Technically, a couple is infertile if pregnancy doesn’t occur after a year of unprotected sex. But don’t wait that long to see a specialist. “We used to say, ‘Go try for a year, then come back,’ ” says urologist Harris Nagler. “Not anymore—especially since people are trying later. It’s okay to raise the question at any time.” For couples who do require treatment, the big news is that success rates with in vitro fertilization are higher, while multi-fetal pregnancy rates are dropping. “Another exciting development,” he says, “is intracytoplasmic sperm injection—injecting a single sperm into the egg. It enables us to treat couples where the man has a terrible sperm count.”
These developments tilt the emphasis back to the woman. “It doesn’t take many sperm to get a woman pregnant anymore,” says reproductive endocrinologist Frances Ginsburg. “So things have become very egg-dependent.” Which is a bit of a problem given the trend toward later pregnancies. “Women’s expectations tend to be too high,” he says. After age 35, the chance-per-month of becoming pregnant drops significantly with each passing birthday.
So how to increase your odds? “I’d love to tell you that eating right and exercising has an effect, but it doesn’t,” says Ginsburg. “That said, women should take folic acid, avoid excessive amounts of caffeine and alcohol, and not smoke.” And for the guys? “The old wives’ tales are just that,” says Nagler. “It’s unwise for a man who is trying to conceive to sit in a sauna every day for an hour or ride a bicycle all day every day in Spandex. But in moderate amounts, these things likely have no effect.” Tightie-whitey fans can breathe a pent-up sigh of relief.
Top urologists specializing in infertility are Harry Fisch, NewYork-Presbyterian–Columbia Presbyterian (212-879-0800); Marc Goldstein, NewYork-Presbyterian–NY Weill Cornell (212-746-5470); Harris M. Nagler, Beth Israel Medical Center (212-844-8900); Peter N. Schlegel, NewYork-Presbyterian–NY Weill Cornell (212-746-5491). Top reproductive endocrinologists specializing in infertility are Alan B. Copperman, Mount Sinai Medical Center (212-756-5777); James A. Grifo, NYU Medical Center (212-263-7978); Frances Ginsburg, Stamford Hospital (203-325-7559); Richard V. Grazi, Maimonides Medical Center (718-283-8600); Magdalen Hull, Huntington Hospital (631-784-7790); George D. Kofinas, New York Methodist Hospital (718-780-5065); David B. Seifer, RWJ University Hospital–New Brunswick (732-235-7055).