A woman's fertility decreases with age and fertility treatment results follow the same decreases in success rates. Fertility rates drop rapidly after 35. Even with IVF (in vitro fertilization), pregnancies over the age of 42 are uncommon. Many resulting pregnancies in this age group are the result of donor egg programs.

2. When to seek help

It is best to seek treatment after one year of unprotected intercourse in a woman under the age of 35 and after six months in a woman who is over the age of 35.

3. Where to seek help

Most women begin at their family doctor or ob/gyn specialist office and many go directly to a fertility specialist. Your family doctor or ob/gyne many do an initial work up but for anything more advanced, most will refer to a fertility specialist. More commonly Ob/gyne's are now referring patients to a specialist when infertility is first suspected in the patient. The reason for this is the advantage of seeing a specialist whose entire practice is focused on infertility treatment.

4. Infertility is a problem for the couple

Infertility affects both men and women equally and for this reason, the initial infertility investigation must involve BOTH partners. Testing for male fertility involves a semen analysis where a fresh sample is observed under microscope in the laboratory. This test is called a semen analysis. Because 35% of fertility problems can be attributed to the male partner, treatment should not initiated before this testing is complete and results available.

5. Infertility is common

An average of seven million couples or 1 in 6 couples in their reproductive years, will experience infertility. If they seek treatment even couples with the most difficult cases can be successful in achieving a viable pregnancy. There are many online patient support groups and associations that advocate for the infertile couple, (see links)

6. Repetition of the same treatment is not always wise.

Repeating the same treatment protocol is not advised and if a treatment has not produced a pregnancy after three attempts it is best to review your options with your fertility specialist. It is especially important to move forward if you are over the age of 35 as your fertility is naturally declining with time. In all fertility treatments, time is of the essence.

7. In Vitro Fertilization is not usually your first option.

Many patients will achieve a pregnancy through timed intercourse either naturally or with medication. Others may achieve success through intrauterine insemination. There are diagnoses which preclude these options such as blocked fallopian tubes or advanced age. These patients will have to go directly to IVF treatment or a Donor Egg Program to help them conceive. Most specialists will take a step by step approach after the results of the initial investigation to allow the patient the opportunity to achieve a pregnancy through a less invasive procedure. Although IVF offers the highest success rates, it is also expensive and time consuming, and ultimately may not be necessary.

8.  IVF is now a common treatment and the incidence of high order multiple births are on the decline.

Technology in IVF care and our knowledge of reproduction has improved dramatically in the last 25 years. Procedures such has Intracytoplasmic Sperm Injection (ICSI) has all but eliminated the need for donor sperm in many cases. The incidence of high-order multiple births has seen a dramatic decrease as more and more centres have started to initiate SET (Single Embryo Transfer).

9. Investigate all your options

Fertility treatment is a stressful endeavour which can be emotionally exhausting. You want to be sure that the centre of your choice will be able to support your needs with complementary services designed to relieve the stress and emotional upheaval. On the clinical side you will want to investigate the clinic's track record for success and their experience in treating large numbers of clients with varying needs. The doctor and nurses who are guiding your care should have the clinical background coupled with specialized training in the area of reproductive endocrinology.  The financial impact of fertility treatment should also be investigated, compare costs with other centres and also any programs the centres provide to assist you in this area. Most importantly, talk to people who have attended the centre and ask your doctor for his opinion on the centre you have chosen.

10. Some private insurance plans cover fertility treatment.

Many insurance plans cover some aspects of fertility treatment such as the medications. Always check with your plan to see what is covered and how this coverage can be optimized. Staff at fertility centres can assist you on the most cost effective way to use your insurance coverage.