It’s very common for a patient to come into my office and want to talk about trouble conceiving. They often refer to this as infertility.
How Quickly Should You Get Pregnant?
If everything’s working perfectly, there is only a one in five chance that they will get pregnant that month. Perfectly assumes that a woman is ovulating every month. The semen count of her male partner is normal. Her fallopian tubes are open. And they have intercourse precisely at the right time of the month,
Therefore, it is very normal for it to take several months of a couple trying before they get pregnant.
In fact, we don’t use the terminology of infertility from a medical perspective. Not until a couple has been trying for 12 months without success.
Infertility In Your 30s and 40s
Now, certainly, there are women, especially in their 30s and early 40s, who don’t really want to wait 12 months. That’s understandable.
In my ObGyn practice, if I have a couple in their 30s or early 40s who have been trying to get pregnant for six months without success, and they don’t want to wait, then we’ll go ahead and start working them up for infertility.
What Needs To Happen To Get Pregnant?
For conception to happen, basically three things have to happen…
The Woman’s Body Has To Release An Egg
The woman needs to ovulate and have that egg available.
A Man Must Produce Normal Semen
The man’s semen analysis needs to be normal enough. That means there’s enough sperm swimming in the right direction with normal morphology or shape so that the sperm can find and fertilize that egg.
The Woman Needs To Have An Open Pathway
There has to be an open pathway from the cervix to the uterus– specifically through the fallopian tubes so that the sperm and egg can find each other and result in a pregnancy.
When we’re looking at a couple who’s having trouble getting pregnant, we’re looking at all three of those areas.
Ovulation and Infertility
In regards to ovulation, we’ll be talking to a woman about how often are their cycles, are they regular, are they predictable.
From a workup standpoint, we will be doing blood work on day 3 of her cycle and day 21 of her cycle, to see if she is ovulating.
Men and Infertility
In around 40% of couples who are having trouble getting pregnant, it’s due to what we call a male-factor. This means that we need to address infertility from the male side of things.
To evaluate a male’s fertility, we help them set up what’s called a semen analysis.
The purpose of the semen analysis is to make sure that there is an adequate number of sperm of the normal shape. And we have to ensure that they are swimming in the right direction.
Infertility HSG Test
In regards to making sure the pathway is open, there is a test called the HSG, a hysterosalpingogram.
It’s an X-ray test that we help set up for you because it’s performed in a radiology office.
In that test, we are pushing dye through the cervix, the uterus, and the fallopian tubes. We take pictures or X-ray pictures along the way to make sure that this pathway is open.
When a couple comes in, and they’ve been trying for an adequate amount of time, and together we decide that it’s time to evaluate their fertility further, then we will be looking at these three areas:
- Are they ovulating?
- Is the semen analysis normal?
- Are the fallopian tubes open?
If we identify problems with any of these areas, that helps direct the next step.