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
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.
Intrauterine insemination (IUI) is an assisted reproductive technology that helps a woman become pregnant by placing the sperm directly into the uterus. The procedure does not require making incisions into the body and is not associated with severe side effects. However, any procedure can be associated with some degree of side effects. Examples of these side effects include cramping and/or some mild bleeding. These symptoms may last anywhere from 24 to 48 hours after the IUI process.
Side Effects of IUI and Fertility Drugs
Sometimes a doctor will prescribe fertility drugs before a round of IUI. This is to encourage a process known as hyper-ovulation, where a woman will release more than one egg during ovulation. Although this has the beneficial side effect of more eggs for sperm inserted into the uterus to fertilize, taking fertility drugs can cause a condition known as ovarian hyperstimulation syndrome. The condition causes the ovaries to become enlarged, which can result in a number of symptoms. Examples of these symptoms include:
- Ascites or fluid in the peritoneal cavity
- Decreased urine production
- Pleural effusions (buildup of liquid in the lungs)
Ovarian hyperstimulation can cause symptoms that range from mild to severe. Severe symptoms affect a woman’s ability to breathe, darkened urine, and severe abdominal pain. These symptoms should not be ignored. If a woman finds she is gaining weight very quickly, this can be a symptom of ovarian hyperstimulation.
Treatments for the condition include stopping taking the fertility medications as well as draining any excessive fluid that may have built up in the peritoneal cavity. Most commonly, the symptoms will subside when a person stops taking the medication and with time.
Multiple Pregnancy Risks
In addition to the health risks associated with IUI and taking fertility medications, a woman is also at greater risk for having multiple pregnancies. This is because fertility medications can lead to hyperovulation where a woman releases multiple eggs. Because the sperm injection contains multiple sperm, it’s possible the sperm could fertilize more than one egg, resulting in a multiples pregnancy. While multiples are not necessarily a problem, a multiples pregnancy is associated with greater risks for miscarriage. It’s important that a woman weigh these risks with her partners and doctor. Other potential risks associated with a multiples pregnancy include:
- Increased risk for gestational diabetes
- Greater risk for preeclampsia (high blood pressure in pregnancy)
- Greater likelihood for requiring bed rest during pregnancy
According to Attain Fertility, an estimated 10 percent of women who take drugs intended to stimulate ovulation will have a multiples pregnancy. An estimated 30 percent of women who take gonadotropins for fertility will become pregnant with multiples.
Risks the IUI Procedure May Not Work
One of the greatest risks associated with IUI is that it may not result in a pregnancy, which is the goal for treatment. According to RESOLVE, the National Infertility Association, the success rates of IUI couples with fertility drugs have improved pregnancy rates compared with women just undergoing IUI. Examples of these medications include Clomiphene, letrozole, or human menopausal gonadotropins.
Much of the success associated with IUI depends on a partner’s sperm quality and the woman’s age. For example, a fertility doctor will often recommend testing to ensure the man has sperm that have at least 5 percent normally shaped sperm. If a man does not, the likelihood of a successful pregnancy with IUI in a woman under age 35 is 7 percent. This number increases to 13 percent likelihood for conceiving if the man’s sperm morphology is greater than 5 percent and the woman is older than age 35.
According to Attain Fertility, the more IUI cycles a woman undergoes, the more likely she is to get pregnant. For example, between three and six IUI cycles is associated with pregnancy rates that near 80 percent. According to Attain Fertility, the likelihood for pregnancy for all women who undergo IUI is:
- 10 to 20 percent in women under age 35
- 10 percent in women between the ages of 35 and 40
- 2 to 5 percent in women ages 40 and above
If a woman has tried six IUI cycles, she should contact her fertility specialist or endocrinologist as she may need to try a different fertility treatment.
Unfortunately, the likelihood for IUI success in a woman who has had trouble conceiving and is older than age 35 is almost zero. Therefore, women may wish to try in vitro fertilization as an alternative to IUI due to the likelihood they won’t conceive. A woman should always discuss the individual likelihood she will conceive using fertility treatments with her doctor. While IUI is not as costly as in vitro fertilization treatments can be, it still represents a cost. If the treatment is unlikely to work, a woman may wish to direct the funds toward other treatments.
Understanding the IUI Process
IUI involves taking sperm from a man and “cleaning” them to ideally make them more effective in fertilizing an egg. The process will start by meeting with a fertility specialist or endocrinologist. This doctor will likely conduct testing that can determine the health of a man’s sperm and/or to identify the potential reasons why a woman may be experiencing infertility. If the doctor recommends moving forward, they may prescribe medications to enhance fertility. These medications are designed to stimulate a woman’s body to release more than one egg, thus enhancing her chances of success when ovulating.
