What Are the Signs You Can’t Get Pregnant?
When you decide you’d like to have a baby, it can take some time to conceive. But knowing how long is too long can be difficult. Some women have a medical condition that may make getting pregnant more difficult, have a partner that may have a fertility issue, or be older than age 35, which can affect the likelihood they will get pregnant. Knowing the potential signs that a woman can’t get pregnant can help you determine if you should seek the advice of a reproductive endocrinologist.
As a general rule, if you have had unprotected sex with your partner for about a year without conceiving, this is a sign you may not be able to get pregnant without additional medical support. However, if a woman is older than age 35, she may wish to seek help from a reproductive endocrinologist after six months of trying to get pregnant. Some of the signs that you may not be able to get pregnant without fertility treatments can include the following:
Being Older Than Age 35
Age can significantly affect fertility in both men and women. In men, being older than age 35, can mean a decreased sperm count. Because there are less available sperm to fertilize the egg, it is less likely that a woman will conceive. However, men are not affected in terms of fertility as quickly as woman are when they turn 35. When a woman is older than age 35, her egg quality and number of eggs is usually affected. Eggs that are of a poorer quality cannot be fertilized as well, nor can the egg mature as effectively. According to Fox News, a woman at age 30 is 20 percent likely to get pregnant each month. These numbers go down as a woman ages.
Women older than age 35 can conceive, but doing so may be more difficult. This is why women older than age 35 often benefit from seeing a reproductive endocrinologist as quickly as possible if they haven’t conceived after six months of trying.
Having Polycystic Ovary Syndrome/Conditions That Affect Ovulation
Polycystic ovary syndrome or PCOS is a medical condition that affects a woman’s menstrual cycle and ovulation. Women with PCOS have an increased amount of male hormones, such as testosterone. This can affect her ability to ovulate, which involves releasing an egg for fertilization. Without ovulation, a woman cannot get pregnant. According to Fox News, an estimated 5 to 10 percent of women have PCOS. Some women may be unaware they have PCOS. Symptoms can include:
- Gaining weight unexpectedly
- Having irregular periods or missed periods
- Growing hair in unusual places, such as on the chest, face, back, and stomach
- Having repeated miscarriages
- Experiencing depression or mood swings
Treatments are available to help a woman control PCOS and help her ovulate. If these symptoms sound like something you could be experiencing, contact your gynecologist.
In addition to PCOS, there are other conditions that may affect a woman’s ability to ovulate. Examples of these include being very overweight or underweight. Having a disorder that affects the balance of a woman’s thyroid hormones can also be problematic.
Having a History of Endometriosis
Endometriosis is a medical condition that causes tissue that normally grows only in the uterine cavity to grow in the abdominal cavity as well. The results can be a significant amount of pain. Heavy bleeding and infertility can also occur in anywhere from 30 to 50 percent of women who have endometriosis. Sometimes the growth of irregular tissue can cause a woman’s fallopian tubes to become blocked. As a result, a woman cannot release an egg that will travel to her uterus as a means to become pregnant. If a woman’s Fallopian tubes becomes blocked, a doctor may recommend in vitro fertilization, where a doctor removes an egg or eggs from a woman’s ovaries directly, so the egg does not travel down the fallopian tube. However, if a woman has endometriosis are her fallopian tubes are open, she may benefit from taking a medication called Clomid. This medication helps to ensure ovulation. A doctor may recommend women with endometriosis take this medication and use intrauterine insemination or IUI as a means to conceive. This method involves taking sperm that have been “prepared” to ensure sperm quality and inserted directly into a woman’s uterus to promote greater chances of conceiving.
Other medical conditions can also cause a fallopian tube to be blocked. Examples include a sexually transmitted disease or STD. Chlamydia can especially cause a woman’s fallopian tube to become blocked.
History of Injury or Damage to the Testicles
Male infertility can contribute to difficulty in conceiving just as much as female infertility can. A woman may have difficulty conceiving if her partner has a history of injuries to the testicles or scrotum. This can damage or destroy semen. A man may not even know that his testicles have been damaged to the point of causing infertility until he and his partner are trying to conceive. Men may also experience temporary damage to the testicles due to overheating, such as from wearing underwear that is too tight or taking baths in hot water. Both of these practices should be avoided while a woman is trying to get pregnant.
According to the Centers for Disease Control and Prevention, an estimated 35 percent of couples have difficulty conceiving due to male and female factors that affect fertility.
Having Unhealthy Habits
Women and men who have unhealthy habits, especially smoking, are less likely. Women who smoke or are subject to significant secondhand smoke exposure typically take longer to get pregnant. There are a number of reasons why smoking can contribute to infertility. For example, smoking affects egg maturation in women as well as sperm maturation in men. Smoking can also damage DNA in eggs and sperm and affects hormone production needed to successfully help an embryo grow. Also, women who smoke are more likely to experience an ectopic pregnancy or miscarriage – all good reasons to quit if you want to conceive.
