Fact Sheets and Information Booklets

ASRM Patient Education Fact Sheets and Information Booklets are available in both HTML to view on the web and as PDFs to download.

Abnormal Uterine Bleeding

Menstruation is considered normal when uterine bleeding occurs every 21 to 35 days and is not excessive. The normal duration of menstrual bleeding is between two and seven days. Abnormal uterine bleeding occurs when either the frequency or quantity of uterine bleeding differs from that mentioned above or the woman has spotting or bleeding between her menstrual periods.

Downloadable PDF version here.

Abnormalities of the Female Reproductive Tract (Müllerian Defects)

Like other organs in the body, a woman’s reproductive organs take shape when she is still a fetus inside her mother’s uterus. These organs include the uterus and fallopian tubes, which develop from two ducts known as the müllerian ducts.

Downloadable PDF version here.

Adhesions: What Are They and How Can They Be Prevented?

When the abdomen (belly) is injured because of disease or surgery, adhesions (scar tissue) can form.

Downloadable PDF version here.

Adoption Booklet

Adoption is an important family-building option to consider as an alternative to infertility therapy. Some couples explore adoption only after infertility treatment has proven unsuccessful. Others couples choose to forego treatment in favor of adoption. Still others have both adopted and biological children.

Downloadable PDF version here.

Adoption Fact Sheet

Many infertile couples choose adoption rather than infertility treatments, or they decide to adopt after infertility treatments have failed. If you are considering adoption, you have many options from which to choose, including private, public, domestic, or international adoption. Each type of adoption has different requirements, but some issues are common to all types. Below are some general guidelines to help you learn about adoption. Familiarizing yourself with the issues unique to adoption will help you make the best decisions each step of the way.

Downloadable PDF version here.

Age and Fertility

Fertility changes with age. Both males and females become fertile in their teens following puberty. For girls, the beginning of their reproductive years is marked by the onset of ovulation and menstruation. It is commonly understood that after menopause women are no longer able to become pregnant. Generally, reproductive potential decreases as women get older, and fertility can be expected to end 5 to 10 years before menopause.

Downloadable PDF version here.

Assisted Reproductive Technologies

This booklet will help you understand in vitro fertilization (IVF) and other assisted reproductive technologies (ART) that have become accepted medical treatments for infertility. Through these procedures, many couples with otherwise untreatable infertility have given birth to healthy babies.

Cancer and Fertility Preservation

In the United States there are approximately 800,000 reproductive-aged men and women who have cancer, many of whom have concerns about their fertility. Lifesaving cancer treatments may reduce fertility by destroying eggs and sperm.

Downloadable PDF version here.

Challenges of Parenting Multiples

There are many psychological, social, and economic issues associated with multiple pregnancies.

Downloadable PDF version here.

Complications and Problems Associated With Multiple Births

Women who can get pregnant without fertility drugs or medical procedures usually have only one baby. Women who need fertility treatment are at higher risk to get pregnant with twins, and rarely with triplets or more. This is called multiple gestation. Multiple gestation can increase the risk of pregnancy for the mother and for all the babies.

Downloadable PDF version here

Conceiving After Tubal Surgery

The fallopian tube connects the ovary (where the egg is released) to the uterus (womb), where the fertilized egg develops into a fetus. Fertilization, the process in which the man's sperm joins the egg, takes place in the fallopian tube. If your fallopian tubes are the reason of why you cannot get pregnant, your doctor may discuss surgery as an option to fix your tubes.

Downloadable PDF version here

Conditions Treated With Adnexal Surgery

Surgery can be used to treat problems with your ovaries or fallopian tubes such as cysts, endometriosis or infections. Adnexal surgery involves any of the organs that are on the sides of (“next to”) the uterus (womb), such as the fallopian tubes and ovaries.

Downloadable PDF version here

Counseling Issues for Gay Men and Lesbians Seeking Assisted Reproductive Technologies (ART)

Are parenting concerns of heterosexual couples different than those of gay or lesbian couples? .

Downloadable PDF version here.

