Difficulty getting pregnant: why, what to do and when to seek fertility care

Motherhood is a very important aspect of life for many women and the greatest step in starting a family. However, many couples nowadays are facing difficulties despite their efforts. In this brief article we will discuss several tips for improving the odds at home and the cases where professional fertility care is advised.

1. Are you certain you are having problems?

Despite the answer seeming obvious, many couples are actually quick to panic and unnecessarily so. By the medical definition, infertility is diagnosed after at least one year of frequent attempts to achieve pregnancy, especially during the fertile days of the menstrual cycle (also read below). So, during the busy routine of current times in particular, it is important to take your time and make enough attempts prior to seeking further assistance.

2. Proper intercourse practices – maximize your fertility potential

It is vital to ensure optimal conditions to achieve pregnancy, therefore intercourse is advised during the fertile days of the menstrual cycle, namely on the day of ovulation, as well as on the day before and the day after, with up to five days before ovulation being considered fertile as well, though not to the same degree. In women with a stable menstrual cycle, ovulation occurs 14 days before menstruation, therefore menstruation journals and phone apps can assist with the timing. If you are experiencing instability, or are unsure, ovulation tests or a visit to your gynecologist will help you.

Regarding intercourse itself, it should take place every 1-3 days during the fertile period of the cycle and ejaculation must occur within the vagina. Different positions or resting afterwards don’t affect the odds and some lubricant agents have been shown to affect sperm motility, therefore instructions and side-effects must be checked prior to use, or avoided completely.

3. Impact of psychological factors: stress and depression

Years of medical research have proven the correlation of stress and depression with infertility, with 35-55% of women seeking fertility care exhibiting symptoms. Several activities may help in combating these symptoms, namely sequential muscle relaxation, breathing techniques, yoga exercises, hobbies and outdoors activities, in particular with your significant other and, as cliché as it might sound, positive thoughts, probably assisted by keeping a journal of positive experiences. Note that some methods might be less effective than others, which should not disappoint you or make you give up. You should find the activities that suite you. However, there might also be cases where professional help is required.

4. The importance of healthy diet and body weight

The cornerstone of combating any health problem, a diet rich in fruits and vegetables, whole-grain products, poultry, fish and with minimal saturated fats, red meat and sweets has been shown to significantly improve fertility potential in females and sperm quality in males. Dietary supplements, namely folic acid (400-500mcg daily) and less so omega-3 fatty acids, antioxidants and Vitamin D have been shown to positively impact fertility as well. Normal body weight, namely a BMI of 19 to 25 is also important, as extreme deviations to either side of the spectrum can lead to anovulation, unstable cycles, drop in oocyte quality and in endometrium receptivity, thus to an overall reduction of fertility potential. However, keep in mind that achieving normal weight must be a gradual process and that in extreme cases a nutrition specialist should be consulted.

5. Dropping bad habits

The usual suspects, namely alcohol and smoking are at play in infertility as well. Alcohol consumption should be limited to 1-2 alcohol units for women and 4 for men weekly, though ideally it should cease altogether, as it greatly diminishes fertility potential, especially in males, causing a drop in sperm quantity and quality. Smoking of conventional, as well as of more modern tobacco products also negatively impact fertility in both genders. Caffeine may also impact fertility, although to a lesser extent, with 1-2 coffees per day being a safe quantity.

6. Treating chronic ailments

Several common endocrine/metabolic diseases, such as diabetes or thyroid disease can impact fertility if not effectively treated. Consult your physician and ensure proper control for optimal fertility potential.

7. When to seek professional fertility care

In general, a young, healthy couple has a 25-30% chance to conceive within the first months of attempts and an 80% chance within the first year. If you have followed all the aforementioned tips and still were unsuccessful, then a fertility specialist might be the solution you need. Additionally, you should seek fertility care in the following cases:

  • When there is a genetic disease in your or your significant other’s family.
  • When you are under medication for chronic diseases, as many drugs affect fertility and alternative medication might not be available.
  • If you are 35 or older and have unsuccessfully tried for 6 months
  • If you are 40 or older, immediate fertility care is advised, since precious time should not be wasted beyond this age
  • When you have prominent symptoms associated with infertility, namely:
    • Females: unstable menstruation and or complete lack of it (amenorrhea), pain during intercourse, heavy and painful menstrual bleeding, intermenstrual bleeding (spotting), hormonal disorder symptoms (acne, increased face and body hair etc)
    • Males: testicular swelling or pain, impotence, loss of libido, ejaculation difficulties etc
  • If you have a personal history of autoimmune disorders or a family history of premature ovarian failure or recurrent miscarriage.
  • If you or your significant other have undergone chemotherapy and/or pelvic radiotherapy

Overall it is important to remember that up to 2 out of 10 couples are facing difficulties conceiving and that it not something to be guilty or shameful for. When all other alternatives fail, keep in mind that capable professionals are there to help you.

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