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The Fertility Diaries: When a Friend Is Pregnant — and You're Not

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Fertility: The Facts

Trying to conceive can feel anything but normal. Here, how Americans fare in the quest for baby.

85% of couples will become pregnant without assistance after a year of regular, unprotected intercourse.

10% of the reproductive-age population is affected by infertility.

43% more babies were born to women ages 35 to 39 in 2004 than in 1990.

40% of the time, the male partner is either the sole cause or a contributing cause of infertility.

85% to 90% of infertility cases can be treated with conventional therapies such as a drug treatment (like Clomid) or the surgical repair of reproductive organs.

Sources: American Society for Reproductive Medicine; National Center for Health Statistics, Centers for Disease Control and Prevention.

When at First You Don't Conceive

If you've been trying unsuccessfully to get pregnant for more than 12 months (or six months if you're over 35), visit your ob/gyn. Most gynecologists can perform the initial tests to help determine the source of the problem, says Arthur Castelbaum, M.D., codirector of reproductive endocrinology and infertility at Temple University School of Medicine. Here, what to expect during your first visits.

Physical exam: After identifying any lifestyle factors that can hinder conception, such as smoking and obesity, your doctor may perform a transvaginal ultrasound to help rule out conditions such as fibroids (tissue growth on the uterus that can block the fallopian tubes), and/or a blood test to determine a hormonal imbalance.

Cycle Day 3 FSH: This blood test, performed on the third day of a woman's period, measures levels of follicle-stimulating hormone (FSH), a hormone that stimulates the ovaries to produce a mature egg for ovulation. Women are born with a set number of eggs that decreases with age, so as egg count drops, FSH levels rise to compensate. In other words, a higher level of FSH indicates that a smaller number of eggs are available in the "ovarian reserve."

Hysterosalpingogram: A week after your period, a tube is inserted into the cervix and a dye is pumped into the uterus and fallopian tubes. X-rays are then taken to detect any abnormalities such as a misshapen uterus (which can impact conception and successful pregnancy) or uterine fibroids and tumors (which crowd the uterus and can result in infertility or miscarriage).

Semen analysis: Your partner's semen is checked for volume, concentration, motility (ability of the sperm to swim), and morphology (the sperm's appearance). Healthy samples contain 40 million sperm.

Depending on what your tests reveal, your doctor may recommend oral or injectable fertility medications. But be aware that some doctors prescribe fertility drugs before performing standard tests. If yours suggests that, save your money: It's important to determine exactly what factors are affecting your ability to conceive before proceeding.

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