Diagnostic Testing for Female Infertility

An evaluation of a woman for infertility is appropriate for women who have not become pregnant after having 12 months of regular, unprotected intercourse. 

Downloadable PDF version here.

Diagnostic Testing for Male Factor Infertility

When a couple has trouble having a baby, there's about a 50-50 chance that the man has a problem contributing to the pregnancy.

Downloadable PDF version here

Dilation and Curettage (D&C)

"Dilation and curettage" (D&C) is a minor (short) surgical procedure that removes tissue from your uterus (womb). You may need this procedure if you have unexplained bleeding between periods or if you have delivered a baby and placental tissue remains in your womb.

Downloadable PDF version here

Ectopic Pregnancy

When you become pregnant, the embryo (fertilized egg) travels from your fallopian tube to your uterus (womb) where the embryo implants (sticks) and grows into a fetus. An ectopic pregnancy occurs when the embryo grows outside of the uterus.

Downloadable PDF version here 

Ectopic Pregnancy (booklet)

The diagnosis of an ectopic pregnancy is usually a surprise and is often emotionally traumatic. Many women are in the midst of enjoying their pregnancy when they receive the diagnosis. Some women diagnosed with an ectopic pregnancy do not even know they are pregnant and suddenly must contemplate the possibility of major surgery or medical treatment. This booklet is designed to provide information on the diagnosis and treatment of ectopic pregnancy.

Egg Donation

Egg donation is when a woman (donor) gives her eggs to another woman (recipient) to allow the recipient to have a baby.

Downloadable PDF version here 

Elective Single Embryo Transfer (eSET)

After the removal and fertilization of eggs with the use of in vitro fertilization (IVF), some women with multiple embryos (fertilized eggs) may decide to have a single embryo transferred to the womb even when multiple embryos are available (elective single embryo transfereSET).

Downloadable PDF version here 

Embryo Donation

In the current practice of in vitro fertilization (IVF), some patients may create more embryos (fertilized eggs) than they need. The extra embryos may be cryopreserved (frozen) so that they can be transferred later. However, sometimes these embryos may not be used. These patients have the option to have their embryos discarded, donated to research or donated to another woman to achieve pregnancy.

Downloadable PDF version here 

Endometrial Ablation

Endometrial ablation is a medical procedure that removes the lining of the uterus, called the endometrium.

Downloadable PDF version here 

Endometriosis

Women with endometriosis may experience infertility, pelvic pain, or both. This booklet will describe options for diagnosing and treating pain or infertility that may be attributed to endometriosis.

Downloadable PDF version here.

Endometriosis and Infertility: Can Surgery Help?

When the tissue that normally lines the inside of the uterus (endometrium) is found outside the uterus, it is termed “endometriosis.”

Downloadable PDF version here 

Endometriosis: Does It Cause Infertility?

When the tissue that normally lines the inside of the uterus (endometrium) is found outside the uterus, it is termed “endometriosis.” Endometriosis may grow on the outside of your uterus, ovaries, and tubes and even on your bladder or intestines. This tissue can irritate structures that it touches, causing pain and adhesions (scar tissue) on these organs.

Downloadable PDF version here 

Evaluation of the Uterus

If you are trying to get pregnant for more than one year (or six months if you are 35 years or older) and have not been successful, a series of tests will be performed to fine the cause of your infertility. Your doctor will test your reproductive organs (fallopian tubes and uterus), your partner's sperm, and possible blood tests to check for hormonal problems.

Downloadable PDF version here 

Fertility Drugs And The Risk Of Multiple Births

Infertility treatments that cause multiple eggs to develop make it more likely that you will become pregnant with twins, triplets, or more.

Downloadable PDF version here.

Fertility Options After Vasectomy

Vasectomy is currently one of the most common methods of sterilization in the United States. After your vasectomy, if you change your mind about having children, there are two procedures that can help you have a child with your partner. The two options are: a vasectomy reversal or sperm aspiration prior to in vitro fertilization (IVF). 

Downloadable PDF version here.

