You have tried getting pregnant in the past few months or even for more than a year. It has not been an easy journey. Why is it so hard to get pregnant?
As we age, our ability to achieve pregnancy lowers. This is a fact.
Fertility in women peaks during the late teens and 20s, after which it begins to drop, with age 35 begins the most rapid decline. (This is why couples age 35 and above are encouraged to seek early help for infertility).
However, infertility can and does affect men and women of all ages.
For most couples, the first symptom of infertility is when after a year of unprotected sex, they can’t get pregnant.
Yes, it is possible to have regular cycles, a healthy sex life, not have any of the risk factors, be generally healthy, and still suffer from infertility.
What is infertility?
Infertility is defined as the inability of a couple to get pregnant after a year of unprotected sex.
The definition of infertility can be further broken down into 3 groups:
Primary Infertility: Primary infertility refers to women who have never achieved pregnancy in the past.
Secondary Infertility: Secondary infertility refers to women who have achieved pregnancy and given birth in the past, but is now having difficulty to conceive.
Recurrent Miscarriage: Women who experience recurrent miscarriages may also receive a diagnosis of infertility if they experience three or more successive miscarriages.
Infertility is not limited to women. Infertility affects women and men equally.
According to the American Society of Reproductive Medicine, one-third of infertility cases are due to female factor infertility, one-third are due to male factor infertility, and the remaining third due to problems from both sides, or unexplained reasons.
Is something wrong with me?
Here are some early warning signs that suggest a fertility problem:
Irregular cycles – An irregular cycle can be a sign of infertility. If the cycles are unusually short or long (less than 24 days, or more than 35 days), or come unpredictably, you should seek early consultation with your doctor. An irregular cycle may be a sign of possible ovulation problems.
Bleed extremely heavily or lightly or excessive cramps
Menstrual bleeding between 3 to 7 days can be considered normal. However, if the bleeding is very light, or extremely heavy and painful, you should see your doctor. Also, if the bleeding changes significantly from month to month, either in terms of the heaviness or colouring, or length of bleeding time, or if you suffer from menstrual cramps or inter-menstrual bleeding or post-coital bleeding, these are also possible symptoms that may hint at a fertility problem.
Older than 35
If you’re past the age of 35, your chances of dealing with infertility are higher.
Partner experiences impotence or ejaculatory problems
Male factor infertility isn’t always so obvious – usually low sperm counts or inhibited sperm mobility is determined by a seminal fluid analysis. But if your husband or partner experiences sexual dysfunction, this could also be an infertility sign.
Underweight or overweight
Being excessively thin or overweight can lead to infertility problems. Also, extreme or poor dieting practices, or too much exercise, can lead to problems with fertility.
Chronic illnesses like diabetes, thyroid problems or hypertension
Chronic illnesses, as well as their treatments, can lead to fertility problems. Chronic illnesses like diabetes and hypo/hyperthyroidism can cause fertility problems. Insulin, antidepressants, and thyroid hormones may lead to irregular cycles.
History of STDs
Sexually Transmitted Diseases (STDs) can be the cause of infertility. Infection and inflammation can cause blockage of the Fallopian tubes, making pregnancy either impossible or putting a woman at risk for ectopic pregnancy.
Smoke or drink alcohol
Smoking has been linked to problems with conception in women, and heavy drinking has been linked with female and male infertility.
What causes infertility?
A diagnosis of infertility often comes in two stages:
1. general infertility diagnosis
2. diagnosis of the specific cause of the infertility
Infertility is almost a symptom itself. To treat infertility in the best possible way, finding the cause is helpful. In fact, in 20% of infertility cases, the cause for the infertility remains unknown.
Two of the most common causes of female factor infertility include:
- Ovulation Disorders: accounting for 18% to 30% of infertility in women.
- Anatomical Disorders: blocked Fallopian Tubes, often the result of infections or inflammations, like endometriosis or pelvic inflammatory disease.
The two most common causes of male factor infertility include:
- Low sperm production: Medically referred to as azoospermia (complete lack of sperm cells) or oligospermia (few sperm cell are produced) – this is the most common cause of male factor infertility.
- Sperm malformations: Even if the amount of sperm is within the normal range, malformed sperm, as well as the ability of the sperm to make it to the egg before dying, can be a cause of infertility.
But the good news is...
In many cases, infertility can be treated.
It is not a hopeless situation. Infertility cases can be treated using conventional treatments such as medication or surgical repair.
Less than 3% of infertility patients require advanced treatments, like in-vitro fertilization (IVF).
Your infertility treatment plan will depend on the causes behind the infertility.
The sooner you get diagnosed, the better it is especially if you’re past 35 or if you long to have children of your own.
If you have been trying to get pregnant for more than a year and have not been successful, it’s time to get yourself assessed. Don’t wait until it’s too late.
Consultant Obstetrician & Gynaecologist