Infertility can be an emotional and trying time for couples who want to start a family. Infertility means that a couple has been trying to get pregnant for at least a year with no success.
Perhaps the most frustrating part of infertility is the search for an answer to the elusive question: “Why?” Infertility can be from female factors, male factors or a combination of both. Your healthcare provider can help you try to sort out the cause, and discuss possible treatment options. The process is different for a man and a woman, but the end goal is the same: a healthy baby.
Top factors for women to consider when faced with infertility
Ovulation
Ovulation is often the first thing a physician will look for in a female who is hoping to conceive. Basically, are they making eggs?
One clue is whether the woman is having regular monthly cycles, which are usually a sign of ovulation. Women can keep track of their menses with a calendar or with an app. The first day of bleeding is day one, and most women will ovulate on day 14, which is the day a woman is most likely to conceive. Women with a regular cycle can increase their chances of pregnancy by having intercourse on days 12, 14 and 16. Couples should avoid daily intercourse that can decrease sperm count.
Abnormal Cycles
If a menstrual cycle is not regular, ovulation may not be occurring. For women who do not have normal monthly cycles, over-the-counter urinary ovulation prediction kits can help determine when ovulation takes place. These kits detect luteinizing hormone (LH) and are highly effective for predicting the timing of the LH surge that reliably indicates ovulation.
If the test is positive at some point during the month, the women is likely ovulating and her chances of becoming pregnant increase by having intercourse when the ovulation test is positive.
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Weight Factor
If the ovulation tests are never positive, this may be the root of conception trouble. There can be many reasons a woman doesn’t ovulate, but one of the most common causes is being overweight. Weight loss can help regulate ovulation cycles.
For most women, the goal is to get down to a healthy BMI, but studies show that losing 10 percent of current body weight can sometimes help ovulation return. Eating a healthy diet, avoiding sodas and junk food and exercising regularly can also help. In fact, studies also show that exercise can help with infertility, so get active! Women should exercise at least three days a week, and those who are trying to lose weight should exercise most days of the week. If weight is not an issue, an OBGYN may be able to induce ovulation with medicine.
Physical Barriers
Sometimes infertility is due to scarring or abnormalities of the fallopian tubes, cervix or uterus that prevents the sperm and egg from meeting. Prior treatments or surgeries for abnormal Pap smears or pregnancy loss may be the cause of such scarring. Another risk factor is a history of sexually transmitted diseases, especially Chlamydia.
An OBGYN may order a hysterosalpingogram (HSG) to help diagnose a blockage or structural abnormality. Conducted by radiologists, this imaging procedure involves injecting fluid through the cervical canal to evaluate the uterine cavity and fallopian tubes. An HSG can also sometimes help unblock the tubes and aid in conception.
The Male Factor
Considering abnormalities in the male partner is a very important step in uncovering source of infertility. An OBGYN may order a semen analysis for a man. If abnormalities are found, he should follow up with a urologist.
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Prenatal Care Starts Now
Women considering pregnancy should also meet with their OBGYN to discuss conceptions plans. It is also important to optimize personal health before pregnancy by taking a prenatal vitamin, avoiding certain medicines and controlling pre-existing medical conditions such as diabetes and thyroid disorders.
Couples also do not need to wait through a year of trying to conceive before talking to a doctor. Often, a physician will be able to offer tips to increase the chances of pregnancy or can uncover potential problems just by chatting with patients. Providers can also suggest affordable interventions couples can do prior to expensive tests or visits with infertility specialists. Couples should also consider being evaluated before the one-year mark if they have concerns about fertility or either partner has a known infertility risk.