In addition to smoking, unhealthy habits such as heavy abuse of alcohol, taking anabolic steroids, or using illegal drugs can all affect a couple’s abilities to get pregnant. If you or your partner use these substances, talk to your doctor about how to quit. Doing so will not only improve your chances of conceiving, it will promote better health overall for you.
Being Overweight or Underweight
Extra fats releases its own hormones, which can affect a woman’s ovulation. Women who are overweight are more likely to have PCOS as mentioned before. They are also more likely to be insulin-resistant, where their bodies cannot use insulin to process glucose. As a result, a woman’s blood sugar is not only higher, her body may start to release male hormones known as androgens. These hormones do not support ovulation.
Being underweight is problematic if you’re trying to get pregnant as well. Women tend to produce less of the hormone estrogen, a hormone needed to support ovulation. This can cause a condition known as function hypothalamic amenorrhea or FHA. Women can also experience FHA is they exercise excessively or have a lot of stress in their lives. If a woman is underweight, a doctor may recommend a program to gain weight in a healthy manner. As a result, a woman may be more likely to get pregnant.
Sometimes, a doctor may not be able to identify why a woman can’t get pregnant. Doctors call this unexplained infertility. Even when a woman has unexplained infertility, there are still fertility treatments she can use that can help her to conceive. If a couple decides they are going to try to conceive, living as healthy a lifestyle as possible can increase their chances for getting pregnant. This includes refraining from smoking, eating healthy foods, exercising, and trying to limit stress whenever possible. These habits promote a healthy body that can foster the growth of a healthy baby. Treating sexually transmitted diseases may also help to reduce inflammation in the pelvic cavity. Men should also refrain from wearing clothing (especially underwear) that is too tight or exposes the testicles to excessive heat, such as when swimming or bathing.
According to the National Institutes of Health, an estimated 7 percent of men and 11 percent of women in the United States have problems with fertility. If a couple hasn’t gotten pregnant in six months to a year, a doctor can perform blood testing for the presence of certain hormones, such as follicle-stimulating and anti-Mullerian hormones that are vital to fertility. They can also test to ensure that a woman is ovulating. Imaging studies of the uterus, fallopian tubes, and ovaries may also help to identify structural abnormalities that may be keeping a woman from getting pregnant. Men can also undergo testing for the presence of male sex hormones, such as testosterone. A doctor may also measure a sample of the man’s semen to determine the amount and quality of sperm present to ensure enough sperm are present (or if sperm are present at all) for fertilization.
Centers for Disease Control and Prevention: Infertility FAQs
Fox News: Can’t Get Pregnant? 5 Surprising Reasons for Infertility
Mayo Clinic: Infertility
The National Infertility Association: What Is Infertility
National Institutes of Health: About Infertility and Fertility
Planned Parenthood: Infertility
In Vitro Meaning
Each year, thousands of couples across the country choose in vitro fertilization as a means of getting pregnant, most commonly when traditional methods have failed. In vitro fertilization is an assisted reproductive technology (ART). The term “in vitro” is Latin for “in glass.” This term is used across several scientific and medical specialties for research that is conducted in a test tube or other laboratory glass. This term is different from “in vivo,” which means “in life” when studies are conducted inside an organism.
There are other ART techniques that involve an in vivo fertilization. This includes the use of artificial insemination. This process involves delivering a man’s sperm into the uterus to increase the likelihood that a woman will conceive. Artificial insemination is an option for women whose partners may have sperm that may not have effectively traveled through the cervix to the uterus. However, in vitro techniques will result in fertilization outside the body, with subsequent implantation into a woman’s uterus.
The term “in vitro” is appropriate for describing in vitro fertilization because an egg and sperm are collected from donor parents and combined in a laboratory for fertilization (a more detailed description of this process is included below). Because fertilization happens outside the womb, doctors use the term “in vitro.” Other names for the process may include IVF or in vitro. This ART method is rarely the first option utilized, but instead is one of the last because of its cost, time-consuming nature, and invasiveness in retrieving eggs.
What Are Some of the Major Milestones in In Vitro Fertilization?
While the greatest strides in in vitro fertilization have been in the past few decades, the concept behind the treatment has been around for more than one hundred years. According to the journal “Reproduction,” experiments that would serve as the foundation for IVF began in 1878. Some of the major milestones in in vitro’s history include:
- In 1884, the first reported artificial insemination took place, injecting donated sperm into a woman’s uterus.
- In the 1940s, researchers learned how to freeze donated sperm. These techniques would form the basis for sperm banks, which started opening in greater numbers in the 1970s.
- In 1959, a research study concerning rabbit eggs that were fertilized in vitro that later developed into normal offspring served as the basis for two other important research studies in 1963 and 1964 regarding hamster gene studies.
