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Should You Just Keep Trying if You're Not Getting Pregnant?

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Try, try again. Does that apply when you're having trouble getting pregnant? Maybe.

You've heard it quite a bit. If you're under 35 and haven't been successful getting pregnant after trying for one year, go see a fertility doctor. The same goes for if you're over 35 and haven't been successful after trying for six months.

But now an Australian study has raised questions around that conventional wisdom. The study, published in Fertility and Sterility, found that one in four women with a history of infertility can still end up having a baby without fertility treatment.

What the Study Shows

University of Queensland researchers found that one in four young Australian women (ages 28-36 years) who reported a history of infertility after 12 months of unsuccessfully trying to get pregnant actually had a baby without using fertility treatment. Another one in four had a baby after undergoing fertility treatment, which included in vitro fertilization (IVF) or fertility drugs such as Clomid.

The study is part of the Australian Longitudinal Study on Women's Health in which researchers have followed more than 8,000 women since 1996. The latest data comes from surveys conducted in 2006 and 2009. Among 7,280 women, 18.6 percent reported infertility. Half (53 percent) of the treated women gave birth compared with 43.8 percent of untreated women. Half of the women who had not used fertility treatment had already had a baby prior to reporting infertility.

The researchers concluded that many women aged up to 36 years with a history of infertility, especially those who have already had a baby, can achieve spontaneous conception and live birth without using fertility treatment, which indicates they are sub-fertile rather than infertile.

"This is an interesting study; however I find that it leaves a few questions that need to be answered and addressed," says Dorothy E. Mitchell-Leef, M.D., a fertility doctor with Reproductive Biology Associates in Atlanta. For example, the researchers say they do not know whether a woman changed male partners during the study period.

"How were these women diagnosed as having infertility?" says Dr. Mitchell-Leef. "Was it documented by a specialist, or was it self-diagnosed? Women cannot be considered the only source of infertility in a couple. What male factors were involved, if any?"

The Fertility Takeaway

What should women take away from the research? Hope. If you are younger — under age 36 — and nothing is clearly wrong with either you or your partner (you are ovulating, and his sperm parameters are normal), this study gives you hope that you can get pregnant on your own.

BUT, that doesn't mean don't go see a fertility doctor to get a fertility work-up and find out if everything is working correctly. "As women age, they also have to be concerned with genetic issues," Dr. Mitchell-Leef says. "Waiting long periods of time may be a problem if their ovarian reserve becomes lower with time."

Documentation of your fertility is important. "At Reproductive Biology Associates, we try to complete the entire evaluation and history before stating that a couple is infertile," Dr. Mitchell-Leef explains. "If the woman’s FSH (follicle stimulating hormone) is elevated or her AMH (anti mullerian hormone) is in the lower range, then hoping and waiting to conceive may not be enough. The age of the woman and her ovarian reserve are vitally important in counseling patients about their possible success rates and time they have to attempt a pregnancy. We want to be the patient’s advocate in helping them achieve a pregnancy — whether it is with simple treatment or more advanced technologies."


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