Fibroids and Fertility

Uterine fibroids (also called myomas or leiomyomas) are benign (noncancerous) tumors of muscle tissue that can change the shape or size of the uterus and sometimes the cervix. They start in the smooth muscle cells inside the wall of the uterus (myometrium).

Downloadable PDF version here.

Gamete Donation: Deciding Whether To Tell

When a couple is unable to get pregnant on their own, sometimes they use a donor's egg or sperm. This is called "gamete donation". When a child is conceived this way, parents must decide whether to tell their child or keep this information private.

Downloadable PDF version here.

Genetic Screening for Birth Defects

Birth defects, which occur in nearly one in 20 pregnancies, range in severity from minor anatomic abnormalities to extensive genetic disorders or mental retardation. Some couples have a greater than average risk of having a child with a birth defect. Genetic screening refers to the use of specific tests to determine which members of a population are at increased risk for an inherited condition.

Downloadable PDF version here.

Gestational Carrier (Surrogate)

A gestational carrier (GC), also called a gestational surrogate, is an arrangement where a woman carries and delivers a child for another couple or person (intended parent[s]). 

Downloadable PDF version here.

Hirsutism and Polycystic Ovary Syndrome (PCOS)

Hirsutism is the excessive growth of facial or body hair on women. Hirsutism can be seen as coarse, dark hair that may appear on the face, chest, lower abdomen, back, upper arms, or upper legs. Hirsutism is a symptom of medical disorders associated with the hormones called androgens. Polycystic ovary syndrome (PCOS), in which the ovaries produce excessive amounts of androgens, is the most common cause of hirsutism and may affect up to 10% of women. 

Hormonal Contraception

Hormonal contraceptives contain a progestin (progesterone medicine) with or without an estrogen. Both progestin and estrogen are made in a laboratory and are similar to the hormones that all women naturally produce. These two hormones together, or the progestin alone, work in several ways to prevent a pregnancy.

Downloadable PDF version here.

Hydrosalpinx

An old infection can cause the tubes to fill with fluid and enlarge (dilate). When this happens, the tube is called a hydrosalpinx. A normal pregnancy in the uterus cannot occur because the tube may be severely damaged and blocked. A blockage will not allow the egg and sperm to meet.

Downloadable PDF version here.

Hyperprolactinemia (Prolactin Excess)

Prolactin is a hormone produced by your pituitary gland, the gland that sits at the bottom of the brain. Though prolactin plays a role in the growth and development of your breasts, its primary function is in milk production after a child is born.

Downloadable PDF version here.

Hypothyroidism

Hypothyroidism (underactive thyroid) occurs when the thyroid gland produces less thyroid hormone than it should. 

Downloadable PDF version here.

Hysterosalpingogram (HSG)

A hysterosalpingogram or HSG is an x-ray procedure performed to determine whether the fallopian tubes are patent (open) and to see if the shape of the uterine cavity is normal. 

Downloadable PDF version here.

Infertility Counseling and Support: When and Where To Find It

Infertility is a medical condition that touches all aspects of your life. It may affect your relationships with others, your perspective on life, and how you feel about yourself. How you deal with these feelings will depend on your personality and life experiences. Most people can benefit from the support of family, friends, medical caregivers, and mental health professionals. When considering infertility treatment options such as sperm, egg, or embryo donation or gestational carriers, it may be especially helpful to gain the assistance of a fertility counselor.

Downloadable PDF version here.

Infertility: An Overview

Infertility is typically defined as the inability to achieve pregnancy after one year of unprotected intercourse. If you have been trying to conceive for a year or more, you should consider an infertility evaluation. However, if you are 35 years or older, you should begin the infertility evaluation after about six months of unprotected intercourse rather than a year, so as not to delay potentially needed treatment. If you have a reason to suspect an underlying problem, you should seek care earlier. 

Downloadable PDF version here.

Insulin-sensitizing agents and polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a common reproductive disorder, affecting 5% to10% of women of reproductive age. Women with PCOS have a number of conditions that may include irregular menstrual cycles, an increase in facial and body hair, increased weight, and infertility. Diagnosis is made on a combination of clinical, laboratory, and ultrasound findings. 

