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    Mother Nature vs. Infertility Treatment

    Still not pregnant? When to seek infertility treatment and when to let nature take its course.
    WebMD Feature
    Reviewed by Louise Chang, MD

    The good, if not great, news is that the latest advances in infertility treatment have made it possible for more people than ever before to become parents. The bad news is that growing numbers of couples may be jumping the gun and seeking infertility treatments without giving Mother Nature a chance. Infertility treatments, such as drugs that stimulate ovulation, are not without their risks -- namely a risk of multiple pregnancies, which can be dangerous for moms and babies.

    "The classic definition of infertility is the failure to cause a pregnancy within one year," says Edmund Sabanegh Jr., MD, director of the Center for Male Fertility at the Cleveland Clinic in Ohio. This is age-dependent, however. Six months of trying is the cutoff for prospective parents aged 35 or older.

    That said, "there is certainly so much anxiety and stress [about having children] that we routinely have couples coming in after only a few months of trying," he tells WebMD. "If we move right to testing and treatment, we do a disservice because a lot of them would do just fine if we left them alone."

    Still Not Pregnant? Take a Deep Breath

    "The first thing we do is to reassure couples that they are still within the normal range," he says. "Humans are efficient reproducers, but we are not rapid reproducers compared to the rest of animal kingdom."

    A little sex-ed refresher doesn't hurt either, he says.

    "If a couple comes in at three months and they are very stressed, we talk to them about what is the normal fertile time and how to best time intercourse to get the best results," he says. "We lower their anxiety by talking about the facts of human reproduction and give them opportunities to talk to other couples who have gone through similar things so they realize that this is normal, they are normal, and that [reproduction] takes time," he says.

    To help cool anxiety, a quick physical exam and history can be done even before a year or six months to help rule out any major causes of infertility. This type of exam may help reassure future parents that there is nothing wrong and that if they continue to try, they will likely be able to conceive a child within a year. In fact, 85% of couples will conceive a child within a year of trying.

    "If there is an obvious factor in their history that is suggestive of a fertility problem, such as a history of cancer or certain chemical exposures, we may do a full evaluation earlier," he says. "In these cases, it doesn't help to wait a year, and we may lose the window of opportunity for pregnancy."

    Other red flags that could indicate a fertility problem earlier in the game include irregular menstrual cycles.

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