Grow Baby Grow

Week 2

Estimated reading time: 14 min reads

Conception usually occurs just two weeks after your period begins, as day 13-15 is typically the time a woman is known to ovulate during a 28-day cycle. However, ovulation can take place anywhere between day 11 to day 21, depending on the length of a woman’s menstrual cycle.

Your due date will be determined by your health care provider counting ahead 40 weeks beginning from the first day of your last period. Your period is a key component of your pregnancy, even though you were not expecting at the time.

Infertility

It’s a proactive step towards conception and pregnancy for you and you partner to make an appointment and meet with your health care team when you are considering starting a family. They can help you prepare your body for a healthy baby, answer your questions on fertility and give you both tips on conceiving.

Did you know that it is estimated that ten to fifteen percent of couples have trouble getting pregnant or reaching a successful delivery day? Or that female infertility, male infertility or a combination of the two affects millions of couples worldwide? So what exactly is infertility? Infertility means that with frequent intercourse for at least a year of actively trying, a couple cannot conceive.

The onus of infertility rests equally between the female and male factoring about one-third of the time for each. The remaining one-third causation is either not known or a combination of both male and female factors. With age, there is a natural decrease in fertility spurring the investigation and management of infertility to be started sooner by some specialists in certain couples.

symptoms-imgIdentifying the cause of female infertility can be challenging but there are several treatments available once the cause is realized. Your possible treatment will depend on the primary problem. Treatment may not always be warranted as numerous infertile couples do go on to conceive a child naturally. It is estimated that approximately six percent of married women (15-44) are not able to become pregnant after one year of unprotected sex, and that roughly twelve percent of women (15-44) struggle with infertility or carrying a pregnancy forty weeks regardless of their marital status.

Male infertility data from the National Survey of Family Growth in 2002 that was analyzed by the CDC showed that 7.5% of all sexually experienced men younger than age 45 reported seeing a fertility doctor during their lifetime. This means that 3.3–4.7 million men sought help for infertility and of the men who wanted help, 18% were diagnosed with a male-related infertility problem, including sperm or semen problems (14%) and varicocele (6%).

Symptoms

The foremost symptom of infertility is the inability of a couple to become pregnant. Female infertility may be associated with a lack of ovulation arising from a menstrual cycle that is excessively long (35 days or more) or short (less than 21 days). An irregular or absent period can signal a lack of ovulation as being the cause of infertility. However, there may also be no other apparent signs or symptoms.

When you decide to see a doctor and seek medical help depends, to some extent, on your age, as a woman’s age is probably the most significant factor related to her ability to conceive. According to the Mayo Clinic:

  • If you’re in your early 30s or younger, most doctors recommend trying to get pregnant for at least a year before having any testing or treatment.
  • If you’re between 35 and 40, discuss your concerns with your doctor after six months of trying.
  • If you’re older than 40, your doctor may want to begin testing or treatment right away.

Your doctor will most likely recommend a member of the American Society of Reproductive Medicine in your area to help you with your infertility.

Causes

Today, the trend of delayed marriage and childbirth are the main social causes of infertility. Physically, in order for you to become pregnant ovulation, sperm, regular intercourse, open fallopian tubes and a normal uterus must all co-exist working simultaneously together. However, there are several factors that can prevent this process from taking place and causing female infertility. Genetic testing will also help determine whether there’s A genetic defect may also be a source of infertility prompting the need for genetic testing.

Ovulation disorders

Ovulation disorders are responsible for roughly 25 percent of couples remaining infertile. This condition causes you to ovulate irregularly or perhaps not at all. Inconsistency in the reproductive hormonal regulation by either the hypothalamus or pituitary gland, or by difficulties within the ovary itself may be to blame for this problem. The Mayo Clinic defines ovulation disorders as:

  • Polycystic ovary syndrome (PCOS). In PCOS, complex changes occur in the hypothalamus, pituitary gland and ovaries, resulting in a hormone imbalance, which affects ovulation. PCOS is associated with insulin resistance and obesity, abnormal hair growth on the face or body, and acne. It’s the most common cause of female infertility.
  • Hypothalamic dysfunction. The two hormones responsible for stimulating ovulation each month — follicle-stimulating hormone (FSH) and luteinizing hormone (LH) — are produced by the pituitary gland in a specific pattern during the menstrual cycle. Excess physical or emotional stress, a very high or very low body weight, or a recent substantial weight gain or loss can disrupt this pattern and affect ovulation. The main sign of this problem is irregular or absent periods.
  • Premature ovarian insufficiency. This disorder is usually caused by an autoimmune response where your body mistakenly attacks ovarian tissues or by premature loss of eggs from your ovary due to genetic problems or environmental insults such as chemotherapy. It results in the loss of the ability to produce eggs by the ovary, as well as a decreased estrogen production under the age of 40.
  • Too much prolactin. Less commonly, the pituitary gland can cause excess production of prolactin (hyperprolactinemia), which reduces estrogen production and may cause infertility. Most commonly this is due to a problem in the pituitary gland, but it can also be related to medications you’re taking for another disease.