- In 1967, the U.S. Food and Drug Administration (FDA) approved the medication clomifene (Clomid) to treat infertility in women who do not ovulate. The medication acted as the gateway for assisted reproductive technology, including in vitro.
- In 1978, researchers reported the first successful human birth from an IVF embryo. This was research conducted at Oldam General Hospital in Great Britain with the couple John and Lesley Brown. On July 25, 1978, Mrs. Brown gave birth to their daughter Louise, who is known as the first “test tube baby.” However, in vitro fertilization does not happen in test tubes, but instead in petri dishes. These are small, plastic or glass circles that have a medium that supports the growth of fertilized embryos.
- In the early 1980s, couples began freezing their embryos for use in subsequent IVF cycles. According to the “Santa Barbara Independent,” there are an estimated 500,000 frozen embryos in the United States.
- In 1992, researchers first reported the first successful intra-cytoplasmic sperm injection (ICSI). This involves a laboratory professional injecting a single sperm into an egg instead of simply exposing the egg to collected sperm. Before the invention of ICSI, thousands of sperm had to be collected. However, if a man had low sperm counts, the couple could not conceive using in vitro. This expanded the availability of options for treatment of couples who could not get pregnant.
- As of 2010, more than 3 million babies have been born as a result of in vitro. On a yearly basis, an estimated 300,000 couples utilize IVF in an attempt to get pregnant, according to the “Santa Barbara Independent.”
In vitro fertilization has been the product of more than a hundred years of research and milestones that have helped couples conceive when it would not have otherwise possible. As researchers continue to develop new medications and methods, the success rates of in vitro has continued to increase. Doctors are also gaining a greater understanding regarding fertility and genes that may affect a couple’s likelihood for conceiving as well as passing on traits that can result in miscarriage for women.
Why Might a Couple Choose In Vitro?
In vitro is chiefly used as a treatment for infertility. If a couple has unprotected sex for a year without conceiving, this can be a sign of an underlying medical condition and fertility concerns that can warrant further interventions. While in vitro is not the only option in terms of fertility treatments, it is one that can be beneficial for infertility related to a medical condition, such as endometriosis or polycystic ovary syndrome. Women with premature ovarian failure, uterine fibroids, or other ovulation disorders can also benefit. Often, women attempting to conceive at an age older than 35 may find greater success through in vitro. However, fertility naturally declines with age.
Some people use in vitro as a method of fertility preservation. For example, if one part of a couple is going to undergo cancer treatments that can affect fertility, they may choose to go through an IVF cycle to create embryos that could be used to have a baby at a later time. The embryos are then frozen until the couple is ready to try to conceive or use a surrogate to carry their baby.
Another reason why a couple may turn to in vitro is if one or both of the couple has a history of a genetic disorder. An example could include cystic fibrosis. While a laboratory cannot screen for all types of genetic disorders, they can screen an embryo for some disorders. Testing is known as preimplantation genetic screening (PGS). Because a woman is also at greater risk for having a child with birth defects as she ages, women may wish to have their embryos screened for the incidences of genetic abnormalities, such as Down’s syndrome, which results from three copies of chromosome 21. PGS could reduce the couple’s likelihood of having a child they passed their genetic disorder on to.
How the In Vitro Process Works
Most couples will seek in vitro treatments at a fertility clinic, where a doctor specializes in treating a couple’s problems related to fertility. The doctor will conduct a thorough interview with the couple regarding their health histories, how long they have been trying to conceive, and their desire to pursue various fertility treatments. Depending upon the couple’s health history, a doctor may also recommend testing to determine potential underlying infertility causes as well as to test how many eggs a woman may still have. This is detected using blood tests known as ovarian reserve tests. Additionally, a doctor may also recommend conducting testing for the male, to determine the number and quality of his sperm. At this time, a doctor may recommend either proceeding with in vitro fertilization treatments or considering pursuing either donor egg or sperm as a means to conceive. Sometimes a woman may not have enough eggs remaining to successfully harvest the eggs for in vitro. This is why it is important that a doctor conduct testing before beginning the treatments.
If a doctor recommends moving forward with in vitro, the process will begin by testing to determine when a woman is ovulating. This is important because a doctor will administer medications that will promote the release of more than one egg so multiple eggs can be harvested for possible embryo fertilization. Right before the eggs are scheduled to be retrieved, a woman will receive a shot that will ideally cause her to release the eggs in a timely fashion.
On the day of egg retrieval, a doctor will perform a procedure known as follicular aspiration to remove the eggs. This procedure involves inserting a small needle using ultrasound imaging to remove the very small eggs. Ideally, the procedure should not cause a woman any pain or discomfort. However, some mild bleeding and cramping may occur.
The clinic will collect the man’s sperm, usually produced through masturbation. However, if a man cannot donate the sperm in this manner, a doctor may have to use retrieval via invasive methods.
