Ironically, there are two diametrically opposed social issues in the news: perpetual singles, a la Ally McBeal, and difficulty with conception. If your interest tends toward the second category, congratulations on having reached the child-bearing plateau -- but you know that this plateau also has its share of heartache. One approach is fertility treatment, but is it right for you? And what risks, including multiple pregnancies and increased risk of ovarian cancer, are involved? Are You Infertile? The American Society for Reproductive Medicine reports that about 5.3 million people are affected by infertility nationwide. How do you know if you have an infertility problem? If you and your partner are younger than 30 and have engaged in unprotected, well-timed intercourse for more than a year or the woman has been unable to carry a pregnancy to term, chances are one or both of you are infertile.Treatment, says the ASRM, almost always consists of drug therapy or surgery to repair reproductive organs. According to Better Health and Medical, when blood and urine tests "suggest some sort of hormone imbalance in one or both partners, corrective therapy with fertility drugs is frequently prescribed." The Drugs The most popular drug is clomiphene citrate, known as Clomid and Serophene, which mainly is prescribed to women with amenorrhea (the absence of menses) or abnormal cycles. The drug goes to work on the hypothalamus. According to the Atlanta Reproductive Health Centre, three to four cycles of treatment should be adequate since research shows 75 to 80 percent of pregnancies occur in the first two or three cycles. Unless combined with insemination, clomiphene will not improve the chance of pregnancy in women who ovulate normally every month. One side effect of Clomid and Serophene, as noted in Better Health and Medical, is poor egg quality. Another is that they can prolong the menstrual cycle, making a woman mistakenly think she has conceived. There's also a risk of multiple births. Another drug actually is a combination of Pergonal and Metrodin, which are naturally occurring hormones excreted in the urine of post-menopausal women. Pergonal acts on the pituitary gland, while Metrodin, or FSH, is the primary natural hormone that stimulates development and maturation of follicles found in the ovaries, which contain oocytes (eggs). During ovulation, eggs are released from the follicles.Fertinex, a highly purified form of FSH, also is available. It's popular because it can be administered just under the skin with a very small needle. As mentioned on the Bay Area Fertility & Gynecology Medical Group site, possible side effects include a temporary enlargement and swelling of the ovary, premature delivery and pregnancy loss. Multiple gestations is another risk, however, 60 to 80 percent of the pregnancies resulting from Pergonal and/or Metrodin are one fetus.A newer, more purified form of FSH is Gonal F, or Follistim Gonadotropin. These drugs are said to have "a more predictable bioeffect [and] fewer contaminants than the current Metrodin, Pergonal, Humegon, or Fertinex" with a track record as high as that of Metrodin. The conception rate is reported to be 15-50%.With all of these drug regimens, there is a chance of developing ovarian cancer. Furthermore, the costs for these drugs can run $200 to $3,000 per month, depending on the drug. Other Options Other options include adoption, in vitro fertilization, egg donation and surrogacy services, insemination (IUI), and various types of surgery. They can cost many thousands of dollars and don't come with a guarantee either. For example, in 1995 the Centers for Disease Control and Prevention in Atlanta reported nationwide success rates of only 20 to 30 percent for "assisted reproductive technology," depending on the woman's age and the treatment used.