Dr. Tariq Jagnarine
Family Medicine, Endocrinology, and Diabetes
Once the choice is made to try having children, any delay can seem like waiting for something that would never happen. Every trip to the store can bring reminders of all the other pregnancies going on. Every monthly cycle without success can bring disappointment, or feelings of failure.
Couples may begin to feel like there is something wrong. After all, how is it possible for babies to be born every day, but not for them (couples) to get pregnant? They may become anxious, depressed, or even desperate.
How long should it take to get pregnant?
If it’s the first months of trying for a baby, it might be surprising to couples that getting pregnant isn’t happening as quickly as expected.
Most healthy couples would conceive within one year, if they are actively trying to conceive.
If couples are under the age of 35 and have been trying to get pregnant for a year or more, they should talk to a doctor — a family physician, or gynecologist, or endocrinologist. If they are over 35, they should see a specialist after 6 months of actively trying.
POTENTIAL CAUSES OF INFERTILITY INCLUDE:
• TIMING
In order to become pregnant, sperm needs to come in contact with the egg during ovulation. Not every day of the month is fair game for this!
If couples just started trying, or haven’t narrowed in on an exact ovulation window yet, they could just be trying to get pregnant at the wrong time during the month. Tracking menstrual cycles can help address this issue. It’s important to remember that even if a woman has determined when she is ovulating, it’s not a guarantee that sex during that time would result in pregnancy. A healthy 30-year-old has about a 20 percent chance of pregnancy each month.
• OVULATION ISSUES
For women who are not ovulating, it can be nearly impossible to become pregnant. In this case, couples can speak with a fertility specialist about additional tests and procedures they can offer to help regulate and identify why ovulation isn’t occurring.
• SEMEN/SPERM ISSUES
While it’s true that men can produce sperm their entire lives, there is also a question of sperm quality. The number, shape, and motility (movement) of sperm can affect fertility. If there is a concern, a semen analysis can be done.
• AGE-RELATED ISSUES
No matter their gender, all people can find it harder to produce children as they age. Generally speaking, a person with a uterus in their early 20s and 30s has a 1 in 4 chance of getting pregnant each month. After age 30, the chance of becoming pregnant decreases though, and by the time they are 40, they have a 1 in 10 chance of getting pregnant each month. By the time a person with a uterus is 45, their chances of becoming pregnant are very low.
The fertility of a person who produces sperm would also decrease with age, but that’s not as predictable as the decline of a person with a uterus.
• FALLOPIAN TUBE ISSUES
If fallopian tubes are blocked, eggs won’t be able to get to a safe place for fertilisation and implantation.
• UTERINE ISSUES
In order to become pregnant, the fertilised egg must be implanted in the uterus. A misshaped uterus or buildup of tissue in the uterus are two examples of things that can prevent this process from happening as expected.
• BIRTH CONTROL
Some types of birth control can impact or delay future fertility, even if they are reversed or otherwise stopped.
OTHER MEDICAL ISSUES
There are many medical issues that can impact your fertility. Some common ones include polycystic ovary syndrome (PCOS) and endometriosis.
Persons with a history of multiple miscarriages or a genetic or other medical condition can have their fertility negatively impacted.
In some cases, there may be unexplained infertility, a somewhat controversial diagnosis of exclusion. This means that, even after testing, there may not be an obvious cause to explain why couples are not getting pregnant.
INCREASING CHANCES
• PINPOINT OVULATION TIMING
The greatest chance of getting pregnant is having sex in the days before and during ovulation. To determine the ovulation period, track the menstrual cycle:
• Take the basal body temperature before getting out of bed — every morning at the same time — using a special thermometer that can read to a tenth of a degree. Ovulation is typically detected by a slight temperature decrease, and then a temperature increase for 3 days in a row.
• Look for changes in cervical mucus. Before ovulation, estrogen levels will rise, which can cause cervical mucus to increase and be thinner and more slippery. This is a sign that it’s good to have sex for conceiving. When ovulation has occurred, cervical mucus will typically become cloudy, thick, and sticky.
• Use ovulation strips. These work a lot like pregnancy tests, and can be purchased at pharmacies. Tracking ovulation by using basal body temperature and cervical mucus changes can help pinpoint when to begin using the test strips.
• REQUEST MEDICAL TESTS
If unable to identify ovulation using the above methods, speak with a doctor about seeing a specialist. A fertility clinic can handle more involved testing, like blood hormone tests and ultrasounds of the ovaries, to determine whether ovulation is occurring.
Tests over the course of one’s cycle are done to track hormones. They can also look for fallopian tube blockages, or other uterine issues that may impact conception.
USE SPERM-FRIENDLY LUBE
Couples should think about what lubricants they are using. Certain lubricants can affect sperm negatively. Avoid things like:
• Astroglide
• K-Y jelly
• Saliva
• Olive oil
Lubricant, fertility-friendly options include:
• Pre-Seed
• Mineral oil
• Canola oil
Make lifestyle changes to get as healthy as possible, and put oneself in the best position to be pregnant. Regular periods, diet, exercise, and a healthy lifestyle can help the body to get in a better alignment. Some suggestions for ways you can change lifestyle include:
• Working towards, or maintaining, a healthy weight
• Avoiding caffeine, tobacco, alcohol, and drugs
• Finding ways to manage or decrease stress
• Taking prenatal vitamins
The first step in getting pregnant is identifying any potential roadblocks. Sometimes just a little tracking of the monthly cycles can result in pregnancy. If the months keep passing and there are no signs of a baby, a fertility specialist can work with couples to maximise their chances of getting pregnant, and address any underlying issues.
While the road to a baby may not be a quick one, the journey that leads to ‘a little one’ can be life-changing. Don’t give up hope!