A fertility doctor may discuss the treatment options with a couple for fertilization. Sometimes, a laboratory will simply expose the eggs to the sperm for fertilization. Other times, if there are concerns over sperm quality or fertilization, a couple will choose intracytoplasmic sperm injection or ICSI. This technique involves injecting a single sperm into the egg. Although this is associated with greater chances for conception, it also is more costly and time-consuming. However, some fertility programs recommend only using ICSI for fertilization as it is associated with greater success rates.
Once the fertilized egg begins to divide, doctors consider it an embryo. The process from fertilization to embryo creation takes about five days. If a couple desires PGD, this testing process is performed about three to four days after fertilization occurs. However, not all centers provide PGD due to its sometimes-controversial nature where some experts contend this is the equivalent to parents manipulating the process of natural selection.
Once the embryos as ready, a woman will return to the fertility clinical for artificial insemination. This is the process where a doctor will insert a special catheter through her vagina and into her uterus. Prior to insemination, a doctor will discuss how many embryos should be transplanted. The more embryos that are transplanted, the greater likelihood for success. However, more embryos also increases a woman’s chances of a multiples pregnancy. Being pregnant with more than one child can result in increased miscarriage risks. As a general rule, the older a woman is, the more embryos that may be transplanted due to the lower conception rates associated with aging.
Ideally, the artificial insemination process will result in a successful pregnancy. However, if a woman does not become pregnant with the first IVF cycle, she may choose to conduct future cycles. Some women will freeze additional embryos in case they are required for additional IVF attempts.
Conclusions on In Vitro Meaning
Infertility and the desire to have a baby has been a challenge for thousands of years. In the past 100 years, researchers have made great strides in helping women conceive when they may not have been otherwise able. While in vitro does not have a guarantee of success, an estimated 1 percent of all babies born in the United States are born to parents who sought in vitro treatments, according to the “Santa Barbara Independent.”
In vitro can be associated with being a very stressful process. As a couple has likely tried to conceive for a year or years, they often view in vitro as their last effort toward conceiving. As a result, tensions, stress, and depression can all be emotions that accompany an in vitro cycle. In addition to the mental health side effects, taking fertility medications, retrieving eggs, and conducting artificial insemination can have physical effects. Examples of these include:
In addition, the medications can cause a syndrome known as ovarian hyperstimulation syndrome (OHSS). This syndrome causes a person to experience swelling in the ovaries that causes significant pain, swelling, nausea, and shortness of breath. Sometimes, severe cases may require treatment that involves draining fluid buildup on the ovaries to reduce symptoms.
American Pregnancy Association: In Vitro Fertilization (IVF)
The Embryo Project Encyclopedia: In Vitro Fertilization
MedlinePlus: In Vitro Fertilization
Reproduction: Early History of In Vitro Fertilization
Santa Barbara Independent: In Vitro Fertilization, Part I: A Brief History
VeryWell: In Vitro Definition
According to the Centers for Disease Control, infertility is fairly common. Around 12 percent of women under the age of 45 find they can’t get pregnant after a year of trying. The majority of these women will go on to have children, either naturally or with the help of a variety of technologies available to treat infertility.
Finding you’re unable to get pregnant can take a toll on your body, mind, and spirit. If you can’t get pregnant, it’s important to take an educated, systematic approach to figuring out the problem and working to correct it.
What Causes Infertility?
In about one-third of infertility cases, the issue is with the woman, and in another one-third of cases, the issue is with the man. The remaining one-third of cases are caused by issues with both the man and the woman, or no cause can be found.
Causes of male infertility include:
- Abnormal sperm production or function.
- Sexual problems like premature ejaculation, some genetic diseases, or a blockage in the testicle
- Exposure to environmental toxins like pesticides or other chemicals
- Cigarette smoking, drug and alcohol abuse, and some medications
- Cancer-related damage, including from radiation or chemotherapy
Causes of female infertility include:
- Ovulation disorders like polycystic ovary syndrome
- Excessive exercise or an eating disorder
- Abnormalities with the cervix or uterus, including uterine fibroids or problems with the opening of the cervix
- Blockages or damage in the fallopian tubes due to problems such as pelvic inflammatory disease
- Endometriosis, a disorder that causes the tissue that lines the uterus to grow outside the uterus, causing problems with the ovaries, fallopian tubes, and the tissue around the uterus and ovaries
- Cancer, particularly those related to female reproduction, and the radiation or chemotherapy used to treat it
- Poorly controlled medical problems like celiac disease, diabetes, or autoimmune diseases like lupus
Risk factors for male and female infertility include:
- Age: Female fertility begins to decline with age, starting around the mid-thirties and rapidly decreasing after age 37 due to fewer eggs or lower quality eggs. Men over the age of 40 are typically less fertile than younger men.
- Smoking: Cigarette and marijuana smoking by men and women reduces fertility, and smoking also reduces the effectiveness of fertility treatments.
