Pregnancy and Fertility BLOG

Not all people have the ability – or even the passion – to produce offspring by default. Some couples choose to focus on their careers at the moment, so that they can prepare enough for the future of the family.


However, when it seems like nothing is happening even after living together for more than 3 years and trying real hard to conceive, a fertility check should be your reason for your next visit to the doctor.

One of the major concerns when trying to conceive is the age of the woman. A woman is most fertile during her late 20s. After the age of 35, fertility may decrease and the increase of having a miscarriage increases. However, this may not be true to women who have already given birth. We very well know that there are women who can still give birth even beyond 35 years old.

A woman who is below 35 years old may still want to allow more time to get pregnant. However, those who are older than 35 years old might need to consider getting help.

Fertility Problems

There are several instances wherein fertility of both man and woman may be affected. These are a few instances that may cause infertility:
    • The woman's reproductive system may be the problem due to some conditions of the fallopian tubes, uterus, or ovulation.
    • The man's reproductive system may be affected due to low sperm count.
    • Inability to conceive may be due to a medical condition.
    • The time when couples are trying to conceive may not be the fertile days of the woman.
    • Stress can also be a contributing factor, preventing couples to conceive.
    • Exposure to environmental toxins, drugs or radiation may aggravate the condition.
    • Infections like sexually transmitted diseases may have damaged the reproductive system.

Fertility Awareness

Before you even jump into a conclusion that you may need some medical intervention, it will be a huge help if the woman learns to record her basal body temperature. This is the temperature when the woman is fully at rest. An increase in the basal body temperature may be due to ovulation.

A woman is most fertile during 2-3 days before the rise in temperature. By tracking the basal body temperature each day, the woman may be able to predict when her fertile days are. In return, she will be able to determine when the best time to conceive is.

In as much as this could be a great way to determine the perfect time to conceive, knowing the basal body temperature can be a huge help in trying to know when to avoid getting pregnant.

Prior to seeking any treatment

There may be personal issues that need to be discussed among the couple themselves prior to seeing a gynecologist or reproductive endocrinologist. These should be well taken care of, to ensure that the couple is on the same page towards the needed step in wanting to conceive.

Available Treatments

There are ways on how a couple may be able to conceive depending on what is causing the problem:
    • There are medicines that can help a woman to ovulate. These injectable hormones that help stabilize the hormone level to aid in ovulation.
    • A procedure called artificial insemination may be done. This is a procedure done where the sperm is directly implanted inside the woman's womb.
    • Inability to conceive may sometimes be due to a medical condition in women wherein the endometrium grows outside the uterus. It is called endometriosis.
    • Seek a procedure that can help increase the sperm count.
  • The last resort may be having an in vitro fertilization (IVF). It is a process wherein egg and sperm cells are harvested from a couple and are mixed in the lab to help the sperm fertilize the egg. Then the fertilized eggs are placed inside the woman's uterus. This procedure is done more than once to ensure a positive result.

Things to consider prior to getting a treatment

The psychological effect of not having a child may be too much. But with that, a couple can do everything that they can so that they can conceive.

Note that this may be costly and stressful. Be aware of how much it would take before you can achieve your goal of becoming a parent.
    • Learn everything about the options. Decide on which options to choose what you think would be best for you to handle.
  • Be aware of the cost of your chosen treatment. Know if your insurance can cover the cost. Otherwise, decide on the treatment options that you can afford.

The adverse effect of taking these treatments is an increased potential of having multiple births – twins, triplets or more.

Ovulation Induction Defined

Ovulation induction is the term used to describe a fertility treatment that involves the use of medication to help stimulate the development of one or more mature follicles in the ovaries, in cases of difficulty of fertility and ovulation.

Those women with anovulation – or abnormal ovulation – have a condition known as polycystic ovarian syndrome (PCOS) whose menstrual cycles are irregular. Other symptoms of PCOS include increased body hair and infertility.

There are several options for ovulation drug therapy that are used to help in stabilizing the hormone level to aid in fertility:
    • Injectable gonadotropins / FSH hormone products: This contains follicle-stimulating hormones (FSH) to help in the development of one or more follicles. This is given through intramuscular injection.
    • Clomid: This is an oral drug is taken either on the third to seventh day of the menstrual cycle or fifth top ninth day of menstrual cycle. Its generic name is clomiphene.