A doctor will conduct blood tests, ultrasound scans, and even temperature monitoring to determine when a woman is ovulating or may start ovulating. This is important because the only time a woman can get pregnant is when she is ovulating.
When a woman is ovulating, her partner will be asked to donate a sperm sample. This is usually accomplished through masturbation. The sperm are then taken to a laboratory where they are prepared for the insemination process. The “washing” process involves exposing the sperm to special chemicals that are able to separate the stronger sperm from the weaker ones. This process also removes toxins from the sperm that are associated with potentially causing an allergic reaction that impairs pregnancy.
Once the sperm has been prepared, a woman returns to her doctor’s office for the insemination. The procedure is similar to a Pap smear. A doctor will insert an instrument called a speculum into the woman’s vagina. Using a small, thin tool called a catheter, the doctor will insert the semen through the vagina and cervix and into the uterus. A woman will usually be asked to sit in the treatment room for anywhere from 30 to 45 minutes. This allows the sperm to stay in position for a longer amount of time. Ideally, this will result in the sperm fertilizing the egg. The IUI procedure itself will typically take anywhere from 10 to 15 minutes and the process of waiting at the doctor’s office afterward will take about one hour.
Sometimes a doctor may recommend coming back to the office the following day for an additional IUI treatment. This can increase the likelihood that an IUI treatment will be effective.
Conclusions on IUI Side Effects
Fortunately, IUI side effects are considered very minimal. A woman may expect to experience some mild bleeding and cramping after the procedure. However, some women may experience side effects from taking medications to stimulate fertilization, such as gonadotropins. This includes ovarian hyperstimulation syndrome, which can cause severe effects from ovarian swelling in some instances.
If a woman has unanticipated effects after undergoing IUI, she should contact her doctor. Seeking treatment as quickly as possible is associated with having the greatest treatment results.
American Pregnancy: Intrauterine Insemination (IUI)
Human Fertilization & Embryology Authority: Intrauterine Insemination (IUI) – The Risks
Human Fertilization & Embryology Authority: What Is Intrauterine Insemination and How Does It Work?
Mayo Clinic: Intrauterine Insemination (IUI)
RESOLVE: Intrauterine Insemination: Will It Help Me Conceive?
WebMD: Infertility and Artificial Insemination
You’ve welcomed one baby into the world, and now you are ready to try again. But there’s just one problem: You and your partner are trying, yet those little blue lines aren’t revealing themselves with each month that passes by. The inability to get pregnant after previously giving birth to a baby is known as secondary infertility, and it affects many women in the United States and beyond. In addition to difficulty getting pregnant a second time, secondary infertility also refers to a woman experiencing recurrent miscarriages. In other words, she is able to get pregnant, but the baby is not carried to a live birth.
Although the causes of secondary infertility are often similar to the causes of infertility in a woman who’s never had a baby (known as primary infertility), there are some exceptions. Fortunately, there are treatments available for women who experience any type of infertility that can help a couple wishing to add to their family. Read on for more information and answers to the question “Why Can’t I Get Pregnant Again?”
Age is one of the greatest determinants of fertility, especially for a woman. A woman is at her most fertile between the ages of 15 and 30. However, more and more American women are waiting until their 30s to conceive. After age 35, a woman’s fertility is particularly affected. According to “Parents” magazine, an estimated one-fourth of women age 36 are infertile and cannot get pregnant (even if they have already given birth to one baby.
The problems with aging and a woman’s fertility is that the quality of her eggs are affected. A woman is born with all the eggs she will release in her lifetime. As she (and therefore, her eggs) age, they experience chromosomal damage that makes them less likely to be carried to a full-term pregnancy or fertilized. Although a woman is very young at age 35, unfortunately, her reproductive health is not at its height and pregnancy can be difficult to achieve.
To a certain degree, men are also affected by aging. Although the timeline is not as accelerated as a woman’s fertility, a man’s semen can carry less sperm and less high-quality sperm as he ages. As a result, a couple may also have difficulty conceiving due to male infertility as a result of advancing age as well.
However, being older than age 35 doesn’t mean a woman won’t get pregnant. However, a couple may have to wait longer to conceive than they did with previous pregnancies.