- Alcohol use: Alcohol use may contribute to infertility in both men and women. Heavy alcohol use among men can reduce sperm count and affect the mobility of sperm.
- Overweight or underweight: Both obesity and being underweight increase the risk of infertility. Eating disorders, restrictive diets, excessive exercise, and a lack of exercise may also cause problems when you’re trying to conceive.
What You Can Do If You Can’t Get Pregnant
If you can’t get pregnant, your first instinct may be to make a doctor’s appointment to try to pinpoint the problem. But while your doctor will probably be happy to offer tips to help increase your chances of conceiving, she probably won’t order any tests this early in the game unless you or your partner have a known problem with sexual function.
At what point should you see your doctor for a serious look at infertility? The U.S. Office of Women’s Health recommends making an appointment with your doctor to discuss infertility if:
- You’re under 35 and haven’t conceived after a year of frequent sex without birth control.
- You’re over 35 and haven’t conceived after six months of frequent sex without birth control.
- You or your partner has an issue with sexual function, such as premature ejaculation or abnormal periods.
Additionally, you should talk to your doctor if you have:
- Irregular periods or no periods.
- Painful periods.
- Pelvic inflammatory disease, or PID.
- A history of miscarriage.
Meanwhile, there are a number of things you can do to improve your odds of getting pregnant.
The better you understand your anatomy and the mechanics of conception, the better you can make choices that will increase your chances of getting pregnant.
Every month, a group of eggs in your ovaries begins to grow inside a small sacs called a follicle. Around two weeks before your next period, one of the eggs emerges from the follicle. This is known as ovulation. The egg develops into what’s called the corpus luteum, which releases a hormone that causes the lining of your uterus to thicken. The egg moves into the fallopian tube, where it stays for 24 hours waiting to be fertilized by a sperm.
If the egg isn’t fertilized, it moves through the uterus and disintegrates. Shortly after, your hormones go back to normal, and the thick lining of the uterus is shed, resulting in your period.
If the egg is fertilized, it will stay in the fallopian tube for three or four days. Within 24 hours of fertilization, it begins dividing into numerous cells. As it moves through the fallopian tube to the uterus, it continues dividing, and once it reaches the uterus, it attaches to the thickened lining. This is known as implantation. As soon as the dividing egg is implanted in the uterus, a hormone called hCG is released. This is the hormone that’s detected by a pregnancy test. Levels of hCG are high enough to be detected between three and four weeks after the first day of your last period.
Understand Your Menstrual Cycle
Knowing the length of your menstrual cycle helps you determine your fertile zone. Since sperm can live for five days waiting around for an egg, which has a lifespan of just 24 hours, the fertile zone is comprised of the six days that lead up to and include ovulation. The most fertile days are the three days leading up to and including ovulation.
Ovulation occurs around 14 days before the day your period starts. If your average menstrual cycle is 28 days, you’ll ovulate around day 14, and your fertile zone will be days nine through 14. Your most fertile days are days 12, 13, and 14.
If your cycle is irregular, figure out the length of your average cycle, with the first day of your period counting as day one and the day before your period counting as the last day. Subtract 14 to determine when you ovulate, and subtract six from that number to identify the day your fertile zone begins.
Once you know your fertile zone, you’ll know when to clear your calendar and plan some romantic candlelight dinners.
Get Medical Conditions Under Control
If you have a medical condition, visit your doctor to get it under control with treatment. Untreated sexually transmitted diseases, high blood pressure, eating disorders, and chronic diseases like diabetes can impede your ability to get pregnant as well as put your pregnancy and the health of your baby at risk.
Make Essential Lifestyle Changes
The lifestyle choices you make have a major impact on your ability to get pregnant. The Centers for Disease Control stresses the importance of preconception health for not only improving your chances of conception but also for helping to ensure a safe pregnancy and healthy baby. Make these important lifestyle changes to boost your odds of conception:
- Quit smoking. A British Medical Association report found that smokers may have up to a 40 percent lower monthly fertility rate than non-smokers. Your partner’s smoking may also affect your ability to conceive.
- Stop drinking and using drugs. Drugs and alcohol reduce your chances of getting pregnant, and they can lead to problems during pregnancy as well as cause birth defects.
- Lose or gain weight. Hormonal shifts that come with extra weight can influence ovulation and semen production. Conversely, being underweight can lead to irregular periods or cause your period to stop. Studies show that losing just five percent of your body weight can improve your chances of getting pregnant.
- Eat healthy food. Limit or avoid processed foods, added sugar, and saturated fat. Indulge every now and then, but for the most part, eat healthy, whole foods every day, including plenty of fruits and vegetables, beans, whole grains, lean proteins, and low-fat dairy.
- Limit caffeine. Studies show that even small amounts of caffeine may reduce your chances of getting pregnant. One study found that women who consumed more than 100 milligrams of caffeine per day were half as likely to conceive as those who consumed less.
