Many couples want to start a family after being together for a while, and get to a point when they want to learn about the steps to take before trying to conceive. They consult their doctors to talk about what kind of diet to stick with, and what foods to avoid while trying to achieve a pregnancy. Their doctors will likely tell them that conception can take a while to happen, and to allow them a year.
However, if a couple has adopted a healthy lifestyle and has been trying for a baby for a year, without a pregnancy occurring, unfortunately there could be a fertility issue getting into the way. If this has been your story, then it is time to go back to your doctor to let him or her know that you have tried to conceive for a year, without achieving any pregnancy. Your doctor will refer you to a fertility clinic so the issue can be examined further.
There are so many factors that can explain why getting pregnant is less likely to happen without assistance from a fertility specialist. The fertility doctor will be assessing the couple, and eventually determine what course of action needs to be taken in order to help make their dreams come true.
Fertility Issues that Women May Face
Problems with Ovulation
It is possible that your general practitioner may run tests on you such as blood work, and arranging for ultrasound technician to do an ultrasound on your reproductive system before referring you to a fertility clinic. However, regardless of whether a problem has been detected or not, your doctor will still end up sending you to a specialist. Many women do not ovulate on a regular basis, and knowing why is not always easily determined. The common cause for irregular ovulation is due to a condition that many women have that is called polycystic ovarian syndrome (PCOS). That is caused by high testosterone levels which can prevent ovulation from occurring on a regular basis. Fortunately, there are fertility drugs such as Clomid which is sometimes referred to as Serophene that can regulate a woman’s cycle, and help her ovulate regularly. If this happens to be your case, then achieving a pregnancy should happen fairly quickly, as long as no other issues with the reproductive system come into play.
Blocked or Damaged Tubes
Before you are put on any kind of fertility medication to help with ovulation, your fallopian tubes will have to be checked. Your fertility specialist will do a test by injecting dye into your tubes to make sure they are open. This procedure is called a hysterosalpingogram, or HSG. If a blockage is found, then tubal surgery can help fix this condition.
Excessive Tissue Growth
Every woman has tissue that lines inside of the uterus. However, when that tissue starts growing outside of the uterus, then not only is it extremely painful, but it can create an obstacle when it comes to achieving a pregnancy. This condition is called Endometriosis and there are many causes. Most of the time this can be corrected with surgery, however in severe cases it cannot be helped.
However, there are plenty of times that the woman is fine. That being said, you may not have anything wrong with your fertility. And in that case, your husband’s or boyfriend’s fertility needs to be looked at.
Fertility Issues that Men Face
If men have a fertility problem, that means they have a very low sperm count and/or poor motility, which means their sperm swim very slowly and not fast enough to go through the path to fertilize an egg.
Sperm can also have poor morphology which means the structure of the sperm is poor which can either not allow the sperm to fertilize an egg, or if a pregnancy is achieved, it may not end up becoming healthy or viable. There are several causes behind poor sperm quality.
Low Testosterone Levels
In some cases, having low testosterone is the cause behind poor sperm quality. Testosterone replacement therapy may be used to help improve the quality.
Undescended Testicles
Many boys are born with their testicles undescended, and the issue never corrects itself as they get older. That can be a cause for low sperm quality in men. There is not much that can be done to improve sperm quality in this situation. However, as long as good quality sperm can be salvaged through a working testicle, there are treatment options that will be discussed later.
In many cases, couples who are facing infertility have to undergo procedures in addition to taking medication. Especially in a situation where very little can be done to help a man’s sperm quality.
Intrauterine insemination (IUI)
This particular fertility procedure is very common, and has a pretty good success rate. Another term for this treatment is artificial insemination. This can help a pregnancy happen when low sperm quality comes into play. A man ejaculates into a specimen cup, and the sperm is washed. There will be little sperm to work with, but the sperm that has the best quality and motility will be saved. Then the specially prepared sperm will be injected into the uterus. This way, the sperm doesn’t have the long path to go in order to fertilize the egg since there is less to work with. Many times, women may be encouraged to take fertility medications to stimulate ovulation before performing this procedure. Even if she doesn’t have fertility issues herself. Although some procedures will coordinate with the woman’s normal cycle.
There are other instances where sperm quality and ovulation are not a problem, but the woman’s mucus contains lethal properties to the sperm, and through IUI, that can be avoided.
However, most clinics don’t want to do more than 6 attempts. If pregnancy is not achieved this way, then the next step has to be taken.
IVF or In vitro fertilization
IVF or in vitro fertilization is quite well known, and is only used in extreme cases. Women who are undergoing in vitro have to take a numerous amount of fertility drugs to stimulate follicle production. Their egg growth will be monitored closely and once maturation is ready to happen, then procedure will be done. IVF involves the specialist to combine sperm and eggs in a dish in a laboratory to create embryos.
After the embryos are created, they are then transferred to the uterus after a certain period of time where they may implant and develop. Keep in mind that not all embryos are transferred on a given IVF cycle. That way the risk of multiple births is kept low. However, there are also different types of IVF procedures to keep in mind. It depends on what is causing the fertility blockage.
Sperm Injection
If sperm quality is for the most part very poor, there is a procedure called intracytoplasmic sperm injection (ICSI) where the fertility specialist injects a sperm in the egg. If fertilization occurs, the resulting embryo is placed in the uterus. This is far more complex than standard IVF because a single sperm is physically being injected into an egg instead of waiting for sperm to meet with an egg in a dish for fertilization to happen.
Preimplantation Genetic Diagnosis
Preimplantation genetic diagnosis (PGD) is an IVF procedure that also involves ICSI. However, infertility is not the reason this procedure is done. If the couple carries the same mutation that can lead to their child ending up with a disease, such as cystic fibrosis or Tay-Sachs disorder- then this particular procedure can prevent that from happening by placing genetically tested healthy embryos into the womb. Diseases embryos will be either discarded or sent off to research, depending on what the couple wishes.
Regardless of what fertility treatment is being used, undergoing the procedure can be financially and emotionally draining. And worst of all, there is never a guarantee for any of it to work. Especially if the issue is complex.
Other options will have to be looked at if every attempt has been tried with no success. Some of those options are donor eggs as well as donor sperm. Surrogacy is another option where another healthy woman can carry the couple’s embryo to term. Or if a couple is open to loving any child, adoption is always an option. However, these choices are also quite costly and emotionally draining.
Whenever a couple faces infertility, the journey is long, difficult, expensive and exhausting. However, one way or another they usually end up with the result they want.