Complications Related to Prior Pregnancy or Uterine Surgery
Women who have had previous uterine surgery, such as a dilation and curettage (D and C) to remove abnormal tissue in the uterus, may experience unknown scarring and/or infections that could make a subsequent pregnancy more difficult. Many women may have this or other uterine procedures immediately after giving birth. As a result, they may not be able to recognize the symptoms associated with a postpartum uterine infection, such as bleeding or lower abdominal pain. A woman may attribute these symptoms to after-effects of pregnancy. While the body’s immune system may have healed the infection, there can be scar tissue and other after-effects associated with the infection.
Changes to You or Your Partner’s Health
A number of medical conditions are associated with greater risks to a person’s fertility. Examples can include high blood pressure and diabetes. This is true for both men and women. While there are many people who may have these conditions and successfully conceive, their effects on the body may make it more difficult to get pregnant again. The same is also true for drinking alcohol excessively and using illegal drugs.
As a general rule, the habits that keep a person healthy are also those that help them conceive. These include eating a healthy diet. Keeping stress levels low can also help. Other healthy habits that can promote conception include:
- Taking a folic acid supplement (usually of 400 micrograms/mcg) or introducing additional folic acid-containing foods into one’s diet. Examples include green vegetables, citrus fruits, and dried beans. Folic acid not only reduces the risks for neural tube defects, it also may help to improve ovulation. Men may also improve their sperm quality through folic acid intake.
- Limiting caffeine intake to no more than two caffeinated drinks a day. While studies are mixed on caffeine’s impact on fertility, some research has pointed to excess caffeine consumption as playing a role in affected fertility.
- Exercising at least 30 minutes a day for four to five times a week. Exercise relieves stress and also helps to maintain a healthy weight, which are two factors that promote fertility.
- Stopping smoking. Smoking more than 10 cigarettes a day greatly affects a woman’s egg release and overall fertility. A woman’s eggs are also more prone to genetic abnormalities that could result in miscarriage. Men who smoke are more likely to have lower sperm counts, affected motility, and abnormally shaped sperm.
Losing weight if one or more members of a couple are overweight can also impact a couple’s fertility. For women, the excess weight actually causes the overproduction of “male” hormones, known as androgens, that impact ovulation and egg quality. Losing about 5 percent of her excess weight can help a woman conceive. Very thin women may also have difficulty conceiving because their bodies delay ovulation. For a woman that is underweight, gaining even five pounds can help her conceive. If a man is overweight, losing weight could help to improve his sperm quality as well.
Healthy habits not only promote a more optimal environment for a couple to conceive, they also support a healthier pregnancy. Eating well, exercising, and keeping stress levels down are all tips that a doctor may advise a woman while she is pregnant.
Impaired Sperm Production in a Man
According to “Parents” magazine, an estimated 40 percent of infertility cases are attributed to male infertility. Examples of these issues and concerns can include a low sperm count or poor sperm motility (motion/movement). Each of these factors affects the sperm’s ability to reach the uterus and fertilize a waiting egg. Sperm have many factors that must be “just right” in order to fertilize an egg. Examples of sperm disorders that can affect a man’s fertility include:
- Sperm that lack motility or do not move in the appropriate motion
- Semen that contains very little sperm
Some men may also have ejaculate that does not contain sperm at all. This condition is known as azoospermia. Kidney failure and low testosterone hormone levels can also impact a man’s fertility. Sometimes, a man may develop a blockage or obstruction to the pathways that release sperm that mean as he ages, his semen no longer contains many active sperm.
In addition to these factors, taking testosterone supplements or exposing the testicles to excessive heat can also impact a man’s sperm count. This can include wearing too-tight underwear, heat exposure from exercise, or even using electronics that start to get hot on a man’s lap (such as a laptop computer). By avoiding these practices, a man may be able to improve his fertility.
Taking certain medications is also known to affect a man’s fertility. Medications used to treat the following conditions may affect a man’s sperm count/quality:
A man should review his medication listing with his doctor to ensure his medicines aren’t impacting fertility.
Damage to a Woman’s Reproductive Organs
There are a number of medical conditions that a women is vulnerable to, and over time, these can affect her fertility. A primary example is endometriosis. This is a condition that causes the muscular tissue associated with the uterine lining to start developing and attaching to other areas of the body. An example can be the Fallopian tubes. Untreated or long-standing endometriosis can cause damage to the Fallopian tubes that prevents an egg from traveling down the tube and to the uterus. Sometimes, if a woman conceives at all, it may be an ectopic pregnancy, where the fertilized egg does not implant itself in the uterus.