- Get plenty of quality sleep. Inadequate sleep affects the functioning of your body’s systems, including your immune and reproductive systems. The hormone leptin, which has a crucial role in conception, is reduced when you’re deprived of sleep, and a lack of sleep increases your stress level, which can also reduce your ability to get pregnant. Strive for at least seven hours of sleep each night for optimum health and systemic functioning.
Reduce Your Stress
A study published in the journal Fertility and Sterility found that stress significantly reduces the probability of conception each day during the fertile window. Keeping your overall stress levels down and reducing acute stress on the spot with breathing exercises or visualization may increase your chances of conception.
Excellent ways to reduce stress include:
- Meditation, which also helps your body better respond to stress.
- Exercise, which also improves your mood and increases feelings of wellbeing.
- Deep breathing, which reduces levels of the stress hormone cortisol on the spot.
- A healthy diet, which helps produce more serotonin, a brain chemical associated with relaxation.
- Adequate sleep, which helps you cope effectively with stress.
A hobby you enjoy, which puts you in a relaxed, meditative state.
Track Your Attempts at Conceiving
In the event you’re unable to conceive within a reasonable time frame, your doctor will want to know all about your diet and lifestyle, when you started trying to conceive, how often you have intercourse during your fertile window, and what medications, vitamins, herbs, and other supplements you’ve been taking, including the doses and how often you take them. Keeping track of all this information as you go will help you answer questions with a high level of accuracy, which can help rule out possible causes more quickly—and with fewer expensive tests.
Difficulty getting pregnant can lead to chronic stress, anxiety, and depression. It can leave you with feelings of isolation, frustration, anger, and even guilt. It can take a toll on your relationship with your significant other, and it can affect your self-esteem.
Strong emotional support is essential for helping to ward off these negative feelings. If you can’t get pregnant, finding support is extremely important for your mental health and wellbeing. Support groups for infertility bring you into contact with others who are going through similar circumstances, and they offer the opportunity to share experiences, advice, tips, and resources.
- Reduce feelings of isolation.
- Reduce the stress associated with the challenges of infertility.
- Gain a sense of empowerment and control.
- Improve your coping skills.
- Express your feelings openly and honestly.
- Reduce depression and anxiety.
- Maintain high self-esteem.
Options for Infertility
If you can’t get pregnant despite lifestyle changes and you’ve spent six months to a year trying—depending on your age—it’s time to pay a visit to your doctor.
After an extensive interview about lifestyle and medical history, your doctor may order some tests for one or both of you. These may include a semen analysis, ovulation testing, hormone or genetic testing, and imaging tests. Depending on the specific diagnosis, infertility treatment may help you conceive. The most common infertility treatments include:
- Fertility-enhancing drugs to boost ovulation.
- Artificial insemination, during which sperm is inserted directly into the cervix, fallopian tubes, or uterus.
- In vitro fertilization, or IVF, wherein an egg is fertilized in a laboratory dish and transferred to the uterus.
- Zygote intrafallopian transfer, or ZIFT, which is similar to IVF, except the fertilized egg is transferred to the fallopian tube instead of the uterus.
- Gamete intrafallopian transfer, or GIFT, involves placing eggs and sperm into the fallopian tube so that fertilization occurs in the body.
- Intracytoplasmic sperm injection, or ICSI, which is used for serious problems with the sperm or when IVF fails for older couples. ICSI involves injecting a single sperm into a mature egg in the lab and transferring the embryo to the uterus or fallopian tube.
Other options for infertility include:
- Using donor eggs or donor sperm, which come from another woman or man in the event a woman can’t produce eggs or the man has poor quality sperm.
- A surrogate is a woman who agrees to become pregnant using her own eggs and the sperm of the man. After birth, the infertile couple will adopt the baby.
- Gestational carrier. Similar to a surrogate, a gestational carrier is another woman who carries a baby to term for a woman who shouldn’t become pregnant due to health problems. The egg and sperm come from the couple. The fertilized egg is implanted in the gestational carrier, who gives the baby to the couple after birth.
Don’t Give Up Hope
After six months of trying, 60 percent of couples will conceive without medical assistance, according to Resolve, the National Infertility Association. Of those who require medical assistance, 65 percent will give birth. Up to 90 percent of infertility cases are successfully treated with drug therapy or surgery, and only three percent need advanced technologies like IVF to conceive.
If you find you can’t get pregnant, don’t give up hope. Stay encouraged, and get support. Live in the present moment as much as possible, and strive to maintain a positive outlook. The odds are in your favor that you’ll eventually conceive and go on to have a healthy, happy baby.
What Are the Major Steps of Twin Pregnancy Development?
Congratulations! It’s twins! Hearing these words from your obstetrician can be both thrilling and alarming. Carrying not one, but two developing babies can seem like a big job for a mom-to-be. But month to month, there are many exciting stages of twins pregnancy development that result in welcoming two bouncing babies into the world. Read on for more milestones that will occur month by month in a pregnancy.