Downloadable PDF version here.

Intracytoplasmic Sperm Injection (ICSI)

A procedure called intracytoplasmic sperm injection (ICSI) can help fertilize the egg by injecting the sperm directly into the egg.

Downloadable PDF version here.

Intrauterine Adhesions

 Injury to and/or infection of the endometrium may damage the lining and cause formation of adhesions (scar tissue) between the inner walls of the uterus. Asherman syndrome is the term used to describe adhesions inside the uterus. The scarring can be mild with thin stretchy bands of scar tissue or more severe with formation of thick bands. In the most severe cases, partial or total destruction of the inside of the uterus can occur.

Downloadable PDF version here.

Intrauterine Insemination (IUI)

Intrauterine insemination (IUI) is a procedure that bypasses the cervix and places sperm into a woman’s uterus around the time of ovulation.

Downloadable PDF version here.

Laparoscopy and Hysteroscopy

A complete examination of a woman’s internal pelvic structures can provide important information regarding infertility and common gynecologic disorders. Frequently, problems that cannot be discovered by an external physical examination can be discovered by laparoscopy and hysteroscopy, two procedures that provide a direct look at the pelvic organs. These procedures may be recommended as part of your infertility care, depending on your particular situation. Laparoscopy and hysteroscopy can be used for both diagnostic (looking only) and operative (looking and treating) purposes.

Downloadable PDF version here.

Managing Pelvic Pain

Many women have pain in their pelvis (lower part of the belly) from time to time, usually during their period. However, if you have daily pelvic pain, it could be a sign of a bigger problem with your bladder, bowels, reproductive organs, or pelvic muscles. Many conditions cause pelvic pain, including endometriosis, adhesions, chronic appendicitis, or hernias.

Downloadable PDF version here.

Medications for Inducing Ovulation

Approximately 25% of infertile women have problems with ovulation. These include the inability to produce fully matured eggs or failure to “ovulate” (release) an egg. The inability to produce and/or release eggs is called anovulation. Fertility specialists use a group of medications, often called “fertility drugs,” to temporarily correct ovulatory problems and increase a woman’s chance for pregnancy. Fertility drugs may be used to correct other fertility problems such as improving the lining of the uterus (endometrium) in addition to inducing ovulation. In certain circumstances, these medications also may be used to stimulate the development of multiple eggs, such as in an in vitro fertilization (IVF) cycle. This booklet explains the basics of normal ovulation and the diagnosis and treatment of ovulatory problems. The specific uses for several types of ovulation drugs are presented, along with the intended results and possible side effects of each drug. 

Downloadable PDF version here.

Minimally Invasive Surgery

You may wonder how any surgery can be called "minimally invasive," but this type of surgery features small or no incisions. Surgeons view your body's organs with the help of small telescopes and tiny cameras. Surgical repairs are made with tiny instruments. Often, problems can be diagnosed and treated as part of one procedure.

Downloadable PDF version here.

Multiple Pregnancy and Birth: Twins, Triplets, and High-order Multiples

Multiple births are much more common today than they were in the past. According to the US Department of Health and Human Services, the twin birth rate has increased by over 75% since 1980, and triplet, quadruplet, and high-order multiple births have increased at an even higher rate. There are more multiple births today in part because more women are receiving infertility treatment, which carries a risk of multiple pregnancy. 

Downloadable PDF version here.

Noncontraceptive Benefits of Birth Control Pills

Most women will use birth control pills at some time in their lives. But many women don’t know that birth control pills also can be used to treat a variety of female problems and can have some surprising health benefits.

Downloadable PDF version here.

Nonhormonal Contraception

Contraceptive agents work in many ways to prevent a pregnancy. They are usually divided into those that are either hormonal or nonhormonal. Most of the hormonal contraceptives work by changing a woman's hormone levels to mimic a pregnancy, therefore preventing eggs from being able to be released from the ovary. In contrast, nonhormonal contraceptive agents or devices work by preventing a man's sperm from joining a woman's egg.

