Infertility means not becoming pregnant after having frequent, unprotected sex for one year or longer. If you are age 35 or older, infertility can be diagnosed after six months. Infertility also includes situations where you can get pregnant, but the pregnancy ends in repeated miscarriage or stillbirth.

Infertility is common. It can affect both men and women. Sometimes both partners contribute to the cause.

Infertility can happen because of a health issue in you or your partner or a mix of factors. In some cases, no clear cause is found.

• Failure to ovulate, often due to conditions like polycystic ovary syndrome (PCOS)
• Blocked or damaged fallopian tubes (the tubes that carry eggs from the ovaries to the uterus), often caused by past sexually transmitted infections (STIs), pelvic inflammatory disease, or abdominal (belly) surgery
• Conditions affecting the uterus (womb), such as fibroids or endometriosis
• Problems producing eggs, which may occur with aging
• Hormonalimbalances, such as having too much estrogen

• Low sperm count
• Sperm that doesn't move well
• Blocked sperm ducts
• Hormonal imbalances, such as having too much testosterone

Certain lifestyle habits can also raise your risk of infertility. These can include smoking, heavy alcohol use, and being very overweight or underweight. Older age and some health conditions may increase your risk as well.

Your health care provider will ask about your health history and may do a physical exam. Testing is different for women and men. It may include blood tests, imaging tests, and a semen test for men.

Treatment depends on the cause, how long you've been trying to get pregnant, and your age. Some treatments are for men, some are for women, and some involve both partners. Common options include treatment for the underlying cause, medicines,assisted reproductive technology, and surgery.

Infertility can be stressful. Counseling and support groups may help you and your partner cope. Many couples who receive treatment go on to have children.

Not all cases of infertility can be prevented, but practicing healthy habits may help lower your risk:

• Quit smoking, or don't start
• Limitalcohol
• Maintain a healthy weight
• Practice safe sex to prevent STIs, except when you're trying to get pregnant

If you're ready to try to get pregnant, see your provider if you are over age 40, haveirregular periods, have a history of pelvic inflammatory disease, or have had fertility concerns in the past.

NIH: National Institute of Child Health and Human Development

Iron is a mineral that our bodies need for growth and development. Your body uses iron to make hemoglobin, a protein in red blood cells. Hemoglobin carries oxygen from the lungs to all parts of the body. Iron is also important for healthy muscles, bone marrow, and organ function. Your body also needs iron to make some hormones.

Iron is found naturally in many foods and is added to some fortified food products. Foods that are high in iron include:

• Lean meat, seafood, and poultry
• Iron-fortified breakfast cereals and breads
• White beans, lentils, spinach, kidney beans, and peas
• Nuts and some dried fruits, such as raisins

Iron is available in supplements, either on its own or as part of many multivitamin/mineral supplements.

Most people in the United States get enough iron. The amount that you need each day depends on your age, your sex, and whether you consume a mostly plant-based diet.

Sometimes people can have trouble getting enough iron. There can be many causes, including blood loss, a poor diet, or a problem absorbing enough iron from foods. Those who are more likely to have low iron include people who:

• Have heavy periods
• Are pregnant or breastfeeding
• Are infants (especially if they were born premature or low birth weight)
• Are frequent blood donors
• Have cancer, certain digestive diseases, or heart failure
• Are on kidney dialysis
• Have trouble absorbing iron because they:
  • Have a digestive condition such as celiac disease, ulcerative colitis, Crohn's disease, or Helicobacter pylori infection
  • Had weight loss surgery

If you have too little iron, you may develop iron-deficiency anemia. It may not cause symptoms at first, but over time, it can cause fatigue, shortness of breath, and trouble with memory and concentration. Treatment for low iron and iron-deficiency anemia is usually with iron supplements.

Too much iron can damage your body. For example, if you are healthy and take too many iron supplements, you may have symptoms such as constipation, nausea and vomiting, abdominal (belly) pain, and diarrhea. Higher iron levels can cause ulcers. Extremely high levels can lead to organ damage, coma, and death.

A disease called hemochromatosis can cause too much iron to build up in the body. Hemochromatosis is inherited (passed down through families). It is usually treated by removing blood (and iron) from your body on a regular basis.

