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Houston Fertility Journal

Fertility: Expectations vs. Reality

[fa icon="calendar"] Mar 27, 2018 11:41:56 AM / by Center of Reproductive Medicine   

Center of Reproductive Medicine

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The majority of us were raised believing that getting pregnant is easy. Parents warn their kids to avoid sexual activity in their younger years, instilling the fear in them that they will get pregnant and be responsible for the child when they are still a child themselves. This lead most people to think that once they chose to settle down and get pregnant on purpose, all it took was a few romantic nights with the one they loved and, boom, a baby would be made.

The reality is, getting pregnant is not easy to achieve. It can take a long time for many couples. Some may even require assistance. 1 in 8 couples struggle to get pregnant or to sustain the pregnancy once achieved. There are many ways that a person’s fertility can be affected, and most people do not suspect this pertains to them until they find themselves among those struggling.

Hopefully, everyone will one day be on the same page about fertility. But for now, at least we can educate ourselves.

Misconceptions about Achieving Pregnancy

There is a lot of information out there that people believe to be fact which is actually completely untrue. If you are going to properly attempt to get pregnant, you should know what these are, or you may be wasting a lot of your precious time. Some examples of these false claims are:

  • Conception is not possible if you are menstruating. People truly believe this. Those trying to have a baby and see this as fact may choose to not have sex during this time because it won’t accomplish anything. A woman’s cycle does not keep the sperm from swimming to the uterus.
  • You must be laying in a certain position to achieve pregnancy. If the sperm is able to swim, it will swim. It may not help to jump up and down once the sperm has made its way in, but doing a headstand isn’t going to ensure that the sperm swim any faster.
  • Have sex with your partner as much as you can and you will get pregnant. This is actually the opposite of the truth. If the man is ejaculating all of the time his sperm count and concentration will decrease.
  • Don’t shower or clean yourself after sex if you wish to get pregnant. Water does not prevent sperm from fertilizing an egg.
  • If you do not conceive after a few weeks of trying you are probably infertile. Conception takes time. Just because you haven't been successful in this short time, does not mean that it isn’t a possibility for you.
  • In order to conceive you have to orgasm. The female orgasm can indeed help the sperm move along, but it isn’t needed to accomplish fertilization. Pregnancy is possible with or without the orgasm.

The Reality of Infertility

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To get a better understanding of the real state of fertility amongst human beings, here are some facts concerning how common success and infertility are:

  • The ability to conceive on a natural basis is 20% per month.
  • 10% to 15% of couples trying to become pregnant in the US have difficulty.
  • It is equally possible for the infertility to exist in the male as it could in the female. There are many who truly believe that infertility is a woman’s problem. It is just as common for a man to experience infertility due to reproductive or health complications as it is for the female partner.
  • Just because a couple may have easily achieved pregnancy with their first attempt does not mean that they cannot experience “secondary infertility”. Some of the possible causes of this are:
    • impaired production of sperm or function
    • damage in the fallopian tubes, endometriosis, uterine conditions, or ovulation disorders in women
    • complications that occurred during the prior pregnancy or during a surgery
    • complications in health due to age, weight, or the use of medications
  • If a couple wants to achieve pregnancy they should focus on the timing of the woman’s ovulation. There is a very particular time in the woman’s menstrual cycle when her body has produced the egg that can be fertilized by the man’s sperm. Without this egg, pregnancy is not possible.
  • Infertility has nothing to do with your ability to have sex, it is a medical disorder. For women infertility is most commonly due to a condition affecting her ovaries, fallopian tubes, and/or uterus. For men, it can be caused by different factors which are typically evaluated by a semen analysis. This process will evaluate sperm concentration, motility, and shape.
  • Be careful if you are using lubricant, some can be toxic to sperm. With the exception of Pre-Seed, most lubricants tested on the market have been found to reduce sperm motility. Researchers have also studied oils (such as canola, sesame, and baby oil) with a mixture of results based on the product.
  • Some think testosterone supplements will help improve their sperm count, but they can actually reduce sperm concentrations. Men who have received infertility treatment at clinics in the US were observed. It was found that once they stopped taking the hormone their sperm counts increased exponentially.
  • Just because you are in good health, does not mean you can’t be infertile. Infertility is not avoided by the protein in your diet or your cholesterol level. You could be the healthiest person out there, but if your reproductive organs are disrupted, your focus on nutrition cannot change that.
  • If you are overweight or underweight, this could be contributing to your struggle. Those who have very poor health are another story when it comes to infertility. 12% of all infertility cases are attributed to issues with weight. The body needs at least 22% body fat in order to have reproductive competence. Being overweight can massively affect the hormones and stop ovulation.
  • The biological clock does not just exist for women, it ticks for men as well. In the past 10 years, research has found that the age of the father could affect the health of their child. Studies done by Kleinhaus concluded that the older a man is at the time of conception, the more likely his partner is to have a miscarriage.

