Women health

 Why can't I get pregnant 

It might be discouraging and stressful when you're ready to have a family but aren't conceiving. Particularly if you've attempted the traditional strategies to increase your chances: engaging in many sexual encounters throughout your reproductive window, taking your temperature each morning, and using tools like ovulation tracker apps and prediction kits.

You can start to question whether you need to exercise more patience or whether there is a medical issue. Not by yourself. Infertility issues affect one in eight couples. Infertility specialist Chantel Cross, M.D., a reproductive endocrinologist at the Johns Hopkins Fertility Center at the Johns Hopkins Health Care & Surgery Center — Green Spring Station in Lutherville, Maryland, explains what aspects may be affecting your ability to conceive and when you might want to think about seeking treatment for infertility.

What constitutes infertility?

For women under the age of 35, infertility is defined as the inability to get pregnant after one year of unprotected sex and after six months for women over the age of 35.

The majority of people who regularly engage in unprotected sexual activity will fall pregnant within the first 12 months of trying to conceive, according to Cross. We advise a couple to get an infertility evaluation after six months to a year of trying, depending on the age of the lady. It's more likely that there is an issue preventing pregnancy at that point.

Medical Issues That Affect Fertility

Infertility may be caused by one or more reasons. The most typical issues are as follows:

Blockage of the fallopian tube

Infertility is frequently caused by blocked or damaged fallopian tubes, which hinder sperm from accessing the egg, especially among African Americans. Your chance of fallopian tube obstruction is increased if you have ever had endometriosis, a pelvic infection, or a sexually transmitted illness.

Unusual uterine shape

A fertilized egg may find it challenging to adhere to the uterine wall if the uterus has an uneven shape. Uterine fibroids, which are benign growths on the uterine wall and scar tissue from surgery or infection, can result in abnormalities. Another factor to consider is the shape of your uterus.

Ovulation dysfunction

Women occasionally fail to ovulate consistently and regularly. Conditions including polycystic ovarian syndrome (PCOS), hormonal abnormalities, or obesity can lead to sporadic menstrual cycles. Stress, low body weight, and extreme activity can potentially affect ovulation.

Men's Issues

Sperm problems, such as low sperm count or irregular sperm motility or shape, occur in more than 30% of instances of infertility. Male factor infertility can be brought on by a variety of situations, including trauma, chronic illnesses like diabetes, and harmful behaviors like binge drinking and smoking.

How Stress Affects Fertility

When you're trying to get pregnant, anxiety is common. It's debatable, though, if that has an effect on fertility. No matter what stage of life you're in, we do know that controlling stress is beneficial for you.

For women, age is a key factor

"Your biological clock is ticking," you've probably heard. Your fruitful window is referred to in this expression. When a woman's menstrual cycle ends, which often happens in her 40s or 50s, she cannot become pregnant. While men continue to generate sperm throughout their lives, women are born with a fixed quantity of eggs that get fewer as they get older.

By the time you reach puberty, you will have lost hundreds of thousands of your two million eggs, according to Cross. "Whatever you do, your body will continue to lose eggs. And around the age of 37, the rate at which women lose their eggs increases.

Over time, the quality of the eggs stored in the ovaries gradually deteriorates. Cross argues that the eggs you are born with are naturally halted in the process of splitting their DNA. When you ovulate them 20 to 40 years later, they finish that process or ripen. The longer eggs are left in the middle of the division process, the greater the chance that the process may go wrong and produce eggs with an incorrect number of chromosomes. That causes chromosomal abnormalities, which cause infertility, miscarriages, or births of children who have genetic disorders.

The bottom line: A woman's quality and quantity of eggs diminish throughout the course of her lifetime, and egg loss quickens at the age of 37, making it more challenging to conceive.

What Infertility Treatment Do I Need?

An expert in infertility may be able to assist you if you're experiencing problems conceiving. An infertility evaluation should be scheduled after a year of attempting to conceive (or six months if you're 35 or older). This extensive evaluation consists of the following:

  1. Physical check
  2. Pelvic ultrasound
  3. Blood work
  4. Semen analysis
  5. Assessment of the uterus and fallopian tubes (by expert x-rays or ultrasounds)

Consult your doctor to determine whether you should be examined sooner if you or your partner have a known medical issue that affects the uterus, fallopian tubes, sperm, or ovulation. For instance, you should consult with an infertility professional even before attempting to conceive if you are aware that both of your fallopian tubes are obstructed.


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