During the time of trying for a baby, there is a moment when concern appears. When couples that are trying to have a baby start to feel helpless after less than a year, we recommend a consultation with an expert in fertility and pregnancy planning – in such moments it is recommended to take advantage of professional and discreet advice.
When the desire for a child continues, it is recommended for many couples to have intercourse on fertile days, which often negatively affects the joy of intimacy. For women over 35, it is recommended to shorten the natural effort by six months and to start the process of diagnosis earlier. If it is decided to consult an expert, one should consider conducting some basic tests – if a woman has regular menstruation, she probably has an ovulatory cycle and there is no need for hormonal tests at the beginning of the attempts to conceive, whereas if there is a presence of irregular and/or anovulatory cycles or other symptoms of endocrine disorders (for instance, obesity, sudden drop or increase of weight, acne, painful and/or heavy periods and hair loss), hormonal tests should be performed.
What is often overlooked is the subject of an early examination of a man’s sperm – a quick, non-invasive and relatively inexpensive test that can quickly exclude or diagnose the cause of the prolonged attempts to conceive.
Unsuccessful attempts to have a baby are often affected by psychological stress, which is why couples observing negative effects of stress on health or mutual relations should learn to have better control over it and to get to know the relaxation techniques – it is worth consulting a psychologist or an expert specializing in Eastern Medicine.
Prolonged attempts to have a baby can also be caused by factors such as previous diseases, a diagnosed hormonal imbalance, an unhealthy lifestyle and a poor diet, therefore, at some point one should obtain advice from an expert.
Ovulation disorders, an ovulation or the so-called oligoovulation, i.e. infrequent ovulation. The primary symptom of ovulation disorders is the disturbed rhythm of menstrual bleeding. Menstrual cycles shorter than 24 days and longer than 35 days are likely to be cycles where there is no ovulation. It is similar in the case of irregular menstruations, especially if they appear infrequently (once every 40–180 days). In the case of women with regular menstruations, whose cycle length is in the range of 24–35 days, most of them will have ovulatory cycles. Sometimes, however, despite regular menstrual bleeding, ovulation does not occur. There are several symptoms of ovulation which can be observed by oneself.
- characteristic fertile mucus appearing in the birth canal within 2–4 days prior to ovulation, whose appearance is compared to raw egg white,
- pain lasting for a few hours on one side of the abdominal area, occurring right after ovulation (not all women experience such pain and its absence does not indicate the absence of ovulation, but its presence indicates a high probability of ovulation),
- spotting or bleeding from the birth canal about 2 weeks before the expected menstruation,
- increase in basic body temperature of 0.3–0.4 degrees Celsius in the second phase of the cycle,
- moreover, there are commercial tests available which detect the peak of the LH hormone in urine – an increase in the concentration of this hormone in the blood serum is a stimulus that causes ovulation. If after 6 months of attempts the above symptoms are not observed, it is necessary to consult a specialist to find the cause of infertility.
The oviduct is a paired organ in the shape of a tube connecting the uterine cavity with the ovary. Fertilization in humans occurs in the distal (i.e. situated near the ovary) part of the oviduct called the oviduct ampulla . In order for it to occur, the ovary must be unobstructed and must function properly. Its final part, the so-called fimbriae of the oviduct captures the egg after ovulation. On the other hand, the oviduct allows the sperm to be transported to the place of fertilization and, finally, after fertilization it allows the developing embryo to move into the uterine cavity where implantation occurs. Pelvic inflammation (i.e., pelvic inflammatory disease) and surgeries within the pelvis (usually appendicitis, and especially peritonitis) lead to a dysfunction of oviducts and their obstruction. Some of the infections in the genital organ do not have any symptoms, which may make a woman unaware of the fact that she went through this disease. Therefore, an assessment of the risk of oviduct pathology and the examination of the condition of oviducts is an important part of diagnosing infertile couples.
