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There is no way to prevent infertility because there are many factors that contribute to your ability to ovulate, conceive and carry a pregnancy to term. Likewise, your male partner also has numerous factors—natural and environmental—that can contribute to infertility. The condition is not exclusively a woman's problem. About one third of infertility cases involve male factor problems alone, and approximately one third involve problems with both partners.

For women, factors that could lead to infertility include:

• Being very overweight or very thin, either of which can affect ovulation and fertility.

• Chronic, debilitating diseases, such as unregulated diabetes, lupus or thyroid problems that can interfere with normal ovarian function. Also, some medications such as high-dose steroids can interrupt ovulation. If you have a chronic health condition, be sure to discuss it with your health care professional. Most women with chronic conditions can become pregnant, have a healthy pregnancy and deliver a healthy baby.

• Polycystic ovarian syndrome (PCOS). Symptoms include lack of periods, excessive facial hair and acne

• Treatment for abnormal Pap smears, including cryosurgery or cone biopsy that can affect the structure of the cervix.

• Hormonal imbalances that cause abnormalities in your menstrual cycles.

• Multiple miscarriages (two or more early pregnancy losses).

• Environmental factors, such as cigarette smoking, alcohol consumption and exposure to workplace hazards or toxins.

• Age. Even if your fertility does not seem at risk now, remember that fertility declines with age; a woman at age 39 has a 7 percent chance of getting pregnant per month compared to a 20 percent chance per month at age 29.

• Sexually transmitted diseases (STDs), which occur at a rate of 12 million cases each year in the U.S. Some STDs don't cause symptoms at first but, if left untreated, can lead to pelvic inflammatory disease (PID)—an infection of the upper genital tract that may compromise fertility. Complications from STDs are more common in women, including scarring and adhesions that can block fallopian tubes, ectopic pregnancy and miscarriage. To reduce your risk of STDs, use latex condoms during sex, avoid having sex with multiple partners and see a health care professional if you have any unusual reproductive symptoms. Also make sure your partner is treated if you do have an STD.

• Fallopian tube disease accounts for about 15 percent of infertility cases. If you are having trouble conceiving, or are worried about your future fertility, tell your health care professional if you have ever had pelvic pain, unusual vaginal discharge, bleeding or fever; pelvic surgery for ruptured appendix, ectopic pregnancy or ovarian cyst; or have used an IUD for contraception.

• Endometriosis, a disease in which uterine tissue is found outside of the uterus, typically on the ovaries, fallopian tubes bladder and bowel, occurs in menstruating women of all ages. While the connection between endometriosis and infertility is not clearly understood, advanced-stage endometriosis makes it very difficult for the egg and sperm to reach each other. Treatment of early-stage endometriosis doesn't seem to make a difference in pregnancy rates, but knowing you have it may influence your choice of reproductive technology. Be sure to report these symptoms to your health care professional: painful menstrual cramps that get worse over time, extremely heavy menstrual flow, diarrhea or painful bowel movements (especially around the time of your period) and painful sexual intercourse.

For men, a variety of factors can lead to infertility. Many researchers believe the causes of declining male fertility during this century are environmental, including pesticide and chemical exposure, drug use, radiation and pollution. Specific risks include:

• Exposure to toxic substances or hazards on the job, such as lead, cadmium, mercury, ethylene oxide, vinyl chloride, radioactivity and x-rays

• Cigarette or marijuana use

• Heavy alcohol consumption

• Prescription drugs for high blood pressure (calcium channel blockers), ulcers and psoriasis

• Chronic exposure of the genitals to elevated temperatures as may occur in some occupations can diminish sperm counts. Occasional visits to the sauna or hot tub will have no effect, however. Though some men may prefer boxers over briefs, boxers aren't any better for sperm production.

• Medical risks, including hernia repair, undescended testicles, history of prostatitis or genital infection, and mumps after puberty

• Some STDs can lead to epididymitis (inflammation of the duct that carries sperm). Ultimately, infertility can be a consequence of STDs. To decrease this risk, practice safe sex by using latex condoms. Also have any unusual symptoms checked out and treated early—and make sure both partners are treated simultaneously.

Infertility Research

Infertility research is very robust. Recent efforts include:

• Pre-implantation genetic diagnosis. This procedure involves evaluating the chromosomes of a single cell obtained from an early developing embryo before the embryo is implanted during an IVF procedure. The purpose is to avoid implanting embryos with genetic abnormalities, therefore increasing the chances of a successful pregnancy.

• Stem-cell research. This involves using cells from donated frozen embryos to create cells that can be grown into healthy replacements for diseased organs or tissues. Stem-cell research may also lead to method for making new eggs for women who have poor quality or few eggs.

• Genetics and male factor infertility. The more we learn about the origins of male fertility problems, the more we find they have a genetic origin. Understanding and preventing the genetic errors that lead to poor sperm quality can lead to better management of sperm problems.