Introduction to Infertility
What is the definition of infertility?
If you have actively been trying to become pregnant for one year, and have not been successful. This means no pregnancies at all, or pregnancies that ended in miscarriage.
We’ve been trying for a year with no luck. What do we do now?
You have options:
You can continue to try on your own. You only have a 20% chance of getting pregnant every month you try, so the math is definitely not in your favor in the beginning.
You can pursue fertility testing to see what the problem might be.
You can look into other ways to build a family, like adoption and foster care.
Will my insurance cover infertility testing and treatment?
If you are interested in testing, you should carve out an hour of your day and call the number on the back of your medical insurance card. This is a pain, but your insurance can tell you EXACTLY what they cover, and how much. There are a few states in the US that have mandated insurance to provide infertility coverage, but it varies greatly from state to state. Check out the link below for more information about your specific state.
https://resolve.org/what-are-my-options/insurance-coverage/infertility-coverage-state/
What testing should I be asking for/expecting?
If you are going to see a fertility specialist (REI - Reproductive Endocrinology and Infertility), they will likely order the following:
Semen Analysis: This determines if there is enough sperm, if it is shaped normally, and if it is mobile (if it can swim).
HSG (hysterosalpingogram or dye test): This determines if the fallopian tubes are open, so that when an egg is released it can move down the tube to be fertilized.
Blood work to determine ovarian reserve. This is typically an AMH (Anti-Mullerian Hormone) and gives us a better estimate of the quality and quantity of eggs. There is NOT a test that can give you a specific number of eggs, or their exact quality.
If you have a primary care or OBGYN, they may not routinely order these tests. You can always ask, especially if you live in an area where there are no infertility specialists. Often your OBGYN can get the ball rolling with some of this testing.
Why do I need all of those tests?
Infertility is a complicated problem. Did you know that causes of infertility are pretty evenly split into thirds? One third female causes, one third male causes, and one third combination/unknown. So yes, all of the tests I listed above are important to get a full picture.
But I don’t want to do IVF.
That’s totally fine. If you go to see a fertility specialist, that does not mean you have to do ANY treatments. You can simply go for testing so you have the information, and that’s it. If you ever feel pressured, or just feel like something’s not right, then I always recommend getting a second opinion.
I’m a single woman, or in a same-sex relationship, what about me?
Unfortunately, insurance still defines infertility as a sperm producing partner, and an egg producing partner, actively trying for one year. So if this is not your exact situation, you will not be diagnosed with infertility, which is one of the first steps in getting full coverage for your services. That being said, many insurances WILL cover labs, medication, or even some IVF services without an infertility diagnosis. So it is worth it to talk to your insurance, and then to your HR department to see if it is worth switching to a different plan for better coverage.
This is just the tip of the iceberg when it comes to infertility. My goal is for this to give you a place to start, and I will dive more deeply in future content. If you are struggling to become pregnant, please know you are not alone, and please reach out for help when you need it. And as always, reach out and let me know if there are any subjects that I can cover that would be of help to you.