Downloadable PDF version here.

Normal and Abnormal Puberty in Females

Puberty refers to the specific physical changes that happen as a child develops into an adult. Though they happen in different areas of the body, these changes are all related to each other.

Downloadable PDF version here.

Optimizing Male Fertility

About 20% of infertility cases are due to a male factor alone. Another 30% involves both male and female factors.

Downloadable PDF version here.

Optimizing Natural Fertility

Before attempting pregnancy, a woman should make sure she is healthy enough for pregnancy by adopting a healthier lifestyle and taking prenatal vitamins. If she has a medical or genetic condition, she should seek advice from a medical professional before conceiving (becoming pregnant).

Downloadable PDF version here.

Osteoporosis

Osteoporosis is a disease characterized by low bone mass which leads to weakening of the bones. Osteopenia is a disease where the bone density is lower than average and can be a precursor to osteoporosis.

Downloadable PDF version here.

Ovarian Drilling for Infertility

The use of a surgical procedure called ovarian drilling can help promote normal menstrual cycles and lower testosterone levels. This may make it easier for you to get pregnant.

Downloadable PDF version here.

Ovarian Hyperstimulation Syndrome (OHSS)

Ovarian Hyperstimulation Syndrome (OHSS) is an exaggerated response to the use of ovulation induction medications, especially during the use of injectable gonadotropin agents

Downloadable PDF version here.

Ovulation Detection

Ovulation, the release of an egg from its follicle in one of a woman’s two ovaries, is one of the most important factors in conceiving a child. 

Downloadable PDF version here.

Polycystic ovary syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a common hormonal disorder that affects 5-10% of women. 

Downloadable PDF version here.

Prediction of Fertility Potential (Ovarian Reserve) in Women

Approximately one-third of couples in which the female partner is age 35 or older will have problems with fertility. Several tests may be useful in assessing fertility potential (ovarian reserve) in women.

Downloadable PDF version here.

Premature Ovarian Failure (POF)

When a woman’s ovaries stop working before age 40, she is said to have premature ovarian failure (POF).

Downloadable PDF version here.

Progesterone Supplementation During In Vitro Fertilization (IVF) Cycles

Progesterone prepares the lining of the uterus (endometrium) to allow a fertilized egg (embryo) to stick or implant. If a pregnancy does not take place, progesterone levels will fall and you will have your period. If an embryo implants into the lining of the uterus, the ovary will produce progesterone until eight weeks into the pregnancy. After that time, progesterone will be produced by the placenta throughout the rest of the pregnancy.

Downloadable PDF version here.

Recurrent Pregnancy Loss

Recurrent pregnancy loss is a disease distinct from infertility, defined by two or more failed pregnancies.   

Downloadable PDF version here.

Reproductive Aging in Women

Your reproductive system ages faster than you may realize. Some women, after completing college, settling into a career, or waiting for the right partner, find that they have problems getting pregnant due to age-related infertility.

Downloadable PDF version here.

Risks of In Vitro Fertilization (IVF)

Serious complications from the medications and procedures required for in vitro fertilization (IVF) are rare. However, as with all medical treatments, there are some risks.

Downloadable PDF version here.

Robotic Surgery

Robotic surgery is a form of laparoscopy. Laparoscopy is minimally invasive surgery, usually performed in an outpatient setting. Small incisions about a half inch each are made in the abdomen that allow a surgeon to place a laparoscope (lighted camera) and surgical instruments through surgical incisions below the belly button.  

Downloadable PDF version here.

Saline Infusion Sonohysterography (SHG)

Saline infusion sonohysterography (SHG or SIS) consists of imaging the uterus and uterine cavity using ultrasonography while sterile saline is instilled into the uterine cavity. The purpose of sonohysterography is to detect abnormalities of the uterus and endometrial (uterine lining) cavity.

Downloadable PDF version here.

