of its effects on fertility is Depo-Provera, an injectable form of hormonal contraception. One injection provides protection against pregnancy for up to four months. But, its effects on fertility can last up to a year. This is not a rapidly reversible contraceptive and shouldn't be used by women who have a particular time in mind for becoming pregnant.

Q: I've had chlamydia and was wondering if this sexually transmitted disease affects my fertility?

A: Sexually transmitted diseases (STDs) can critically compromise fertility and, if you get pregnant, can affect the health of a baby. Women who have had a history of STDs or known exposure to infection should discuss this issue with a health care professional to determine how their fertility may be affected. Screening for STDs is also a good idea at any time, but particularly if you're considering pregnancy. Remember, a Pap test is not a test for STDs. Ask your health care professional specifically for an STD screen. Chlamydia is one of the fastest spreading STDs in the country. Ten to 15 percent of infertile couples will have had exposure to chlamydia. This STD frequently has no symptoms, especially in women. It is responsible for as much as 80 percent of tubal infertility in women.

Q: My husband and I are ready to have a family. What can we do to ensure a healthy pregnancy?

A: When planning a pregnancy, couples should begin by pursuing a healthful lifestyle. Eliminating cigarettes, alcohol and other recreational drugs, and increasing your focus on good nutrition, stress reduction and moderate exercise, are the first steps to achieving a healthy pregnancy. Talk with your health care professional about your plans.

Q: Are hot tubs really bad for men?

A: Yes! High temperatures can kill sperm. That is why the scrotum is located outside the body — to keep sperm cooler. So, it's a good idea for a man to avoid hot tubs, saunas and steam rooms when a couple is trying to become pregnant.

Q: What's the most common cause of female infertility?

A: Usually, female infertility involves an ovulation disorder. Other causes include blocked fallopian tubes, which can occur when a woman has had pelvic inflammatory disease or endometriosis (a condition causing adhesions and cysts). Congenital anomalies (birth defects involving the structure of the uterus) and uterine fibroids are associated with repeated miscarriages.

Q: What is IVF and how much does it cost?

A: In vitro fertilization (IVF) is used when a woman has blocked or absent fallopian tubes, or when a man has a low sperm count. In IVF, eggs are removed from the ovary and mixed with sperm outside the body in a Petri dish. After about 40 hours, the eggs are examined to see if they've been fertilized and are dividing into cells. Some of these fertilized eggs (embryos) are then placed in the woman's uterus. The cost of an IVF treatment ranges from about $5,000 to about $15,000.

Q: When is a donor egg used?

A: Donor eggs are an option for women who cannot produce eggs or for whom egg quality is an issue. Another woman donates her eggs to be used for an IVF procedure. A woman using a donor egg becomes the biological mother to the offspring, but she doesn't share the child's genetic make-up. However, if the male partner's sperm was used in the fertilization process, the child shares his genetic background. Approximately 30 to 60 percent of patients will have a successful pregnancy from using donor eggs. This procedure is recommended most often for women over 40.

Q: I have lupus and was wondering if that means I won't ever be able to conceive?

A: Chronic, debilitating diseases, such as unregulated diabetes, lupus or thyroid problems, can interfere with normal ovarian function. Also, some medications such as high-dose steroids, can interrupt ovulations. On the other hand, if you don't get pregnant, your chronic condition may not be the cause because many other things can affect fertility. Discuss your condition with your health care professional so that he/she can work with you to determine the real cause of your infertility — and don't assume anything!

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Copyright 2003 National Women's Health Resource Center Inc. (NWHRC).