In addition to endometriosis, a woman may experience changes in hormone levels over time. She may enter early menopause, in which she no longer ovulates. Or, her hormone levels associated with pregnancy may simply decline, affecting her ability to get pregnant again. Another condition that affects fertility is polycystic ovary syndrome (PCOS). This condition disrupts ovulation, where a woman may not ovulate at all. A woman with PCOS has an excess of hormones traditionally associated with being “male” hormones, such as testosterone. In addition to irregular menstrual periods, PCOS symptoms include acne, obesity, unwanted hair growth, and diabetes.
When to Seek Help
If you are over age 35 and have had unprotected sex for six months without getting pregnant, talk to your OB/GYN, who may make a referral to a fertility specialist known as a reproductive endocrinologist. If you are under age 35, a doctor will usually recommend having unprotected sex for a year before seeking fertility evaluation and treatments.
A reproductive endocrinologist is a doctor who specializes in hormones associated with pregnancy, both from a male and female perspective. This doctor can evaluate you and your partner for the potential underlying causes of secondary infertility as mentioned above. Examples of these tests can include blood tests for hormone levels, evaluating a semen sample, and imaging studies to determine if a Fallopian tube is blocked or there are other uterine abnormalities that are affecting a person’s fertility.
Unfortunately, there is a large percentage of couples for whom a doctor may not be able to determine an explanation for infertility. This can be frustrating and stressful for couples hoping for another child.
Conclusions on Why Can’t I Get Pregnant Again
According to “Parents” magazine, an estimated one-fourth of couples who are seeking fertility treatments to conceive have one or more children. Sometimes, these couples had difficulty conceiving their first child. Others may have had no difficulty, but are facing infertility issues with subsequent pregnancies. According to Michael DiMattina, MD, and director of Dominion Fertility and Endocrinology in Arlington, Virginia, interviewed in “Parents,” “In fertility, past success is no guarantee of future success.”
While secondary infertility is a known medical concern, many couples are hesitant to seek fertility treatments due to misconceptions that these treatments will not benefit them if they have already had one child. However, waiting too long to seek fertility treatment options can mean that a couple is waiting until it’s too late to receive treatments. This is especially true if a woman is 35 and older or reaching this age.
Couples experiencing secondary infertility have feelings that are no less important than a couple who has been unable to conceive at all. Couples may have grief, sorrow, and misunderstanding as to why they could successfully conceive one baby, yet have such difficulty in having another child. They may also feel guilty for being so upset when they already have one child at home. Some couples may even express guilt they haven’t provided a brother or sister for their child. They may also find they don’t receive the same support for their infertility from family and friends because they have one or more children. However, the couple’s feeling and concerns over secondary infertility are very real and shouldn’t be ignored. A couple may wish to seek counseling as they struggle with infertility. RESOLVE, the National Infertility Association, also offers support specifically for those with secondary infertility by calling 866.NOT.ALONE (866.668.2566) and pressing extension 8.
Cleveland Clinic: 6 Reasons for Trouble Getting Pregnant a Second Time
Mayo Clinic: Secondary Infertility: Why Does It Happen?
The New York Times: Secondary Infertility: I Have One Child. Why Can’t I Get Pregnant Again?
Parents: We Can’t Get Pregnant Again
Resolve, The National Infertility Association: Secondary Infertility
Urology Care Foundation: What Is Male Infertility?
Intrauterine insemination, or IUI, is a common fertility treatment that may help you conceive. One of four types of artificial insemination, IUI is a fairy simple procedure, and IUI side effects are generally minor, although some can be serious. Understanding what IUI is, how it works, and the risks associated with it can help you make the best decision when it’s time to explore your options for fertility treatments.
What Is Artificial Insemination?
Artificial insemination was originally used on livestock, but it’s now one of the most common solutions to infertility for many couples and involves inserting sperm directly into cervix, uterus, or fallopian tubes. Artificial insemination is most commonly used when:
- A couple is unable to have intercourse due to erectile dysfunction or another condition.
- A woman’s cervical mucus doesn’t allow sperm to pass through, or it contains an antibody to sperm, which kills the sperm before they can reach the egg.
- A woman has mild to moderate endometriosis.
- A woman or man has a sperm allergy.
- A man produces too few sperm, or the sperm isn’t mobile enough to reach the egg.
- A same-sex couple wishes to conceive with donor sperm.
- No cause of infertility can be found, but the couple has tried unsuccessfully to conceive.
Four Types of Artificial Insemination
IUI is the most common insemination procedure used today. During IUI, up to one milliliter of sperm from a woman’s partner or a donor are washed in a lab to isolate the sperm from the solution surrounding it. The washed sperm is injected directly into the uterus.
The other three types of artificial insemination are:
- Intracervical insemination, or ICI, which is less expensive than IUI but not quite as effective. The ICI procedure involves placing the semen directly into the cervix.
