Conception Is A Process With Many Variables

It often takes several months of trying to conceive before you become pregnant, simply because there are such a large number of factors involved. If you have not been able to conceive after a year it may be time to discuss potential fertility problems.

There are a variety of issues which may contribute to infertility for both men and women. For women, ovulation may not be occurring regularly. In other cases, a problem with the reproductive organs may be preventing pregnancy, as may a hormonal irregularity. Factors like these can be caused by genetics as well as conditions like endometriosis, thyroid abnormalities, polycystic ovary syndrome, and certain lifestyle factors.

Fertility also decreases with age in both men and women, though the change in a woman’s fertility is significantly more predictable. Women are born with a fixed number of eggs, which continually decreases over time. The likelihood of pregnancy in each menstrual cycle begins to lower when a woman reaches her early 30s, and then declines more rapidly around age 37.


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Treating infertility typically depends on the underlying cause. Fortunately, there are a variety of tests available to determine the reason for a couple’s infertility. A detailed medical history is usually the first step to determine where to begin with medical testing. Some tests can actually be performed at home, such as tracking your basal body temperature. This will help determine whether you are ovulating regularly and when ovulation is occurring.


Laboratory tests using blood or urine to look for certain ovulation markers or potential hormone problems may be needed. A urine test may be used to measure your luteinizing hormone (LH), which triggers ovulation. Blood tests, on the other hand, can be used to determine your progesterone levels (to determine if and when you’re ovulating), look for thyroid problems, detect high levels of prolactin , and measure the remaining eggs in your ovaries. Because fertility is affected by your partner’s sperm as well, a semen analysis can also be performed.

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Ultrasounds can be used to non-invasively examine certain internal organs. In the case of fertility, ultrasounds can examine a woman’s reproductive organs to detect whether there are problems with the uterus or fallopian tubes. Transvaginal ultrasounds may also be recommended, which allows a better look at a woman’s reproductive organs to detect cysts/abnormal growths or other possible female concerns such as endometriosis.

Another imaging procedure which can be used to look for potential fertility problems is a hysterosalpingogram, or HSG. This is a type of x-ray in which a contrast dye fills the uterus and fallopian tubes in order to show the shape and size of your reproductive organs, as well as to locate any potential blockages.

One of the most common reasons for infertility is a problem with your ability to ovulate. In this case, there are several medications which can be used to induce ovulation. The most common choices include letrozole and clomiphene citrate, but another option is a group of drugs called gonadotropins. These are administered as a series of injections at specific times in the menstrual cycle. Ovulation induction can be performed either to facilitate natural conception or to increase the number of eggs for use in assisted reproductive technologies (ART) like in vitro fertilization and intracytoplasmic sperm injection.

Infertility FAQs

While determining the root cause of infertility can allow for more targeted and sometimes simpler treatment, pregnancy can often be achieved even if no cause is found, often as a result of the more direct and hands-on approach of ART. Surgical options, such as minimally-invasive laparoscopy, may be recommended to treat a variety of gynecological conditions in addition to unexplained infertility.
In some cases, fertility can be affected by lifestyle choices, so living more healthily can improve your ability to conceive. Though it’s still a good idea to get your gynecologist’s recommendation, both men and women may be able to improve their fertility by reaching a healthier weight (if you are either overweight or underweight), doing more or less exercise (if you currently exercise too much or too little), limiting your alcohol intake, and quitting smoking and/or using illegal drugs.
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