Twin Pregnancy Development: Month 1
Twins can be identical, meaning they split from the same fertilized egg and share the same placenta, or fraternal, where two separate sperms fertilized two different eggs in the uterus. Fraternal or non-identical twins will have separate placentas because they arose from two different eggs. While most women may not start to experience symptoms associated with pregnancy until weeks 5 to 6 of their pregnancy, women pregnant with twins may notice symptoms earlier. This is because growing two babies can result in a lot of hormones, especially human chorionic gonadotrophin (hCG) hormone. This hormone can unfortunately result in morning sickness where a woman feels especially nauseous in the mornings during her pregnancy.
Twin Pregnancy Development: Month 2
Another sign associated with twin pregnancy development is that an expectant mom may appear larger or further along in terms of her uterus size than when compared to a mom pregnant with one baby. While a mom at two months may not yet be showing signs of pregnancy, her doctor will note that she is larger than is expected. That’s because she is already growing two babies that will have arms and legs that bend. They also have hearts that will start beating at roughly week six of pregnancy.
Twin Pregnancy Development: Month 3
At month three, your babies can suck their thumbs and are starting to develop their genitalia. They also have functioning urinary and kidney tracts. Ideally in the third month of pregnancy, nausea will start to subside as hormones that increased to support the twins’ growth start to regulate and the placenta takes over more of the hormone production functions.
Twin Pregnancy Development: Month 4
During month four of pregnancy, each baby will have his or her own fingerprints. You won’t have to wonder about their gender much longer either! Most babies’ gender can be visualized on an ultrasound by about 16 weeks. If the twins are of different genders, they are fraternal (non-identical) twins. However, if the babies are the same sex, a doctor may not be able to predict at this time if they are identical or fraternal.
Twin Pregnancy Development: Month 5
Moms pregnant with twins can often feel their babies moving at an earlier time compared to women pregnant with only one baby. This may be because there are two babies in there, moving around and making themselves known. At this stage in development, the babies are still small enough that their movements may feel like fluttering. However, as they start to grow larger, the movements will more closely resemble kicking. Your twins are also developing their hearing, meaning they can hear you if you talk to them.
Twin Pregnancy Development: Month 6
By this time, your babies may be growing together so much that they will rub close together. Often, ultrasound imaging will reveal the babies touching heads in the womb, separated by only a thin amniotic sac. During this phase, a doctor will measure the babies carefully, especially their heads, to ensure they both are developing at the same pace. This is because with a twins’ pregnancy, it is possible that one twin could get significantly more nutrition or blood flow than the other.
Twin Pregnancy Development: Month 7
As you near the home stretch of pregnancy, your babies are achieving important milestones that will help them be strong and healthy outside the womb. This includes developing lungs as well as a liver that is maturing. Each babies’ bones will continue to ossify or harden during this time, including the skull bones. Although the pieces of the skull bones will not fuse together until after the babies are born, they are still developing toward this goal.
Twin Pregnancy Development: Month 8
During month 8, the babies have made most of their needed organ developments and are just continuing to grow more and more in preparation for delivery day. At this time, your babies’ body systems are developing and functioning, including being able to pee in the womb. During month 8, it’s important to ensure you have your hospital bag packed because your babies will be delivered soon.
Twin Pregnancy Development: Month 9
According to Huggies, most twin pregnancies will be delivered on or before the 40-week mark that is considered a full-term pregnancy. The most common cause of preterm labor in moms who are expecting twins is simply running out of room. When babies cannot grow any more due to lack of space, a mother’s body may trigger labor. Ideally, you will be far enough along in your pregnancy that you can deliver twins with healthy lungs and organs. According to the Mayo Clinic, most women pregnant with twins will deliver their babies via induction (giving medicines to induce labor) or C-section by weeks 38 to 39 of pregnancy.
Conclusions on Twins Pregnancy Development
Most babies develop in a twins pregnancy in a very similar manner to women pregnant with only one child. However, there are unique challenges to mom and babies in terms of space. You will go to your doctor’s office on a regular basis (usually monthly at first, then bi-weekly or weekly as your due date gets closer) to check on the babies’ development. As your due date nears, your doctor will especially examine the babies for their positioning. If neither baby is in a head-down position, it may not be possible to deliver the babies vaginally. This is why it is important for moms and doctors to talk about the possibility of C-section before a twins’ delivery.
BabyCenter: Twins Fetal Development Month by Month
Huggies: Twin Pregnancy Week By Week
Mayo Clinic: Twin Pregnancy: What Multiples Mean for Mom
Parents: Twins: A Closer Look at Your Developing Babies
What Is IUI?