Sexual Dysfunction and Infertility

You probably don't realize how many people have problems having sex. But sexual dysfunction is common: 43% of women and 31% of men report having at least one symptom.

Downloadable PDF version here.

Side effects of injectable fertility drugs (gonadotropins)

Gonadotropins are fertility medications given by injection that contain follicle-stimulating hormone (FSH) alone or combined with luteinizing hormone (LH).

Downloadable PDF version here.

Smoking and Infertility

The health risks of tobacco smoking are well known with regard to diseases of the heart, lungs, and blood vessels. Substantial harmful effects of cigarette smoke on fertility have become apparent, but are not generally appreciated. 

Downloadable PDF version here.

Sperm Recovery after Spinal Cord Injury in Men

There are more than 10,000 spinal cord injuries per year in the United States. The majority of these injuries occur in healthy men of reproductive age. Spinal cord injury may produce both sexual and reproductive problems.

Downloadable PDF version here.

Sperm Shape (Morphology): Does It Affect Fertility?

For many years, experts have focused on semen analysis, but research studies show that the number of sperm (count) and the movement of sperm (motility) do not always predict fertility very well by themselves. It may also be useful to look at the shape of the sperm (morphology), which is also one of the important parts of the semen evaluation.

Downloadable PDF version here.

Stem Cell Research

Stem cells are special cells found in very early stage embryos (i.e., 5 days after fertilization of an egg) and in some types of adult tissue.

Downloadable PDF version here.

Stress and Infertility

Stress can come from just about anything that you feel is threatening or harmful. A single event (or your worry about it) can produce stress. So can the little things that worry you all day long.

Downloadable PDF version here.

The Intrauterine Device (IUD): A Long-acting Reversible Contraception

One group of methods that is becoming more popular for many women is Long-Acting Reversible Contraception (LARC). These methods do not fail as often and fewer women become pregnant because they are always in place and last for a long time. Because of this, the failure rate is less than 1 in 100. LARC methods reduce the number of times women get pregnant when they do not want to, called unintended pregnancy. The number of abortions is also lower when women use LARC. LARC methods include subcutaneous (under the skin) implants, intrauterine devices (IUDs), and injectable methods (a shot). The shot fails at a higher rate than other LARC methods because it does not last as long. LARC methods also help women in other ways and there are very few reasons they cannot be used. This page will tell you more about IUDs.

Downloadable PDF version here.

The Menopausal Transition (Perimenopause)

During the menopause transition, the length of menstrual cycles often changes and women may skip their menstrual periods more often. The duration of the menopausal transition varies from woman to woman but averages about five years.

Downloadable PDF version here.

Third-party Reproduction: Sperm, egg, and embryo donation and surrogacy

The phrase “third-party reproduction” refers to the use of eggs, sperm, or embryos that have been donated by a third person (donor) to enable an infertile individual or couple (intended recipient) to become parents. Donors may be known or anonymous to the intended recipient. “Third-party reproduction” also includes traditional surrogacy and gestational carrier arrangements.

Downloadable PDF version here.

Treatment of Uterine Fibroids

Fibroids usually do not require treatment because most patients with fibroids do not have symptoms.

Downloadable PDF version here.

Understanding Clinical Studies

This information sheet briefly outlines examples of the three major types of clinical studies in use, their advantages and their shortcomings.

Downloadable PDF version here.

Varicocele

The veins in your testes -- like those in your legs -- have valves that help blood to flow upward toward your heart. If the valves stop working, blood pools in the veins, which bulge or dilate. This is called a varicocele and varicoceles may make it difficult for you and your partner to have a baby.

Downloadable PDF version here.

Weight and Fertility

Many women in the underweight, overweight, and obese categories will not have a problem becoming pregnant. But women who are not an ideal body weight may have problems with ovulation. This could lead to problems with fertility.

Downloadable PDF version here.

What are Fibroids?

Uterine fibroids (also called myomas or leiomyomas) are benign (non-cancerous) tumors of muscle tissue that can enlarge and/or distort the uterus (womb) and sometimes the cervix.

Downloadable PDF version here.

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