Before you and your partner start treatment for infertility, talk about how far you want to go. For example, you may want to try medicine but do not want to have surgery. While you may rethink this end point during your treatment, it’s a good idea to have an idea where you want to draw the line. Many couples do not think about this in the beginning and become emotionally and financially drained from trying a series of treatments.

Treatment for fertility can also be quite expensive, and insurance often does not cover these expenses. If cost is a concern for you, find out how much medicines and procedures cost and if your insurance covers any costs. Talk with your partner about what you can afford.

Keep in mind that some infertility problems are more easily treated than others. In general, as a women ages, especially after 35, her chances of getting pregnant decrease and her risk of miscarriage markedly increases.

If you are 35 or older, your doctor may recommend that you skip some of the steps younger couples usually take because your chances of having a baby decrease with each passing year.

Also, understand that even if you are able to get pregnant, no treatment can guarantee a healthy baby. On the other hand, scientists in this field have made many advances that have helped millions of couples have babies.

Your doctor will first try to find why you have not been able to get pregnant. He or she will do tests to look for a cause. Sometimes doctors do not find a problem with either the man or the woman and don't know why a woman cannot get pregnant.

Treatment for female infertility

Problems with ovulating. If your doctor finds that you have a problem with ovulating, he or she may first recommend that you try the medicine clomiphene (Clomid, Serophene, Milophene). This medicine (which you take as a pill) stimulates your ovaries to release eggs, so it improves your chances of getting pregnant. It is often tried first because it is considered safe and effective.

Clomiphene has more side effects than gonadotropins but clomiphene costs less, has a lower risk of ovarian hyperstimulation syndrome, and is less likely to result in a pregnancy with more than one baby.

If you're not ovulating because of a condition called polycystic ovary syndrome (PCOS), your doctor might suggest you take a drug such as metformin in combination with clomiphene. For more information, see treatment of women with polycystic ovary syndrome (PCOS).

Unfortunately, clomiphene does not always work. Typically, hormone shots are the next medication tried. You and your partner can weigh the risks and benefits of proceeding to this next step. You start the first series of daily shots at the beginning of your menstrual cycle. You will probably have mild side effects, such as feeling sick to your stomach and bloating. Some women have more serious side effects due to multiple, large ovarian cysts (ovarian hyperstimulation syndrome). While clomiphene increases your chance of having twins or triplets (especially twins), women who take hormonal injections are even more likely to have twins, triplets, or more babies.