But if they seek medical help sooner rather than later, the outlook has never been brighter. Infertility treatments have improved, options have expanded, and doctors are more skilled at the techniques. Evaluations are done earlier than in years past, and the trend is to treat more aggressively, especially if the hopeful mom-to-be is older.
Tubal ligation is surgery to close or block a woman's fallopian tubes so eggs released from the ovaries cannot enter the uterus and sperm cannot reach the egg. The procedure is done to prevent pregnancy.
It is also called female sterilization surgery, or "getting your tubes tied." The fallopian tubes may be closed by:
Tying the tubes together
Sealing them closed using a ring or clip
Burning (cauterizing) them together using a mild electric current
Tubal ligation is intended...
"Success rates have improved dramatically in the last 10 years," says Mousa Shamonki, MD, director of in vitro fertilization (IVF) and a reproductive endocrinologist at the University of California, Los Angeles David Geffen School of Medicine. The average success rates for births at fertility clinics have roughly doubled in the past decade, he says.
In 2003, more than 48,000 babies were born in the U.S. as a result of assisted reproductive technology or ART, according to the CDC. That's an increase of more than 2,000 over 2002 and 7,000 more than in 2001.
The Earlier the Better
"Often couples [who can't conceive] are told by family members, 'Just relax and take a vacation, you will get pregnant,''' says Eric Surrey, MD, former president of the Society for Assisted Reproductive Technology (SART) and a fertility specialist in Denver.
That won't work for couples with underlying fertility problems, he says. And at some point, seeking medical help is wiser than persisting on their own. If a woman is under age 39 and has been attempting to conceive for a year without success, it's a good time to seek medical help, says Surrey. If she is over 39, the evaluation should be performed after six months of trying to conceive without success, he says.
Sometimes infertility can be treated with medication or surgical repair of reproductive organs. Another standard fertility treatment is to do one to three cycles of ovarian stimulation and intrauterine insemination, says Guy Ringler, MD, a reproductive endocrinologist at the Santa Monica -- UCLA Medical Center.
That involves stimulating the ovaries to boost egg production by giving medicine such as Clomid and then inserting a thin catheter into the uterine cavity to place the sperm there.