Are you ready to become pregnant? Have you tried for a while with no success? You may have many questions in regards to conception..."Am I doing everything right? What can my partner or I do to better our chances?" Or are you just getting started and need advice?
Well, if you are just getting started and need advance, please refer to the previous blog on "Are you ready for pregnancy?"
Otherwise, if you have been trying for a while, here is some information for you...
First, you need to make sure you are having regular menstrual cycles and ovulating. If your cycles are regular and coming at the same time monthly, chances are you are ovulating (which occurs about 14 days following the first day of your last menstrual period). Ovulation is when the egg is released from the ovary and is the prime time that you should have sex to better your chances of getting pregnant. However, if your cycles are irregular and you can't predict when your period may come, you may need evaluation. Certain issues with health can cause this such as thyroid disorders or polycystic ovarian syndrome (PCOS). People with PCOS have extremely irregular cycles and sometimes need medication to help get them get pregnant. If you haven't had a period in a while, your doctor (after a thorough evaluation) may give you a medicine to start your period and advise you to use a detector (like an ovulation kit) or will bring you in for lab-work to see if you are ovulating. If you have difficulty ovulating, that may be a time your doctor can help with a medication (such as Clomid or Femara) which can help with ovulation and achieving a pregnancy. Usually after two or three rounds of these medications, if there is no success then you may be referred to a reproductive endocrinology and infertility doctor for further work-up and treatment.
So what is infertility? Infertility is ACTIVELY trying to get pregnancy without birth control x 1 year...and 6 months if you are over the age of 35. There can be multiple causes but the definite first step in evaluation is a semen analysis--it is the cheapest and best first screening test to evaluate if your partner's sperm is motile, enough in number, and functional. Usually if your partner has had a child before, likely chances are sperm is functional is high. Next would be to evaluate yourself. I will always remember one of my staff doctors in residency telling me, "You need three things to become pregnant, 1. an egg 2. a sperm 3. a place for them to meet. Thus, you need to 1. make sure you are ovulating 2. make sure your partner's sperm is functional and 3. make sure that your tubes are functional and patent. A test such as a hysterosalpingogram (HSG) can help with this. They inject dye into your uterus and take an X-ray to see if it spills out into your belly which would indicated that your tubes are open.
There are multiple things than can cause blocking of the tubes...for example, history of endometriosis can create scar tissue around your tubes or a history of a sexually transmitted disease GREATLY increases your risk of tubal scarring/blocking and also the risk of an ectopic pregnancy (pregnancy outside of the uterus).
Overall, the things listed above are a good starting point to help evaluate infertility along with your doctor likely running a few other blood tests to rule out other causes (such as thyroid or hormonal issues). In regards to men, you want to make sure that you take care of "that area" to make sure sperm are producing appropriately and staying functional! Stay away from hot things on the lap (like computer, etc), tight fitting underwear that can compress the area, and NO male enhancing drugs (like steroids) which have been known to decrease sperm count and kill sperm.
Overall, to achieve a pregnancy you need three things: 1. an egg, 2. a sperm, 3. a place for the two to meet. The goal is to make sure all of these things are present and working together to achieve the same goal. You may need assistance with achieving this goal, and that's okay. The important thing is knowing when to recognize after trying for a period of time and seeking further work-up for it, whether that be with your obstetrician gynecologist or a reproductive endocrinology and infertility doctor.
Hope this was helpful.
Thanks y'all!
Dr. Riley