IUI is short for intrauterine insemination. This is a fertility treatment designed to help women conceive who have not been able to via unprotected sex. Prior to the creation and refining of the IUI process, doctors would perform artificial insemination by placing sperm directly into the vagina. However, sperm still had to “swim” through the uterus and to the cervix. IUI is an improvement on this process because it involves a doctor placing sperm directly into the uterus where the sperm can ideally fertilize an egg and implant into the uterus.
What Does the IUI Process Involve?
The IUI process involves careful timing on the part of doctors and the participating couple. A doctor will frequently perform ultrasounds and/or blood testing to determine when a woman may be ovulating as this is the time that a woman can get pregnant. When a woman is ovulating, her partner will donate a sample of his sperm. The sperm are then taken to a laboratory where they are “washed” within an hour of a man’s ejaculation. The washing process involves applying chemicals that will separate the “best” sperm that have the greatest likelihood of fertilization. Also, while less common, it’s possible for a woman to be allergic to proteins in her partner’s sperm. This can cause great pain and discomfort when he ejaculates. Some couples may choose the washing process because it often removes the proteins associated with discomfort and a potential allergic reaction.
The sperm are then placed into a thin tube called a catheter. This catheter is inserted into the vagina, through the cervix (the passage between the vagina and uterus), and into the uterus. While this procedure takes a relatively short amount of time, most doctors will ask a woman to lie down for 15 to 45 minutes. This increases the likelihood the sperm will correctly meet with and fertilize an egg.
Often, a doctor may recommend several additional steps that could increase the likelihood a woman will become pregnant. One is to refrain from having sex two to five days before a man donates his sperm. This will increase the number of sperm present in the ejaculate. Another step a woman can take is to take fertility drugs. An example is the medicine clomiphene citrate (Clomid). This medication can stimulate hyperovulation, where a woman releases multiple eggs.
What Do Doctors Say About If the IUI Procedure Is Painful?
The IUI process should not be painful, but it may be uncomfortable. According to WebMD, many women describe the discomfort as being similar to that of having a Pap smear to test for abnormal cells in a woman’s cervix. However, some women do report side effects, such as cramping and/or light bleeding. This may last up to 48 hours after a woman undergoes the IUI procedure. Although a doctor may direct otherwise, most women can return to their regular activities after IUI.
Sometimes women may experience an infection after having IUI. This could potentially be painful as infection can cause irritation, fever, and discomfort. Because a doctor is inserting instruments into the vagina and onward, it’s possible that bacteria that cause infection could potentially be introduced. If a woman is taking fertility drugs to support ovulation, it is possible that she could experience a condition called hyperovulation syndrome, where the ovarian follicles will swell and cause pain. This side effect is not due to the IUI procedure, but instead due to the medications a woman may be taking prior to undergoing IUI.
Why Might a Couple Try IUI?
If a couple has not conceived within 6 to 12 months of having unprotected sex, a doctor may recommend trying IUI. Some women may try three to six rounds of IUI before they become pregnant. If they do not conceive after this, a doctor may recommend more invasive methods, such as in vitro fertilization. Both IUI and in vitro fertilization are associated with greater risks for multiple pregnancies due to medications given to stimulate hyperovulation and sometimes that multiple embryos are inserted into the uterus, in the case of in vitro fertilization.
Just as there are many reasons why a couple may not be able to conceive, there are many explanations as to why IUI may not be effective. Examples include:
- A woman being older. Traditionally, women older than age 35 may have more difficulty conceiving.
- Poor quality of eggs or sperm. Sometimes a doctor may recommend using donor sperm for the IUI process to increase the chances the procedure will be effective.
- History of Fallopian tube damage, such as from a severe pelvic infection. If a woman’s fertility concern is a blockage of her Fallopian tube, IUI will not typically work.
According to the American Pregnancy Association, the success rates for IUI are about 20 percent per cycle. The chances that the process will work depend upon many variables, especially if a doctor knows why a woman is experiencing fertility problems.
Conclusions: Is the IUI Procedure Painful?
While the IUI procedure may not be one that a woman wishes to undergo on a daily basis, it is not usually painful. A woman may find it temporarily uncomfortable. She may also experience some cramping and spotting after the procedure. This does not affect her chances of getting pregnant. However, the short duration of the procedure and the lack of invasiveness mean that it rarely causes severe pain. A woman should always immediately tell her doctor if she experiences a great degree of discomfort or pain during or after the IUI process.
Sometimes a doctor will have a woman come back the following day for a repeat IUI process. This may be associated with greater discomfort because of the tissues being disrupted more than once. An over-the-counter pain reliever is typically sufficient to help reduce any discomfort a subsequent IUI treatment may cause.
American Pregnancy: Intrauterine Insemination (IUI)
Human Fertilization & Embryology Authority: What Is Intrauterine Insemination and How Does It Work?
Mayo Clinic: Intrauterine Insemination (IUI)
WebMD: Infertility and Artificial Insemination
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