- Intratubal insemination, or ITI, during which washed sperm are injected directly into the fallopian tube or near the entrance. ITI is more invasive than IUI, and its success rate isn’t much higher, making it the least-used method of artificial insemination.
- Intravaginal insemination, or IVI, which is also known as self-insemination because it can be done by couples trying to conceive. During IVI, semen is injected into the vaginal canal near the cervix. This method is far less effective than IUI, but it’s virtually free.
A Closer Look at IUI
An IUI is scheduled just after ovulation, when you’re the most fertile. If you have a 28-day menstrual cycle, this will be around day 14. If your menstrual cycle is irregular, you’ll probably use an ovulation prediction kit that detects hormones in the saliva or urine and accurately predicts when you’ll ovulate.
If donor sperm is used for the IUI, it will be obtained from the sperm bank and tested for transmittable diseases. If your partner’s sperm will be used, the sperm sample will be collected through masturbation. If your partner is unable to ejaculate due to a medical condition, the sperm will be surgically removed directly from the testicles or epididymis. The sperm is washed to separate them from the fluid that surrounds them. The fastest, healthiest sperm are then collected for the IUI.
During the procedure, a speculum is used to open the vaginal walls and expose the cervix. A catheter is inserted through the cervix and into the uterus, and the sperm are injected through the catheter.
After the procedure, you’ll rest for a short time and then go home and wait six to fourteen days before taking a home pregnancy test, which should be followed up by a blood test to confirm the results either way.
Intrauterine Tuboperitoneal Insemination
Intrauterine tuboperitoneal insemination, or IUTPI, is a newer method of IUI that uses a larger quantity of prepared sperm. The larger volume fills up the uterus and forces it into the fallopian tube as it overflows. During an IUTPI, a special device known as a double-nut bivalve, or DNB, speculum is used to clamp the cervix closed to prevent the excess sperm from flowing back out.
IUTPI has a higher success rate than IUI, according to a study published in the journal Sterility and Fertility, but it’s more expensive.
IUI Side Effects
The side effects of the IUI procedure itself are minimal. Some women report mild cramping during and after the IUI, but many report little to no pain during the procedure. In some cases, a vaginal infection may occur due to the introduction of bacteria. This may cause burning or itching, discharge, and a foul odor. In rare cases, bleeding or spotting may occur if the cervix is injured during the procedure.
Fertility Drugs and IUI
In some cases, such as when the cause of infertility is unknown, fertility drugs may be used along with IUI to increase the chances of success by stimulating your ovaries to produce more eggs, a process known as “superovulation.” The most common fertility drugs used with IUI include:
- Clomid, or clomipene citrate, which is an oral drug that works by blocking estrogen receptors in the brain, stimulating the release of follicle simulating hormone (FSH) and luteinizing hormone (LH) to promote egg development.
- Gonadotropins like hMG, which is administered daily by injection for a week or two to promote the development of eggs in fluid-filled sacs known as ovarian follicles. Blood tests and ultrasounds monitor their development, and when the follicles are big enough, a shot of hCG triggers the follicles to release the eggs into the fallopian tubes.
- Aromatase inhibitors, such as letrozole, which inhibit the enzyme aromatase to suppress estrogen levels and increase the output of FSH.
While IUI side effects are typically mild, the side effects of the fertility drugs can be more intense.
Common side effects of Clomid include:
- Hot flashes
- Breast tenderness
- Mood swings
Serious side effects that require a call to your doctor include vision problems, yellowed skin or eyes, bloating, and stomach or pelvic pain.
Common side effects of gonadotropins include irritation at the injection site, headaches, and fatigue. Serious side effects include vomiting, breathing difficulties, and abdominal swelling.
Common side effects of letrozole include nausea and hot flashes, but negative effects are unusual due to the speed with which this drug is cleared from the body.
All three of these drugs increase your risk of a multiple pregnancy, although letrozole carries the lowest risk of multiples.
IUI and Multiple Births
If you’re not taking fertility drugs in conjunction with your IUI, your chances of having multiples are the same as if you conceived naturally. But most women who undergo IUI do take fertility drugs, and depending on the drug, this increases your chances of having twins, triplets, or other multiples. Around 10 percent of women taking clomid or letrozole and 30 percent of those taking gonadotropins will become pregnant with multiples.
While multiple pregnancies are a cause for celebration for couples struggling with infertility, multiple pregnancies increase the risk of complications, including:
Premature birth. Most single pregnancies last 39 weeks, while most twin pregnancies last 36 weeks and triplet pregnancies last 32 weeks. Nearly 60 percent of twins are born prematurely, while nearly 90 percent of triplets are delivered pre-term, according to the March of Dimes.
