The challenge of infertility

At least one out of seven couples in the United States has trouble conceiving, according to the American Society for Reproductive Medicine (ASRM). If you are among them, seeing a fertility specialist may be your best hope for having a baby.

“Often it is said couples in their early 30s or younger should try to conceive for one year before consulting a doctor,” says James Goldfarb, MD, Medical Director of University Hospitals Fertility Center. “However, if a couple suspects a problem or is stressed by not conceiving, they can be seen at any time. In addition, all couples ages 35 or older should see a specialist no later than six months after starting to try to conceive.”

For women, irregular periods, endometriosis and pelvic inflammatory disease are among the health issues that can cause infertility, while age, hormonal issues and lifestyle choices can play a role for either sex. In fact, the March of Dimes recommends that both women and men refrain from smoking and heavy alcohol consumption when trying to conceive. For women, achieving a healthy weight and reducing stress may also aid in conception.

“Many different factors and problems can cause infertility, including problems in the female reproductive system, the male reproductive system or a combination of the two,” says Dr. Goldfarb.

Testing and treatment

To identify the cause, the doctor may check the man’s sperm and the woman’s ovulation, uterus and fallopian tubes, which carry eggs to the uterus.

Once a diagnosis is made, the fertility specialist will work with the couple to determine a course of treatment based on:

  • Age, overall health and medical history
  • Extent and cause of the infertility
  • How aggressive a couple wants to be

“Depending on the cause of infertility, there are a variety of treatment options available,” says Dr. Goldfarb. “We begin with the least invasive, least expensive treatment options, and progress to more advanced options only if necessary,” says Dr. Goldfarb.

According to the ASRM, up to 85 to 90 percent of infertility cases can be successfully treated with relatively simple therapies, such as inexpensive medication.

Artificial insemination and assisted reproductive technology (ART) are among a number of other treatment options. In vitro fertilization (IVF) is the most common form of ART and involves extracting a woman’s eggs, fertilizing the eggs in the laboratory with sperm, and then transferring the resulting embryo through the cervix and into the woman’s uterus where it can develop. IVF can be used in almost all cases where simpler therapy does not work.

“By seeking the expertise of a fertility specialist, most couples are able to achieve their dream of having a baby,” says Dr. Goldfarb.

The best answers come from experts

When starting a family, you have questions. We have answers. You can ask a UH fertility physician your question anytime, day or night. We will respond within 48 hours. Submit your question at

Affordable options

The cost of infertility diagnosis, treatment and associated medications can be extremely high, especially for couples with insurance plans that do not offer coverage for tests or treatments.

UH Fertility Center patients have access to a variety of financing options, including affordable and predictable fertility treatment packages, payment plans, refund guarantee programs and pharmacy financing packages.


Medical Director,
UH Fertility Center
Clinical Professor, Case Western Reserve University School of Medicine

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