Fertility is a highly personal issue, and different families face different challenges. But there are helpful steps you can take when you’re ready to conceive, and medical interventions which can help if you can’t. If you’re struggling to conceive, remember that you are not alone. When it comes to falling pregnant naturally, the odds are not always in your favour. One in six couples have difficulty conceiving.
See Also: Conceiving Your Baby
Some background
If you are having trouble conceiving, first believe us when we tell you that you are not alone, and second, be ready to talk about the problem, because there are lots of ways you can get help.
Getting pregnant at the drop of a hat is not as common as our sex-education classes might have led us to believe. In fact, recent research suggests that a 25-year-old has only an 18 percent chance of falling pregnant in the first three months of trying. For a 40-year-old woman, this number decreases to seven percent.
A couple is not diagnosed as having fertility issues until they have been trying to conceive for over a year with no success; yet, a year can feel like a long time. Once pregnant, staying that way is more of a lottery than many mothers may realise—as many as 50 percent of all pregnancies end in miscarriage, most often before a woman misses a period or knows she’s pregnant.
See Also: All You Need To Know About IVF
Know your ovulation
There’s a difference between having sex and having sex to try to conceive. Yes, the two go hand-in-hand and sometimes you manage to conceive without even trying (whoops!). But if you are one of the more than half of women for whom it takes six months or more to conceive, then timing will play a big part in your journey.
This is where tracking your ovulation comes in.
Ovulation occurs when a mature egg is released from one of your ovaries and pushed down the fallopian tube in order to become fertilised. When, as occurs more often than not, the egg is not fertilised, it gets shed during menstruation, along with the lining of the uterus that built up to accommodate a potential foetus.
It’s an oversimplification that women ovulate on the 14th day of their cycle, based on the myth that all women have 28-day cycles. Yes, some women do have very regular, four-week cycles. But it’s also quite normal for cycle length to vary from 21 to 40 days—even just for one woman! And while ovulation falls in the middle of the cycle, it does not reliably fall smack dab between the first day and the last.
See Also: The Fertility Facts
Basal body temperature
To gain an accurate idea of when you’re ovulating, get in the habit of taking your basal body temperature (BBT), which is the lowest body temperature attained during rest. For best results, take it as soon as you wake up every morning with a thermometer that measures out to two decimal places.
Tracking these temperatures will give you an accurate idea of when you’re ovulating, as you will see a sustained increase of 0.2 degrees Celsius on those days. Your BBT can also tell you when you’re pregnant, sometimes even before a pregnancy test. Eighteen consecutive days of elevated temperatures are an indication of pregnancy.
Fertility awareness method
Some couples use basal body temperature as a natural birth control method. Doctors don’t recommend this, as it has a one-in-four failure rate. Sperm can live in a woman’s body for up to six days, so if you are having sex before ovulation, it’s possible that a pregnancy may still occur even if you avoid the ovulation days.
No luck, now what?
If you’ve been trying to conceive without result for twelve months, it’s time to make an appointment with your doctor. They will be able to help you understand what may be happening and possible next steps.
Your doctor will perform a routine exam, making sure that everything is fine with your reproductive system. Conditions such as Polycystic Ovarian Syndrome (PCOS), endometriosis, fibroids or even a cyst on your ovaries can cause complications with fertility. An exam will be able to detect any of these issues, and your doctor will be able to guide you with regard to what to do next.
It’s also time for your partner to visit the doctor for a male fertility test. While infertility issues tend to be considered a female problem, falling sperm count causes problems just as often. A male fertility test will assess your partner’s sperm, checking to see if the sperm concentration is above or below 20 million sperm cells per millilitre of ejaculation fluid.
Can I take anything?
One reason the subject of infertility can be scary is that the leap between trying to make a baby the old-fashioned way and the world of in-vitro fertilisation is a huge one.
However, somewhere between these two are medications that may help, and your doctor will be able to determine what is right for you. Clomiphene citrate, metformin, bromocriptine and recombinant FSH injections such as Gonal F or Puregone can all be used to help with ovulation problems.
There are also over-the-counter remedies such as Elevit, Cod Liver Oil and vitamins that may have a positive effect. Herbal supplements that have been suggested to help when trying to conceive include Red Raspberry Leaf, Nettle Leaf, Dandelion, Alfalfa, Red Clover and Maca.
Intrauterine insemination (IUI)
IUI is a fertility treatment that involves directly inserting sperm into a woman’s womb. This treatment is more commonly used by single women seeking to have a baby on their own, as well as female couples; however, it is sometimes used by heterosexual couples.
IUI separates the better-quality sperm from the sluggish, non-moving or abnormally shaped and then injects them directly into the womb. IUI is less invasive and less expensive than IVF, but it has a lower success rate and often necessitates trying more than once.
In vitro fertilisation (IVF)
If you have been trying to get pregnant for two years, it could be time to consider IVF. Discuss it with your doctor to see what’s right for you.
During IVF, an egg is removed from the woman’s ovaries and fertilised with sperm in a laboratory. The fertilised egg, or embryo, is then returned to the woman’s womb to grow and develop. IVF can be done with your own eggs and your partner’s sperm, or with eggs and sperm from donors.
IVF is the most expensive but also the most effective fertility treatment. It can also be disruptive, requiring patients to inject themselves with hormones that add another layer to an already stressful and emotional process.
Not Alone
Fertility problems affact one in six couple in the UK and can be caused by a multitude of conditions. The most common causes fall into two categories: ovulation failure and sperm disorders – these can occur from hormonal disorders or disorders of the reproductive systems, among other things. However, in 25 percent of couples, fertility problems can’t be explained. So, if you are having trouble, remember that there are countless other couples who are going through the same thing.
Find a support group, keep the line of communication open with your partner who is probably feeling just as alone an frustrated, and stay positive. hile make a baby is a natural thing, it doesn’t always happen naturally.
This feature was originally published in the winter edition of Live to 100 with Dr Hilary Jones, which you can read here