Low birth weight. Babies who are less than 5.5 pounds are considered to have low birth weight, which increases the risk of a range of problems, including vision and hearing loss and developmental problems.
Intrauterine growth restriction. The growth rate of multiples begins to slow around 30 weeks for twins, 27 weeks for triplets, and 25 weeks for quadruplets. This may either be due to the inability of the placenta to grow any larger or to the babies competing for nutrients.
Preeclampsia, a complication that can cause high blood pressure, damage to the kidneys, and seizures.
Gestational diabetes. A multiple pregnancy increases your risk of gestational diabetes, which can lead to high blood pressure and pre-term birth or stillbirth. Gestational diabetes also puts your babies at risk for breathing problems, jaundice, childhood obesity, and diabetes later on in life.
Placental abruption, a serious condition in which the placenta separates completely or partially from the uterus, potentially depriving the baby of oxygen and nutrients and causing severe bleeding that can dangerous to both you and your baby.
Birth defects. According to the University of Rochester Medical Center, multiple-birth babies are at twice the risk of birth defects like spina bifida and heart abnormalities.
Cesarean birth. While twins are often delivered vaginally, triplets and larger numbers of multiples are more often delivered by cesarean section.
Twin-to-twin transfusion syndrome, or TTTS. This condition occurs in about 15 percent of twins who share a placenta, and treating it requires surgery or early delivery. In TTTS, the blood vessels that connect in the placenta sends blood from one of the babies to the other, and over time, the recipient baby may receive too much blood.
Bed rest. In some cases of multiple pregnancies, bed rest is needed to stabilize the mother or the babies. Bed rest can help reduce or prevent stress on your heart, kidneys, and other organs, and it increases the flow of blood to the uterus and improves the delivery of nutrients to the babies. It can also help prevent early contractions by taking the pressure off the cervix.
Birth complications. Complications at birth may include cord entanglement, where the babies’ umbilical cords get tangled, and postpartum hemorrhage of the mother due to the over-distended uterus and the large placental area.
Each additional baby you carry increases your risk of complications. Your doctor will monitor your pregnancy closely and take steps to prevent or immediately treat these problems to help ensure a safe, healthy pregnancy and delivery.
Factors Affecting IUI Success
A study published in the Journal of Human Reproductive Sciences found that the pregnancy rates per IUI cycle range from eight to 22 percent. Researchers cite a number of factors affect the success of IUI cycles:
- The IUI success rate in women over 40 is as low as 1.4 percent, according to the study.
- Duration of infertility. The longer the duration of infertility, the less effective an IUI may be.
- Type of infertility. The study found the success rate slightly higher in unexplained fertility cases than in endometriosis and male-factor infertility cases.
- Endometrial thickness. With endometrial thickness of 6 millimeters and greater, the success rate was higher, but not significantly so.
- Total motile fraction, or TMF, of sperm. When the TMF, or the number of “good” sperm in a sample, was in the range of 10 to 20 million, the success rate was highest, at a little over 18 percent. When the TMF was between five and 10 million, the pregnancy rate was a little over five percent. A motility rate of less than five million was associated with a 2.7 percent success rate.
- Number of dominant follicles. A higher number of preovulatory follicles is associated with higher success rates. When fertility drugs are used to promote superovulation, the success rate is as high as 33 percent.
What if IUI Doesn’t Work?
Most doctors recommend three to six cycles of IUI. If you still haven’t become pregnant after six cycles, your doctor will likely recommend an alternative fertility treatment like in-vitro fertilization, or IVF. During IVF, eggs are extracted from the woman and fertilized manually with the male’s sperm in a laboratory dish. The resulting embryo is transferred into the uterus.
Infertility can be stressful. It takes a toll on your body, mind, and spirit, and getting plenty of support and keeping your stress levels down is important for your wellbeing and, according to many experts, for helping you conceive.
While you’re undergoing artificial insemination and other infertility procedures, spend time nurturing your relationship with your spouse or significant other. Engage in hobbies and other enjoyable activities to help you stay active and engaged with other areas of your life. Join a support group to help you maintain good mental health and keep you feeling positive and hopeful for the future. Remember that the majority of couples struggling with infertility will eventually conceive, and those who don’t have other options available, including surrogacy and adoption.
We Answer: Why Can’t I Get Pregnant After an Abortion?
