I can not get pregnant. What should I do?

What happened?

You want a child and you not use protection for a while during sex in the hope of getting pregnant, but nothing happens. Troubled thoughts began to creep into your head. In this article we will find out when it’s time to worry and what can hinder conception.

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Why I can’t get pregnant?

There may be many reasons for this, but it is considered that it is possible to speak about some problems only after a year of regular attempts. This period is usually reduced to six months, if a woman is 35 years old or more. Immediately you can suspect that something is wrong, if you have an irregular cycle (then, obviously, there are problems with ovulation). Difficulties can also occur if you have sex very rarely. Doctors advise not to limit themselves to the period of ovulation – it is better that sex was two to three times a week or more often.

And what if all the blame is infertility? Is it generally treated?

They treat it, but it all depends on its cause. If you have not been able to conceive for a year, it is worth visit a gynecologist. A man in this case should go to the urologist, who first of all asks to do a spermogram. Approximately 35% of couples who have encountered problems in conception need to undergo treatment for both partners. In another 8 percent of cases, the male factor is the only cause of infertility. When female infertility is sometimes enough to take medicine or change the lifestyle, but often requires surgery.

One of the most popular methods of treatment infertility is to stimulate ovulation. Today Clomid is one of the most affordable and effective drugs that are used today to stimulate ovulation in women. In this case, it is necessary to know that any stimulation should be performed under the strict supervision of a doctor and ultrasound monitoring.

In men, infertility is also treated with drugs and surgery. For some couples, a physician can advise IVF when the sperm is injected directly into the ovum.

And you can do without a surgery?

Sometimes you can. For example, with endocrine disorders. The absence of ovulation and, as a consequence, infertility can be associated with hyperprolactinemia – an elevated level of the hormone prolactin. To restore reproductive function, in most cases it is enough to take pills for some time. Which ones, the doctor will say. Problems with ovulation can lead and polycystic ovary syndrome (it happens in 5-10% of women). Then the doctor will prescribe pills or injections of hormonal preparations, and also can advise to lose weight.

How are excess weight and ability to conceive?

A high level of insulin for obesity is associated with an increase in the level of androgens, which, in turn, interferes with the normal operation of the ovaries. Doctors recommend weight loss for problems with ovulation when the patient’s body mass index is greater than 27. A loss of only 5-10% of its own weight helps women with polycystic ovary syndrome to restore ovulation in 55-100% of cases.

However, the violation of the cycle or the termination of menstruation can be caused by insufficient weight. For example, if a woman has a body mass index of less than 17, she suffers from eating disorders or is too active in training. In such cases, to restore the cycle and return the ovulation, doctors recommend to gain weight and reduce physical stress.

Can endometriosis interfere with conception?

In general, yes. According to statistics, 25-50% of women with infertility have endometriosis, and if there are symptoms (for example, pain during sex and (or) during menstruation), it should be treated as much as possible. If the goal is not just to remove the symptoms, namely to become pregnant, then most likely the doctor will recommend the operation. Drug therapy in this case does not help. However, the operation does not always lead to the onset of pregnancy. In that case, you are on IVF.

And if a woman has an ovarian cyst, can this be the reason for infertility?

In some cases. Problems with conception may occur in the syndrome of polycystic ovaries and endometriome – an ovarian cyst caused by endometriosis. To treat it with infertility is recommended only if there are symptoms and it is more than 5 cm. But functional cysts (follicular cysts, yellow body cysts), cystadenomas and dermoid cysts of small size do not affect fertility.

They say that partners can be simply incompatible.

This happens very rarely. And in general the term “incompatibility of partners” is a household concept and is almost not used in medicine. When doctors talk about problems with conception due to “incompatibility”, an immune factor is implied – in particular, when a woman develops antibodies to the sperm of a man – however this is a rather rare and controversial factor of infertility. If the doctor still believes that the problem is in this, then he can recommend artificial insemination or IVF.

And when you can not do without surgery?

If you have a large fibroids or fibroids that deform the uterine cavity. In such cases, it can cause infertility or have a negative impact on pregnancy. The doctor can also recommend surgical treatment to restore the patency of the fallopian tubes. Moreover, the operation is carried out for diagnosis. It can not be said that this is a routine method of infertility research – it is used when all laboratory and instrumental non-invasive methods have already been used. And in some cases it is the operation that helps to detect the pathology of the fallopian tubes and endometriosis.

The doctor says that it is easier to do IVF than to restore the patency of pipes.

All individually. In some situations, the doctor may suggest laparoscopic surgery, but often the most effective treatment is IVF, especially if the woman is over 35 years old.

And yet, operations are very scary, dangerous, and after it for a long time to recover!

Do not be afraid, you need to be treated. Many problems (removal of fibroids, endometriosis, restoration of patency of the fallopian tubes) are now solved with the help of minimally invasive operations, mainly laparoscopic ones. This is when small incisions are made and a telescopic tube and tools are inserted through them. After such operations, patients recover faster.

A long time you can not become pregnant after the operation? What can be unpleasant consequences?

Recovery fast, the consequences are minimal. In most cases, the hospital will need to spend only a few days, and sometimes only one day. How many will need to wait with pregnancy depends on the situation. For example, women after laparoscopic myomectomy (i.e., removal of fibroids) are recommended to become pregnant no sooner than three to six months later.