Dr. Mary Wingfield:

On the Chairman's question regarding who needs treatment, I often say to patients that to get pregnant the woman needs to be producing eggs, the man needs to have a sperm and the woman's pelvis needs to be normal for a natural conception. That is basically it. In the case of some couples the woman will not be ovulating and may need fertility drugs to help her ovulate but if her partner has a sperm problem as well, then IVF may be a better treatment. In the vast majority of male factor fertility where there are sperm issues, IVF is often the only treatment and people are often surprised about that. The first test one does on a man is a semen analysis and one can see straightaway that for many men no other treatment will work except IVF. People are often surprised about that and will ask if they could not try some other treatments first. Therefore, male factor infertility is a very big cause of the necessity for IVF treatment. If a woman has damaged fallopian tubes or has had ectopic pregnancies and has had her fallopian tubes removed, then the only way she can get pregnant is with IVF treatment, or in the case of women who have endometriosis or who have had many surgeries for Crohn's disease or other conditions, their pelvis will not be normal and they will need IVF treatment. There are many different reasons involved.