It can be disappointing when you realise that getting pregnant is not going to be as easy as you expected. Fertility problems are more common than you might think. The World Health Organization (WHO) indicates that one in four couples in developing nations is affected by infertility. And an estimated 12-15% of American couples have difficulty with conceiving.
A U.S. study showed that as much as 25% did not know the cause of their problem and of those that sought fertility treatment, 47% had gone on to successfully conceive. Note that infertility is not just about failing to conceive. Many cases of stillbirths and miscarriages are also related to fertility issues.
The main concern then becomes when does one consider that infertility may be the reason they are not getting the family they want. Here we will look at the situations when it is advisable to seek medical diagnosis and consider available fertility treatments.
Premarital check-ups should include fertility testing. Family planning concerns can sometimes make or break a marriage, so ensuring you are both healthy enough to have a healthy child is important. By making sure everything is in order, you can more confidently go into marriage and begin to try for a baby.
These tests will delve into the couple’s general state of health, blood tests, and gynaecological exams to detect possible reproductive conditions. Problems brought out at this time do not mean ending the marriage. It is often a good opportunity to get early treatment and increase chances of successful pregnancies later on.
After a year of unprotected sex with no conception
Medical experts recommend giving it at least a year of trial before making such a judgement. You should be under the age of 35 years and have been having regular sex. Regular sex should be unprotected and every 2-3 days. No form of birth control should have been taken during that time. For women over the age of 35 years, this waiting period should be shortened to just 6 months before consulting a doctor.
If 40 years or older
Fertility in women begins to decline in the mid-30s as the quality and number of eggs produced begin to fall. This is why those over 35 years of age are advised to seek medical help if they fail to conceive after 6 months of trying. If the woman has however reached 40, then seeing a doctor even sooner is recommended. The risk of miscarriage also increases as the pregnancies at this age are more high-risk. Your doctor will likely order fertility testing such as an anti-mullerian (AMH) or follicle-stimulating (FSH) hormone test.
Medical history related to reproductive conditions
This can apply to both men and women, though some reproductive conditions can be gender-specific. Some illnesses and their prescribed treatments can have a negative impact on fertility. It could be you have been afflicted by the illness, or are at risk of developing it due to genetics. These can include:
- Breast and reproductive cancers
- Early menopause
- Menstrual conditions like endometriosis and PCOS
- Sexually transmitted infections
Chronic medical conditions
Some medical conditions do not directly link to reproductive organs. They may however still affect your fertility. These can include:
- Hypertension/High blood pressure
- Kidney disease
- Thyroid conditions
If you suffer from chronic conditions like these it is advisable to consult a doctor. Not just because of difficulty in conceiving, but also to ensure a safe pregnancy and birth. The woman will likely need extra monitoring during pregnancy to ensure the condition is well-managed as well.
Erectile Dysfunction (ED)
Being able to achieve and maintain a full erection will directly impact the ability to naturally conceive. While more men are likely to develop ED as they get older, ageing is not the cause of the condition. It is worth noting that it is possible to suffer from this problem due to genetics. If ED is a problem you are facing, speak to your doctor. You will likely be referred to a urologist or other male fertility specialist to help diagnose the cause and find a treatment.
Having a miscarriage is not unusual. It is typically a one-off event with about a third to a half of all pregnancies prematurely terminating. A miscarriage occurs when a pregnancy is lost within 20 weeks of conception. It is termed a stillbirth if the loss happens past the 20-week mark.
Miscarriages often result from chromosomal problems on the part of the egg or sperm that make the fertilized egg unable to develop normally. It can also be caused by poor implantation. Rarely is the mother at fault for this occurrence as the cause is often beyond her control.
If a woman suffers two or more miscarriages, it is advisable to consult with a doctor. Your health will need to be more closely monitored when trying to next conceive and maintain a pregnancy.
Women should become familiar with their menstrual cycles as this information can help in diagnosing potential fertility conditions. Charting your cycle can help determine if there is irregular ovulation. Having no period could indicate that ovulation is not occurring.
The luteal phase is the duration when an egg released during ovulation travels down the fallopian tube and ends when the next menstrual cycle begins. It is during this journey that an egg encounters a sperm and is fertilized. This phase can last anywhere between 11-17 days. If too short a period, it may mean that the uterine lining is not being given enough time to develop and support a growing baby. This can make conceiving harder. Tracking your basal body temperature (BBT) helps to determine when ovulation has occurred so you can chart your luteal phase.
Bleeding between periods can also indicate a reproductive condition like fibroids or cervical lesions. Excessive bleeding is another concern. Any more than 7 days and soaking through a pad or tampon within less than an hour for several hours are signs of this. Such symptoms may indicate the presence of fibroids or some hormonal problem.
If your cycle and bleeding fall outside normal parameters, it is a good idea to consult a doctor as this could be an indication of fertility issues.