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Many Options Available to Address
Many effective options are available for women
and couples having difficulty conceiving, and
UCLA fertility experts urge women and their
partners not to delay in seeking consultations
to address potential concerns.
An estimated 10-to-15 percent of couples in
the United States are considered infertile —
defined as not being able to become pregnant
despite frequent unprotected intercourse
for a year or more — and the percentage
rises with the age of the female, notes UCLA
reproductive endocrinologist Daniel Dumesic,
MD. Many possible causes exist. Among
women, Dr. Dumesic says, a common cause
of infertility involves damage to the fallopian
tubes, including infections from sexually
transmitted diseases or as a result of previous
Common issues also include absence of
ovulation — typically signaled by menstrual
cycles more or less frequent than every
three-to-five weeks, and often easily corrected
through medication. In other cases, the
problem is traced to the male, often stemming
from low sperm count or poor sperm
function due to a variety of possible, and
often correctable, factors.
Infertility “The important thing is that if there are any doubts, people should
err on the side of coming in sooner rather than later, because you
don’t want to wait so long that fewer options are available to you.”
One of the most dramatic changes in the
fertility field in recent years is the ability to
successfully freeze women’s eggs for later use.
“A woman who is otherwise fertile but faced
with a disease process or a treatment such as
chemotherapy that will render her infertile can
have her eggs frozen to save her reproductive
capacity for later in life,” says Ingrid Rodi,
MD, director of fertility services at UCLA
Medical Center, Santa Monica.
The technology is now also being applied more
widely. “Women who are planning to delay
conception until their late 30s, early 40s or
beyond should consider freezing eggs,” says
Mousa Shamonki, MD, UCLA reproductive
endocrinologist. He notes that the process
has brought the egg-freezing survival rate
from approximately 70 percent to more than
90 percent. The procedure is considered very
safe, and the medicines are well tolerated, but
it can be costly, and there is the chance the
frozen eggs won’t yield a viable embryo.
Advances in genetic screening are improving
the ability of fertility experts to detect
problems in the embryo, Dr. Shamonki adds.
Better techniques make the process less likely
to harm the embryos and more likely to yield
complete information, which can help couples
in excluding unhealthy embryos.
In general, women up to age 35 with no known
cause of infertility are advised to consult with
a specialist after a year of unsuccessfully
trying to conceive. When the woman is older
than 35, or the couple has known issues,
the UCLA experts recommend seeking an
evaluation after six months without success,
or sooner. “The important thing is that if
there are any doubts, people should err on
the side of coming in sooner rather than
later, because you don’t want to wait so long
that fewer options are available to you,”
Dr. Shamonki says.
Vital Signs Winter 2014 Vol. 61