There are many common factors that can cause problems with getting pregnant. Many of these problems can be diagnosed and treated by your fertility specialist to put you back on the path to parenthood.
Timing of Sexual Intercourse
Timing is everything if you are trying to get pregnant. You are fertile only a few days every month when you ovulate. If you have a 28-day menstrual cycle, where day 1 is the first day of your period, you will likely ovulate between days 10 and 17. Your basal body temperature will increase by one-half degree just after ovulation takes place, so taking your temperature every morning when you get up can be used to determine when you are fertile. You can also buy an ovulation predictor kit at your pharmacy and use it at home to predict when you are likely to ovulate based on changes in levels of luteinizing hormone.
During your fertile period, you should have intercourse with your partner every couple of days to increase the chances you will conceive. If you are under 35 years of age and intercourse is well-timed, it still may take as much as a year to become pregnant, so do not despair if you don't get pregnant right away.
Absent or Irregular Periods
If your periods are highly irregular or disappear all together, it's time to see your gynecologist or a reproductive endocrinologist specializing in infertility because not having regular periods is a common cause of infertility. If you are not ovulating, it may be due to a hormonal imbalance which can be treated. Your doctor can order blood tests to look at levels of gonadotropins (FSH and LH) and steroid hormones (estradiol and progesterone) to help diagnose why your periods have stopped. Overactive or underactive thyroid glands can cause irregular periods, but restoring thyroid function to normal can restore normal periods as well. Polycystic ovarian syndrome (PCOS) is another condition which can cause irregular periods and which can be diagnosed and treated.
Physical Barriers to Conception
Sometimes ovulation can occur normally and sexual intercourse is well-timed but the sperm and egg are unable to connect due to physical barriers. Fertilization occurs in the Fallopian tubes. The egg is ovulated from the ovary and swept up into the tube and propelled along the tube toward the uterus. Sperm enter from the vagina, swimming through the cervical opening into the uterus and into the Fallopian tube, where they meet up with the egg and fertilize it. If the tube is blocked due to scarring from a previous infection or trauma, egg and sperm can not physically meet and fertilization doesn't happen. Your doctor can tell if your tubes are blocked by injecting dye into the tubes and visualizing the path of the dye to see if areas are blocked.
Some men have a condition called congenital absence of the vas deferens. The vas deferens carry the sperm from the testes to the ejaculatory ducts. If this critical duct is absent, sperm can not be ejaculated, making conception through intercourse impossible.
Sperm Problems
Low sperm quantity and quality are responsible for one-third of the problems couples have with becoming pregnant. A semen analysis is a simple first step to find out whether enough normal sperm are in the ejaculate to conceive with sexual intercourse. Normal semen parameters as defined by the World Health Organization (WHO) are a minimum sperm concentration of at least 20 million sperm per milliliter (approximately a quarter teaspoon), of which at least 50 percent must have strong forward motion and at least 30 percent of the sperm must have a normal shape (morphology). An abnormal semen analysis may have an underlying medical cause that can be treated by a urologist. Conversely, a normal semen analysis limited to these traditional tests can not completely rule out a male cause for infertility. Newer functional sperm tests that evaluate sperm binding capacity or DNA integrity may be more meaningful in ruling out male causes of infertility.
