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Evaluating Infertility
Couples may be infertile if they have not been able to conceive after 12 months of having sex without the use of birth control. If you and your partner are trying to have a child and can't, you may want to have an infertility evaluation. Based on the results of these tests, treatment may be needed. If you have not been able to conceive after 12 months of having sex without the use of birth control, you may want to think about having an infertility evaluation. For healthy, young couples, the odds are about 20% that a woman will conceive (become pregnant) during any one menstrual cycle. In an average 28-day menstrual cycle, ovulation occurs about 14 days after the first day of your last period. Other tests, such as a Pap test and blood tests, may be done.

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Planning Your Pregnancy
Good care and a healthy lifestyle before and during pregnancy increase the odds that you'll end your 40-week journey (and begin a whole new one) with a healthy baby in your arms. Also, if you are prepared, it will help your body handle the stress of pregnancy, labor, and delivery. If you're planning to become pregnant and have already planned a pre-pregnancy checkup, good for you-it's a smart move. As a part of this visit, your doctor will ask about your medical and family history, medications you take, any past pregnancies you've had, and your diet and lifestyle. Your answers will help your doctor decide whether you need special care during pregnancy. Some women have medical conditions-such as diabetes, high blood pressure, and seizure disorders-that can cause problems during pregnancy. Be sure to let your doctor know if a past pregnancy was complicated by diabetes, high blood pressure, premature labor, preterm birth, or birth defects. Folic acid, taken before pregnancy and for the first 3 months of pregnancy, can reduce the risk of neural tube defects.

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Endometriosis
Sometimes, tissue like that which normally lines the inside of the uterus grows elsewhere in the body. Endometriosis can cause pain before and during the menstrual period. For some women, the pain is mild. Severe endometriosis also may lead to infertility. Endometriosis can cause pain and infertility. Endometrial tissue outside the uterus responds to changes in hormones. Severe endometriosis also may cause infertility. If other causes of pelvic pain can be ruled out, your doctor may treat endometriosis without doing any further exams or surgery. Although treatments may relieve pain and infertility for a time, symptoms may come back after treatment.

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Laparoscopy
To diagnose certain problems, a doctor needs to look directly into the abdomen and at the reproductive organs. The word laparoscopy comes from the Greek words that mean "look into the abdomen. It is also used to check for ectopic pregnancy, causes of pelvic pain, and masses. Besides using the laparoscope to look into the abdomen to diagnose a problem, your doctor can use it for treatment as well. For some procedures, laparoscopy has replaced the need for laparotomy. Laparotomy involves opening the abdomen to operate on reproductive organs. Laparoscopy is often used to diagnose causes of abdominal pain. If the doctor finds that he or she can treat the condition during the procedure, diagnostic laparoscopy can turn into operative laparoscopy. When a woman has pain in her lower abdomen during early pregnancy, the doctor may suspect an ectopic pregnancy. Laparoscopy: A surgical procedure in which a slender, light-transmitting instrument, the laparoscope, is used to view the pelvic organs or perform surgery.

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Uterine Fibroids
Uterine fibroids are benign (not cancer) growths in the uterus. Many women who have fibroids are not aware of them because the growths can remain small and not cause symptoms. Fibroids can cause problems because of their size, number, and location. Like any growth, fibroids should be checked by a doctor. Uterine fibroids are growths that develop from the cells that make up the muscle of the uterus. Fibroids may appear on stemlike structures or be attached directly to the inside or outside of the uterus. Fibroids occur more often in black women than in white women. Fibroids also may cause infertility. Fibroids may cause no symptoms and require no treatment.

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Hysterosalpingography
Hysterosalpingography (HSG) is a procedure used to diagnose certain problems of the uterus and fallopian tubes. HSG most often is used to see if a woman's tubes are partly or fully blocked. Blocked tubes are a common cause of infertility. HSG also is used to help find the cause of repeated pregnancy loss. HSG is a way to diagnose problems of the uterus and fallopian tubes. With HSG, the doctor can check for blockage or growths inside the uterus and tubes. This may help your doctor find the cause of infertility or repeated pregnancy loss (also called repeated miscarriage). Blockage of one or both fallopian tubes causes about 35% of cases of infertility in women. HSG also is done to detect growths or scarring inside the uterus or problems in its size or shape. The fluid slowly is placed through the thin tube into the uterus and fallopian tubes.

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Gonorrhea, Chlamydia, and Syphilis
Infection with gonorrhea and chlamydia causes two of the most common sexually transmitted diseases (STDs). Syphilis, another STD, occurs less often, but can be serious if it is not treated. If you think you may be at risk for gonorrhea, chlamydia, or syphilis, get tested. Gonorrhea and chlamydia often have no symptoms. When symptoms do occur, they may show up 2 days to 3 weeks after infection. Pregnant women also may be offered testing for gonorrhea and chlamydia.

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How to Prevent Sexually Transmitted Diseases
Sexually transmitted diseases (STDs) are infections that are spread by sexual contact. Except for colds and flu, STDs are the most common contagious diseases in the United States, with about 12 million new cases of STDs each year. The human immunodeficiency virus (HIV) is a virus that causes acquired immunodeficiency syndrome (AIDS). Acquired Immunodeficiency Syndrome (AIDS): A group of signs and symptoms, usually of severe infections, occurring in a person whose immune system has been damaged by infection with human immunodeficiency virus (HIV). Chlamydia: A sexually transmitted disease that can cause pelvic inflammatory disease, infertility, and problems during pregnancy. Genital Herpes: A sexually transmitted disease caused by a virus that produces painful, highly infectious sores on or around the sex organs. Gonorrhea: A sexually transmitted disease that may lead to pelvic inflammatory disease, infertility, and arthritis. Human Immunodeficiency Virus (HIV): A virus that attacks certain cells of the body's immune system and causes acquired immunodeficiency syndrome (AIDS). Human Papillomavirus (HPV): A sexually transmitted virus that can cause small growths, called condylomas or genital warts, on or around the genitals. Syphilis: A sexually transmitted disease that can cause few initial symptoms, but may lead to major health problems or death in its later stages.

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Pelvic Inflammatory Disease
Pelvic inflammatory disease (PID) is a broad term used to refer to infection of the uterus, fallopian tubes, or ovaries. About 1 million women are treated for PID in the United States each year. About 1 in 7 women are treated for PID at some point in their lives. PID often can be treated with success, but the infection still may damage a womanís reproductive organs and cause long-term problems. PID most often affects sexually active women during their childbearing years. Most cases of PID are thought to stem from sexually transmitted diseases (STDs). Without treatment, the same organisms that cause these diseases can also cause PID. PID may cause severe symptoms, minor symptoms, or no symptoms at all.