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.
Find a support group online or in your community to help you:
- 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.