        • The gynecologist will measure FSH and estradiol level on the third day of the woman's menstrual cycle.

        • 100 mg of clomiphene will be given on the fifth to ninth day of menstrual cycle.

        • The FSH and estradiol level will again be measure on the 10th day of menstrual cycle. Test kits such as ZRT Fertility Profile are available in the market to determine the level of estradiol and FSH.
    • Bromocriptine: This drug is used to treat pituitary tumors and other related issues, all of which may cause infertility.
  • Femara: This is the second drug of choice if Clomid is unsuccessful in helping the woman to conceive. However, many physicians would not prescribe this drug due to an increased incidence of birth defects.

Common Female Fertility Tests

Here are some of the popular tests in the market to check fertility in women:

Hysterosalpingogram

This scanning method checks the uterus and the fallopian tubes. This is done to see if there is a blockage in the fallopian tubes and uterus.

How Hysterosalpingogram is done
    • A dye is injected into the vagina and cervix through the uterine cavity.
    • A blocked uterus will not be filled with dye.
    • If the dye spills out then it means that there is no blockage.

Laparoscopy

This is a surgical procedure that allows examination of the organs inside the abdomen.

How Laparoscopy is done
    • A laparoscope will be inserted into the abdomen.
    • A small incision is made for the laparoscope to pass through the abdomen to check the fallopian tubes, cervix and uterus.
    • If there are any pelvic structure abnormalities, the doctor may be able to treat it as well as get rid of scar tissues and blockages that may have been the cause of infertility.

Hysteroscopy

This helps in identifying and treating uterine conditions.
How Hysteroscopy is done
    • A hysteroscope is inserted into the abdomen.
    • The doctor may be able to view and treat any abnormalities and may diagnose polyps, fibroids, remove scar tissues and blockage.
    • This procedure may be done in a doctor's office with either local or general anesthesia.

Endometrial Biopsy

This procedure is done to determine any hormonal disorder that may be causing infertility.

What to expect during Endometrial Biopsy
    • A pregnancy test is performed to ensure that the patient is not pregnant.
    • The biopsy is done several days prior to menstruation.
    • A small tissue is taken out from the endometrium for observation.

Cervical Mucus and Post-coital Test

This test can best determine the quality and consistency of the cervical mucus for the doctor to know how the sperm interacts with it.

Success Rate within using Induction Ovulation

The success of the use of this treatment varies, as it depends on the age of the woman, the type of medication used, other underlying causes that may affect fertility and several other factors.

Fertility Tests for Men

While the female may be the one bearing the child in her body, difficulty to conceive does not mean that the infertility issues are exclusive to women. In fact, some men may also have infertility problems that should be identified.

Here are some of the tests that men should undergo in order to check for fertility:


Health Evaluation

A complete medical history is needed to eliminate possible causes of infertility, such as:
    • Medications
    • Surgeries
    • Physical activities
    • Smoking
    • Sexual activity (presence or had STD)

Sperm Count and Analysis

There should be at least two tests given to confirm if the patient has low sperm count, normal sperm count, or does not have sperm at all. Having no sperm may mean that there is a blockage, which may be corrected through surgery.


Physical Examination

The doctor may look for the presence of varicoceles. Such abnormal formation of veins may also need to undergo surgery.


Hormone Evaluation


This test checks for hormonal balance to determine if the level is within normal or if there is a deficiency and needs to be corrected using hormone therapy.


Genetic Testing

This test should determine if there are genetic problems, which may be the reason for not conceiving.


Anti-sperm Antibodies

A male may have a normal sperm count but may be going to a different direction instead of going to where the eggs are.


Other Factors Which May Cause Infertility in Men

Having a low sperm count will definitely not be helpful in wanting to conceive. Here are some of the causes of having a low sperm count in men:
    • There could be a blockage between the penis and testicles.
    • The male may have idiopathic infertility, a term used by doctors to denote that the cause could not be identified.

Conclusion

Taking necessary treatments may cause a lot of money and time to spend. In fact, the assurance to conceive after going through the methods mentioned above is not 100 percent. Still, these tests and treatments should be able to not only increase the chances of reproduction but also enhance the mindset and passion of the couple to have a child of their own.