Damaged fallopian tubes (tubal infertility)

The inability of sperm to reach the egg or the failure of the fertilized egg to reach and implant in the uterus may be due to damaged or blocked fallopian tubes. The Mayo Clinic states tubal damage or blockage may be a result of:

  • Pelvic inflammatory disease, an infection of the uterus and fallopian tubes due to chlamydia, gonorrhea or other sexually transmitted infections.
  • Previous surgery in the abdomen or pelvis, including surgery for ectopic pregnancy, in which a fertilized egg becomes implanted and starts to develop in a fallopian tube instead of the uterus.
  • Pelvic tuberculosis, a major cause of tubal infertility worldwide, although uncommon in the United States.

Endometriosis

Uterine tissue that implants and grows elsewhere is called endometriosis. This additional growth of uterine tissue when removed surgically may cause scarring obstructing the narrow fallopian tube. If this occurs, the egg and sperm will not unite. Equally, endometriosis may also affect the lining of the uterus jeopardizing the implantation of the fertilized egg. This condition may also be indirectly responsible for upsetting fertility by causing injury to the sperm or egg. It is estimated that 25-50 percent of women have this condition.

Uterine or cervical causes

There are a number of uterine or cervical conditions that may interfere with your egg becoming implanted in the uterus. This increases the risk of a miscarriage. The Mayo Clinic defines these conditions as:

Benign polyps or tumors (fibroids or myomas) are common in the uterus, and some types can impair fertility by blocking the fallopian tubes or by disrupting implantation. However, many women who have fibroids or polyps can become pregnant.

fb_img_1463447051656-300x193

  • Endometriosis scarring or inflammation within the uterus can disrupt implantation.
  • Uterine abnormalities present from birth, such as an abnormally shaped uterus, can cause problems becoming or remaining pregnant.
  • Cervical stenosis, a cervical narrowing, can be caused by an inherited malformation or damage to the cervix.
  • Sometimes the cervix can’t produce the best type of mucus to allow the sperm to travel through the cervix into the uterus.

Male infertility

This may be caused by various factors. It is usually diagnosed by two semen analyses taken at least one month apart. A specialist evaluates the number of sperm (concentration), motility (movement), and morphology (shape). If the result is slightly abnormal, a diagnosis of infertility is not necessary made. However, if the abnormal result is due to an illness such as a viral infection, it will take roughly two to three months before the sperm parameters change and the test can be repeated. This analysis will aid in deciding how male factors are possibly contributing to the couple’s infertility.

According to the CDC, the conditions that can contribute to an atypical semen analyses include:

  • Varicoceles, a condition in which the veins on a man’s testicles are large and cause them to overheat. The heat may affect the number or shape of the sperm.
  • Medical conditions or exposures such as diabetes, cystic fibrosis, trauma, infection, testicular failure, or treatment with chemotherapy or radiation.
  • Unhealthy habits such as heavy alcohol use, testosterone supplementation, smoking, anabolic steroid use, and illicit drug use.
  • Environmental toxins including exposure to pesticides and lead.

img_0567-300x300The National Institute of Health (NIH) state that other causes of male infertility may include:

  • Physical problems with the testicles.
  • Blockages in the ducts that carry sperm.
  • Hormone problems.
  • A history of high fevers or mumps.
  • Genetic disorders.
  • Lifestyle or environmental factors.

Unexplained infertility

Unfortunately, a source for your infertility may never be discovered. Unresolved fertility issues may result from a combination of various minor causes affecting the couple as a whole. It can be devastating to not know the reason for your infertility but the good news is that infertility can possibly be reversed in time.

Risk factors

According to the Mayo Clinic, there are definite risk factors that may increase your chances of infertility. They are:

img_1748-300x296

  • Age. With increasing age, the quality and quantity of a woman’s eggs begin to decline. In the mid-30s, the rate of follicle loss accelerates, resulting in fewer and poorer quality eggs, making conception more challenging and increasing the risk of miscarriage.
  • Smoking. Besides damaging your cervix and fallopian tubes, smoking increases your risk of miscarriage and ectopic pregnancy. It’s also thought to age your ovaries and deplete your eggs prematurely, reducing your ability to get pregnant. Stop smoking before beginning fertility treatment.
  • Weight. If you’re overweight or significantly underweight, it may hinder normal ovulation. Getting to a healthy body mass index (BMI) has been shown to increase the frequency of ovulation and likelihood of pregnancy.
  • Sexual history. Sexually transmitted infections such as chlamydia and gonorrhea can cause fallopian tube damage. Having unprotected intercourse with multiple partners increases your chances of contracting a sexually transmitted disease (STD) that may cause fertility problems later.
  • Alcohol. Heavy drinking is associated with an increased risk of ovulation disorders and endometriosis.