Abnormal semen parameters are an increasingly common cause of problems with conception. In order for fertilization to occur under natural conditions, an ejaculate should contain an adequate number of properly constructed sperm cells, characterized by their rapid movement. Only this fraction of sperm cells has a chance to reach the place of fertilization and penetrate the egg. Semen analysis is a basic, mandatory diagnostic test performed at the beginning for each couple having problems with conceiving a child. It should be noted that the semen quality depends on the health of a man. The process of producing human sperm takes approximately 72–74 days, so any infections, febrile illnesses, stress, etc., will be reflected in the sperm test results after about 3 months. In the case of receiving an incorrect result of a single test, the test should be repeated after about 3 months. In every man, variability of quantity and quality parameters of sperm reaching up to several hundred percent is observed. Another situation is when the analysis confirms an overall absence of sperm (i.e., azoospermia). In such a case, the test should be repeated after several days and, if the result is confirmed, it is necessary to consult a specialist in urology and andrology.
It is a disease involving the presence of uterine mucus membrane, the so-called endometrium, in places other than the uterus. The endometrium is the tissue which, under the influence of hormonal changes in the menstrual cycle, is going through functional and structural changes – their symptom is the peeling off of mucosa and bleeding during menstruation. The same changes apply to the endometrial foci located in places other than the uterine cavity. Therefore, the most common symptom of endometriosis is pain: very painful menstruation, lower abdominal pain in other phases of the cycle and painful intercourses; less frequent is hematuria and problems with urination, painful bowel movements and the presence of blood in the stool. The second most common symptom of endometriosis, in addition to pain, are problems with conceiving a child. The method which allows for the unambiguous identification of this disease is the exposure of characteristic lesions during surgery, usually it is laparoscopy. Endometriosis foci can be found in the ovaries and then they cause endometrial cysts (suspicion of these lesions can be confirmed by ultrasonographic examination) on the peritoneal surface or deep in the tissue between the vagina and rectum. It needs to be remembered that endometriosis may, but does not need to, proceed symptomatically; some women can have no symptoms, but they learn that they suffer from the disease during surgery performed due to a completely different reason.
The cause of problems with conceiving a child may be congenital or acquired abnormalities within the uterus that can impair the nesting of an embryo. The congenital factors include all kinds of developmental anomalies of the uterus, such as septum, double uterus, unicornuate uterus or bicornuate uterus. The acquired abnormalities include fibroids, polyps or intrauterine adhesions. The method which may raise the suspicion of the pathology within the uterus is transvaginal ultrasonographic examination, preferably in 3D/4D, while the final diagnosis and treatment in selected cases is enabled by hysteroscopy.
It is defined as infertility of unknown origin. This applies to couples whose results of all performed examinations are normal and still the woman cannot get pregnant. It is believed that this is the case in approximately 25% of couples having problems with conception. There are several causes of idiopathic infertility: psychogenic factors, lack of optimal lifestyle, especially diet, as well as subtle changes on the immunological and/or molecular level, which in the current state of our knowledge cannot be diagnosed.
After several months of unsuccessful attempts to conceive a baby, couples should check their condition of health, which is important for both women and men. Some basic examinations should be performed, and it is recommended to use the expanded packages of examinations to make sure that no illness or worse results interfere with the attempts of having a child. If the results of basic examinations are good, a consultation with a specialist should determine the next steps. If basic examinations have not been performed, a sperm test for men should be done (or, if the doctor deems it necessary, also a testicular biopsy), whereas, in the case of women, it is worth performing ultrasound diagnostics (for example, of the thyroid and the reproductive organ) or the HyCoSy test.
The key to success during attempts to get pregnant, especially if these attempts are prolonged, is the support of experienced specialists. At FertiMedica we do not only focus on modern medicine; here patients are under the complex care of an interdisciplinary team. Apart from gynecologists, our team also consists of endocrinologists, andrologists, urologists, geneticists, specialists in ultrasound diagnostics and nuclear medicine. We work with psychologists, a dietician and an Eastern medicine physician. At FertiMedica we will provide you with all the care you need.
FertiMedica specializes in a holistic approach to supporting couples that are trying to have a baby, as well as infertility treatment. The philosophy of the clinic assuming complexity, empathy, the need for dialogue and maximum efforts for pregnancy, has contributed to the continuous expansion of additional activities, treatments, workshops and support groups. FertiMedica offers consultations not only with specialists in the fields of gynecology, sexology and andrology, but also with a nutritionist, expert in Eastern Medicine or “Your Advisor” who prepares a consultation and additional activities plan for couples trying for a child.