Defining infertility It's a problem that's affecting one in ei

Chances are you know someone who is trying to get pregnant but can't.

Maybe that person is you.

Infertility affects roughly one in eight couples in the United States, meaning one in eight women younger than 35 years old have tried conceiving children but have been unsuccessful. For women older than 35, infertility is defined by three months of failure. For women under 35, a year of failure is defined as being infertile.

Infertility has an array of causes, treatments and a wide range of physical and psychological side effects.

According to the Advanced Fertility Institute, men contribute to the problem in approximately 40 percent of the cases.

Countless environmental or physical factors can lead to low sperm counts or abnormal sperm.

Women have a few more issues to worry about. They may, for instance, have trouble with ovulation, which can be caused by thyroid problems, excessive male hormones or too much physical or psychological stress.

Women may have cervical problems, preventing the sperm from passing through the uterus. They may have pelvic problems like scar tissue, blocked fallopian tubes, benign tumors or a fairly common and painful condition called endometriosis. It is an incurable condition -- doctors aren't sure what causes it -- in which scar tissue gathers in a woman's abdomen.

When considering the gamut of reproduction, there are many things that can go wrong.

"If they're above 35 years old, they should see a doctor right away if they're not pregnant by three months or so," said Dr. Valerie Ratts, a specialist affiliated with the Washington University School of Medicine in St. Louis. "If they've had fertility troubles in the past they shouldn't wait, or if they have a condition like endometriosis they should consult with a doctor right away. But if they have no medical history, give it a year and then see a doctor."

The first important step is to acknowledge the problem, Ratts said.

The solutions are as numerous as the causes. Oral pills can be taken; fertility shots can be administered. Another method, in vitro fertilization, can combine a woman's egg and a man's sperm in a laboratory. The embryo is then inserted into the woman's womb or the womb of a surrogate mother.

"I never say never," Ratts said. "Certain cases are harder than others. My job is to outline the options. The patients' job is to decide what they're comfortable with from either a cost or moral standpoint."

Ratts said it's difficult to determine exactly what percentage of women become pregnant after using fertility drugs. A lot depends on how far the patient is willing and able to go with the treatment. But the technology is available for most couples to have biological children of their own.

Beyond fixing the physical problems, many couples struggle with psychological issues as well.

Couples often go through many highs and lows while trying to become pregnant. The frustration may lead to mood swings, particularly around holidays when children are often the focus of attention at gatherings.

"It's a stressful time," Ratts said. "For both the women and the husbands."

bmiller@semissourian.com

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