When Plan A Fails

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Whether you have a fertility problem . Choosing a fertility specialist . The fertility workup . The causes of infertility . The types of treatments available . The stress of infertility . The truth about surrogacy . The facts about adoption

When Plan A Fails

If things haven't gone according to plan and you have not yet been able to conceive, you may feel that you are the only person living through the nightmare of infertility. If friends and family members seem to be able to conceive at the drop of a hat, while you continue to try and try and try, you may feel particularly discouraged and alone.

The fact of the matter is that there are far more people with infertility problems than you realize. The problem is that no one wants to talk about it. Because many couples feel embarrassed by their inability to conceive, the subject of infertility tends to get brushed under the carpet. Although it's easy to conclude that you're the only one who's having difficulty getting pregnant, chances are that someone you know is currently going through or has gone through a similar experience.

Consider the numbers for yourself. According to the National Center for Health Statistics

• approximately 2.1 million married couples experienced some type of fertility problem in 1995,
  
  
• approximately 1.8 million women used fertility drugs in 1995,
  
  
• approximately 9 million American women have used the services of fertility clinics to date.

In this chapter, we tell you how to determine if you have a fertility problem, how to choose a fertility specialist, what to expect from your initial fertility workup, what causes infertility and how it can be treated, how to cope with the stress of infertility, and what you need to know about two other routes to parenthood: surrogacy and adoption.

Unofficially…
Medical historian Robert Marion, M.D., believes that George Washington's fertility problems changed the course of American history. In an article that appeared in Newsday in 1994, Marion argued that Washington turned down the chance to become "King" of the United States because of his lack of heirs to inherit the throne.

Do you have a fertility problem?

If you and your partner have been having unprotected intercourse for more than a year yet still haven't managed to conceive, it's possible that you, your partner, or the two of you have some sort of fertility problem.

The American Society of Reproductive Medicine (formerly the American Fertility Society) defines infertility as the inability to conceive after one year of unprotected intercourse. Although it recommends that most couples under age 35 give themselves a full year before seeking treatment, it suggests that couples over 35 as well as those who have some underlying cause of infertility (for example, endometriosis, fibroids, irregular periods, prior abortion, DES mothers, varicoceles, or significant health problems) seek the help of a specialist sooner.