Abortion is defined as ending a pregnancy through medical means. There are many women across the world who choose to have an abortion for health, safety, and lifestyle reasons on an annual basis. Just because a woman does not wish to have a baby at the time of the abortion does not mean she never will want to have a baby. For this reason, many women have concerns about how having an abortion may impact their future fertility.
Fertility can be a complicated issue for both a woman and a man. Timing, health, and many other factors must all come together for a woman to successfully conceive. Carrying a baby to term is also challenging. However, if a woman did have a history of previous abortion, it is highly unlikely to prevent her from getting pregnant in the future. There are, of course, some exceptions to this statement. The discussion of abortion and future fertility also should emphasize the importance of having an abortion performed by a licensed medical provider in a safe and sterile setting. Having an illegal abortion can be one of the greatest risk factors to a woman’s future fertility and overall health.
Considerations on Abortion Types
While having a single abortion performed by a qualified medical professional should not impact a woman’s fertility, there may be exceptions for women who have multiple procedures. To consider this, it is important to understand the two types of abortions.
Medical abortions are those that involve taking oral medications to result in a miscarriage. An example is the medication misoprostol or taking a combination of methotrexate and misoprostol or mifepristone followed by misoprostol. These drugs work by causing the lining of the uterus to shed and/or causing contractions that will effectively push out the fertilized egg. According to the Comprehensive Women’s Health Center, a medical abortion will effectively end about 95 to 98 percent of all pregnancies without the need for surgical abortion. Some women who are having a miscarriage may also take these medications to speed up the miscarriage process. According to “Self” magazine, medical abortions should not have an effect on future pregnancies. The medications are FDA-approved and do not carry any long-term risks. They do, however, have short-term risks that include:
Surgical abortions are invasive procedures that involve inserting an instrument into the cervix and progressed into the uterus to remove the fetus. Because the procedure is more invasive, it’s possible that scarring or other damage that occurred could result in more difficulty conceiving or carrying a child to term. The more surgical abortions a woman has, the more her risk increases for difficulty.
“For women who have had multiple abortions, it’s the same risk as a woman who has had multiple pregnancies in general,” said Kimberley A. Thornton, MD, a reproductive endocrinologist and infertility specialist at RMA of New York in an interview with “Self” magazine.
While there are many women who have had surgical abortions that have no problems conceiving at a later time, it is possible that scar tissue could be affecting the maintenance of a successful pregnancy. There are surgical procedures that can remove the scar tissue that may help to restore her fertility.
ABC News reported on a study published in the “New England Journal of Medicine” regarding medical abortions. The study examined more than 12,000 Danish women who had undergone medical or surgical abortion for non-medical reasons and then gone on to have a pregnancy. According to the study’s researchers, there were no statistically significant differences between the women who had undergone any type of abortion and women who hadn’t in terms of pregnancy complications. The researchers considered factors such as ectopic pregnancy, miscarriage, pre-term labor, and low birthweight babies. This research provides hope for women wishing to conceive after either type of abortion.
What Else Could Affect My Fertility?
When a woman is trying to get pregnant and cannot conceive after six months to a year, her first thought may be to blame the abortion she had some time ago. However, it is important she understand there are many factors that affect fertility and could be leading to difficulty conceiving. Examples of these factors include:
- Age: Age is one of the biggest factors to consider in regards to fertility. After age 30 and especially after age 35, the quality and number of a woman’s eggs can decline. As a result, a woman may have significantly more difficulty conceiving. A doctor can perform blood testing to estimate a woman’s “ovarian reserve” or amount of healthy eggs that she may have remaining. Examples of these testing include a follicle stimulating hormone (FSH) level and estradiol levels. Doctors commonly recommend these types of testing as well as ultrasound imaging to determine if a woman has signs of a healthy ovarian reserve when they are attempting to conceive at an older age.
Men are also affected by this as the amount and quality of their sperm can decrease with time. However, the rate of this decrease does tend to be slower than a woman’s. If a woman had an abortion at age 17 and is trying to conceive at 36, it’s likely her fertility may be more related to age than a previous abortion.
- Medical History: There are a number of medical conditions that can affect a woman’s uterine health and hormone balance, which can affect pregnancy. For example, a history of polycystic ovary disease or endometriosis may affect a woman’s ability to get pregnant. If a woman has a history of having a sexually transmitted disease, this could lead to a condition known as pelvic inflammatory disorder that affects her chances of getting pregnant.
