Common Questions

In general, infertility is defined as not being able to get pregnant (conceive) after one year (or longer) of unprotected sex. Because fertility in women is known to decline steadily with age, some providers evaluate and treat women aged 35 years or older after 6 months of unprotected sex. Pregnancy is the result of a process that has many steps. Infertility may result from a problem with any or several of these steps.

Most experts suggest at least one year for women younger than age 35. However, for women aged 35 years or older, couples should see a health care provider after 6 months of trying unsuccessfully. A woman's chances of having a baby decrease rapidly every year after the age of 30.

It is a good idea for any woman and her partner to talk to a doctor in the field of reproductive immunology before trying to get pregnant. They can help you get your body ready for a healthy baby, and can also answer questions on fertility and give tips on conceiving.

However, if you have a reason to suspect you may have a problem getting pregnant such as a history of pelvic inflammatory disease, painful periods, miscarriage, irregular menstrual cycles, or if your partner has a low sperm count, you should seek help sooner. Many couples have a hard time admitting that there may be an infertility problem, but be reassured there are many things we can do to help you build your family.

Another problem related to reproduction is recurrent pregnancy loss or miscarriage. Many women can readily conceive, only to suffer repeated pregnancy losses. Pregnancy loss rates are remarkably high at all ages, with 10% to 25% of all clinically recognized pregnancies undergoing spontaneous abortion even in women during their peak fertility years (between 20 and 30 years old). The rate of miscarriage is age related, rising to over 50% in women older than age 40. These women represent a special subset of those who are unable to successfully reproduce and should be evaluated by a medical professional.

Women with recurrent miscarriages should consider making an appointment with a reproductive immunologist—a doctor who specializes in managing infertility. Reproductive immunologists may also be able to help women with recurrent pregnancy loss, defined as having two or more spontaneous miscarriages or prevent one in women.

According to latest scientific research miscarriages may occur due to several factors but one of the most common is of Immune etiology (20-40%). Other reasons for miscarriages are chromosomal aberrations, uterine abnormalities, endocrine disorders, autoimmune disorders, coagulation fact disorders and infectious.

Initial blood tests should include: a) a check of reproductive hormone levels in the woman; estradiol (E2), progesterone, follicle stimulating hormone (FSH), anti-mullerian hormone (AMH), luteinizing hormone (LH), thyroid hormone (TSH), prolactin, and possibly male hormone levels. b) A complete semen analysis on the male partner. C) A complete immunological analysis including the absolute number and cytotoxicity of NK cells.

Infertility is not just a woman's problem. After a diagnostic work up, about 40% of cases will involve a female factor, while 40% of the time we will diagnose a male factor. In about 15% of cases there will be a combination of both male and female factors. In 5% of infertility cases the cause is unexplained.