It must also be noted that passive smoking has also been established to have an effect on fertility and the heavy use of marijuana decreases fertility in both men and women.

Preparing for your appointment

If you decide to have your infertility evaluated, it’s important that you begin tracking your periods, your symptoms and dates of intercourse before your first visit. You will also want to make a list of medications and supplements — either vitamins or herbal remedies — with doses and frequency for your specialist. Any pertinent medical records with previous tests or treatments should accompany you.

Both you and your partner will have a medical and sexual history taken; any previous pregnancies with your current partner will be discussed. You will both be assessed for possible causes as well as potential treatments to correct this condition.

Don’t forget to bring a notebook or iPad with you for two reasons. First, beforehand you can prepare any questions that you would like answered, and second, you will be able to jot down any essential information given to you at this time.

Tests, diagnosis, treatments and drugs

Your specialist may possibly order any number of tests that he or she feels will help to evaluate, diagnose and treat your condition. Testing may range from a simple over-the-counter ovulation prediction kit to a laparoscopy which is a minimally invasive procedure visualizing your fallopian tubes, ovaries and uterus to genetic testing which will indicate if a genetic problem is responsible for your infertility. It is important to remember that no one test is a perfect predictor of fertility.

Nearly 85-90 percent of infertility cases are treated conservatively with drugs or the surgical repair of reproductive organs. Although numerous surgical procedures can correct difficulties or increase female fertility, the surgical interventions for fertility are rare these days as fertility treatments such as laparoscopic surgery, microscopic tubal ligation reversal surgery and tubal surgeries have high success rates.

Endometriosis may be diagnosed by using ultrasonography and endometrial biopsy that are not considered part of the basic infertility investigation. Neither blood tests nor imaging studies alone can correctly diagnose endometriosis. Although ultrasound might identify an ovarian cyst that includes an endometrioma, a laparoscopy is still required to make the diagnosis.

The fertility drugs used today may increase a woman’s chance of becoming pregnant with twins, triplets, or other multiples. If you are pregnant with multiples, additional problems, monitoring and health care visits may be increased. Multiple fetuses have an increased risk of being born prematurely and are also at a higher risk of health and developmental problems.

20160626_215011-300x249Male factor infertility, depending on the primary cause, may be approached either medically, surgically, or helped with reproductive therapies. Medical and surgical treatments will normally be handled by a urologist specializing in infertility. A reproductive endocrinologist may also be needed. This specialist may offer intrauterine inseminations (IUIs) or assisted reproductive technology (ART). ART includes all fertility treatments in which both eggs and sperm are handled outside of the body. These procedures involve surgically removing eggs from a woman’s ovaries, combining them with sperm in the laboratory, and returning them to the woman’s body or donating them to another woman. The main type of ART to overcome male infertility is in vitro fertilization (IVF), which currently accounts for more than 99 percent of ART procedures; tens of thousands of babies have been born around the world with this procedure. Severe male factor infertility is associated with genetic disorders such as mutations in the cystic fibrosis genes and is treated effectively only with IVF. ART accounts for approximately 10-15 percent of the remaining infertility treatment options.

Overall, many factors will determine how your specialist will treat your infertility. The complexity of infertility requires a substantial fiscal, physical, emotional and time commitment on your and your partner’s part. It may only take a couple of treatments to correct your infertility. However, some couples require numerous appointments and therapies before conception is possible. As mentioned above, medication or even surgery may be necessary to assist with conception, or complex procedures may also be warranted or introduced.

Coping and support

The quest for finding a cause for your infertility may be a strenuous and demanding one both physically and emotionally. Did you know that studies indicate that couples experiencing psychological stress have poorer results with infertility treatments? It will help to relieve any unnecessary anxiety by making sure you that you are aware, informed and understand the success rates, risks, and benefits of the potential therapies that are being offered. After consulting with your doctor, you and your partner will select the option that you feel is most advantageous to create a successful conception.

Don’t forget to keep your close friends and family informed of your progress. Many couples find comfort and support through the anonymity of online groups via social media. Professional help is always available to you both so never hesitate to reach out to your health care team for advice or a reference.

Continue your healthy lifestyle entertaining a moderate level of activity and exercise, and a well-balanced diet. This combination can boost your spirits as your tackle your infertility. Remember, that you always have alternatives to infertility. Adoption, surrogacy, gestational carriers or even deciding on not having any children may be choices you will want to consider. You should discuss these possibilities or another course of action that may appeal to you early in your infertility process as this can lower stress during treatments and disappointment if conception does not take place.

Prevention

It’s important that you try to improve your chances of normal fertility if you are considering becoming pregnant now or in the future. Simply incorporating the basics of good health is paramount. By maintaining a normal weight, eliminating smoking, alcohol and limiting your caffeine level to less than 200 to 300 milligrams a day, and reducing your stress level will improve your chances of normal fertility and the hope for conception to ensue.

Show More