She could also have a disorder related to ovulation due to her weight or family history that may be unknown. If a woman is not currently having regular periods, she may not be ovulating (the release of an egg for fertilization). Lack of ovulation (known as anovulation) means that a women cannot get pregnant. Some women may ovulate, but have what is known as tubal factor where their fallopian tubes are not open. In this instance, a woman cannot become pregnant. Tubal factor is a contributing cause of nearly one-third of fertility problems that affect a woman’s ability to conceive.
- Partner’s Sperm Health: Both men and women can have problems with fertility. Perhaps a woman has a different partner later in life she is trying to conceive with. It is possible that male partner may have sperm that is of a lower quality or quantity. A man may also have hormone imbalances of testosterone that could impact his fertility. Fortunately, testing is available to determine if a man’s fertility may be impacting a couple’s abilities to get pregnant.
It is also possible that a doctor may not be able to determine the cause of a woman’s infertility. This is known as unexplained fertility and occurs in an estimated 10 percent of all couples. However, options still remain for conception. Adoption is also possible for couples who may not be able to conceive due to fertility concerns.
The good news is that having a history of successfully getting pregnant increases a woman’s chances for getting pregnant in the future. If a couple has been having unprotected sex for more than a year without getting pregnant, they should contact their physician to discuss aspects that could be impacting their fertility. The doctor can recommend testing that will start the process of learning why a couple may be unable to conceive.
How Long Should I Wait to Conceive After an Abortion?
Many American women who have abortions may wish to get pregnant at a later and/or more advantageous time in their lives. They should speak with their physician about timing in the event that the doctor has individual recommendations regarding trying to get pregnant. According to New Kids Center, many doctors recommend waiting at least three months before trying to get pregnant again after having an abortion. The reason for this timeline is that the time allows the body to heal in order to provide the best environment to grow a healthy baby. Additionally, women planning on becoming pregnant should make considerations, such as taking a prenatal vitamin to prevent neural tube defects and making healthy lifestyle choices, such as refraining from smoking and maintaining a healthy weight.
Doctors also often recommend waiting to have sex for anywhere from two to three weeks after having an abortion, according to Columbia University. This is true for both medical and surgical abortions. Having sex during this period could lead to increased risk for infections as more of the woman’s tissue is healing and more vulnerable to bacteria and other organisms that could lead to infection. Many doctors will recommend going to a follow-up appointment to ensure all portions of the pregnancy do not remain in the uterus. Otherwise, remaining tissue could lead to health complications for a woman and further surgical intervention may be required.
When deciding when to conceive again after an abortion, it is important that a woman consider not only her body, but also her mental health and physical safety. For example, some women may get an abortion because they are in an unsafe or abusive relationship where they fear for their baby. If these circumstances have not changed, a woman should likely wait to get pregnant again until her circumstances are more stable. It is important also to remember that a baby does not “fix” a bad situation or fill a psychological void.
From a physical perspective, providing a woman underwent a legally sound abortion from a medical provider, they can get pregnant at their next ovulation cycle. This makes using some form of birth control especially important for women just after abortion if they do not wish to get pregnant. According to New Kids Center, women can get pregnant as soon as one week to 10 days after an abortion.
Conclusions on Why Can’t I Get Pregnant After an Abortion
If a woman is concerned about her fertility, her history of having an abortion or abortions is only one piece of the fertility puzzle. She should make an appointment to see a reproductive endocrinologist or ask her obstetrician for a referral to a fertility specialist. If a woman is age 35 or older, she should seek the expertise of a reproductive endocrinologist about six months after trying to conceive and being unsuccessful in doing so.
The desire to conceive again after an abortion allows relays the importance of seeking a legal abortion at a safe medical facility with a medical professional. Illegal abortions and those who provide them do not have to follow the same health code standards and safety measures that can protect a woman’s fertility. For this reason, it is very important that a woman seek a legal abortion, both for her current health and for considerations regarding her future fertility. These are provided in private offices, hospitals, and/or family planning clinics.
There are many techniques and technologies available today to help a woman successfully conceive. Examples include in vitro fertilization and intrauterine insemination. There are medications that can encourage ovulation and the release of multiple eggs for fertilization. Lifestyle changes can also enhance a woman’s fertility. A woman should never let the fear or memory of a past abortion stop her from seeking out these and other treatments to conceive again.
ABC News: Medical Abortion Won’t Affect Future Pregnancies
Columbia University: Can You Get Pregnant Within Two Weeks of Having an Abortion?
Comprehensive Women’s Health Center: Medication Abortion: FAQs
Mayo Clinic: Could an Abortion Increase the Risk of Problems in a Subsequent Pregnancy?
New Kids Center: Pregnancy After Abortion
Self: Does Having an Abortion Affect Your Future Fertility?