NIH: National Institutes of Health, Office of Dietary Supplements

You have two kidneys, each about the size of your fist. They are near the middle of your back, just below the rib cage. Inside each kidney there are about a million tiny structures called nephrons. They filter your blood. They remove wastes and extra water, which become urine. The urine flows through tubes called ureters. It goes to your bladder, which stores the urine until you go to the bathroom.

Most kidney diseases attack the nephrons. This damage may leave kidneys unable to remove wastes. Causes can include genetic problems, injuries, or medicines. You have a higher risk of kidney disease if you have diabetes, high blood pressure, or a close family member with kidney disease. Chronic kidney disease damages the nephrons slowly over several years. Other kidney problems include:

• Cancer
• Cysts
• Stones
• Infections

Your doctor can do blood and urine tests to check if you have kidney disease. If your kidneys fail, you will need dialysis or a kidney transplant.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Laboratory tests check a sample of your blood, urine, or body tissues. A technician or your doctor analyzes the test samples to see if your results fall within the normal range. The tests use a range because what is normal differs from person to person. Many factors affect test results. These include:

• Your sex, age and race
• What you eat and drink
• Medicines you take
• How well you followed pre-test instructions

Your doctor may also compare your results to results from previous tests. Laboratory tests are often part of a routine checkup to look for changes in your health. They also help doctors diagnose medical conditions, plan or evaluate treatments, and monitor diseases.

Legionnaires' disease is a serious type of pneumonia caused by Legionella bacteria. The disease got its name when a group of people at an American Legion convention became ill with this type of pneumonia.

Legionella is found naturally in freshwater, such as lakes and rivers. It can also be found in soil. But people usually only get sick from it when if it grows and spreads in man-made water systems. These systems can include hot tubs, fountains, and the plumbing systems of large buildings, such as hotels or nursing homes.

Legionella can also cause Pontiac fever. This is a milder, flu-like illness that doesn't infect your lungs.

You usually can't get infected by drinking water that contains the bacteria unless you aspirate it (accidentally breathe the water into your lungs). The bacteria don't spread from person to person. Disease outbreaks happen when many people are exposed to the same water source that contains the bacteria.

Most healthy people who come in contact with the bacteria do not become sick. You are more likely to develop an infection if you:

• Are over the age of 50
• Are a current or former smoker
• Have a chronic (long-lasting) disease such as diabetes or kidney failure
• Have a chronic lung disease such as COPD or emphysema
• Have a weakened immune system due to a disease such as HIV or cancer or are taking medicines that suppress your immune system
• Live in a long-term care facility
• Have recently stayed in a hospital or had surgery requiring anesthesia

The symptoms usually show up 2 to 14 days after you were exposed to Legionella bacteria. Most of the symptoms are similar to those of other types of pneumonia. But Legionnaires' disease may also cause gastrointestinal symptoms and mental changes.

The symptoms of Legionnaires' disease may include:

• Cough
• High fever
• Chills
• Headache
• Chest pain
• Shortness of breath
• Fatigue
• Nausea and vomiting
• Diarrhea
• Confusion

Legionnaires' disease can cause life-threatening complications such as respiratory failure, kidney failure, and sepsis.

About 1 out of every 10 people who get sick with Legionnaires' disease will die from complications of the illness.

To find out if you have Legionnaires' disease, your health care provider will probably order a chest x-ray to see if you have pneumonia. If you do have it, lab tests such as a urine or sputum test can check for the Legionella bacteria. Your provider may also order a blood test to see if you have been exposed to the bacteria.

If you have Legionnaires' disease, you will likely need care in a hospital. The treatment is with antibiotics. Most people will recover, especially if they were healthy when they got the disease. Getting treatment early can increase the chances of getting better.

You can lower your risk of getting Legionnaires' disease if you:

• Clean all your water-related devices regularly. This could include portable humidifiers, water heaters, air conditioners, and nasal rinses.
• If you haven't used your faucets and showerheads for a week or more, flush them by letting the hot and cold faucets run for at least two minutes before use.
• Avoid exposure to water sources such as decorative foundations or hot tubs if you don't know how well they are maintained.
• Use windshield cleaner in your wiper fluid tank in your car instead of water.
• Ask about how well your buildings' water systems are maintained.

Centers for Disease Control and Prevention