There is a lot that goes into Getting Pregnant

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A survey that was published in Perspectives on Sexual and Reproductive Health showed that the majority of people believed that the chance of getting pregnant on any day was 50% or more. The actual true percentage is about 3% on average, starting at 0% around the time the woman has her period, up to 10% when it is just before she ovulates. It is all about timing, and here is how:

A woman’s menstrual cycle consists of more than just her period. This is something you must understand if you are going to pay accurate attention to the most productive time to have intercourse. The first day of a woman’s period is when the cycle begins. The first half of the cycle is called the follicular phase because an egg is maturing inside of the ovary’s coating (called the follicle).

A number of follicles begin to grow at this time, but the fastest grower will be the only one to be ovulated.The follicle will then release its ovum near day 14 within the 28 day cycle. Ovulation occurs once the follicle ruptures and the egg can swim down the fallopian tubes and into the uterus.

The final 14 days are called the luteal phase because the follicle has now transformed into a ‘corpus luteum’ (which is latin for ‘yellow body’). It begins to secrete hormones that prepare the uterus for pregnancy.

Understanding when the woman will ovulate is key. Many people are misinformed on this front and believe that they should attempt to conceive on the day of ovulation. In order to allow the meeting of the egg and sperm, sex must occur a few days before ovulation does.

The reproductive tract can store sperm for up to 7 days. The storage area is often located near the ovary. When ovulation begins, the sperm that are in storage are activated, making it easy for them to fertilize the egg the moment it pops out. So the time to focus on is the week ahead of ovulation, particularly the final 2 or 3 days within that window.

Some knowledge that will help a couple track the woman’s ovulation is:

  • the body temperature raises half a degree on the day of ovulation
  • hormone levels can be test with an ovulation predictor kit
  • the cervix becomes softer when you’re fertile
  • the cervical mucus becomes thick and gooey
  • some women may experience some spotting or cramping, which may be a useful sign to you if you have been charting ovulation

Tracking these details is not always easy. For example, the body temperature must be measured at the same time and in the same environment every day.

When to Seek Out a Specialist

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Once a couple has been trying to conceive for several months without any success, it is common to start wondering if they should be talking to a fertility specialist. This is a difficult conversation to have, and many struggle with wondering if they have given the effort enough time. Here are some instances when a couple should seek out help:

  • if the woman is 35 or younger and the couple has had sex at least twice a week without conceiving in a 12 month period.
  • women over the age of 35 who have had sex at least twice a week without conceiving after 6 months.
  • if the woman has a history of miscarrying, it is a good idea to speak to a specialist before trying to conceive again. These women can still have healthy babies naturally. Yet, a specialist may be able to attribute the miscarriages to an irregular shaped uterus, weak cervix, hormonal disorder, or issues with the implantation process. When one knows the cause of an issue, they can properly assess the smartest way to move forward.
  • a woman with endometriosis, ovarian cysts, or blocked fallopian tubes will likely require a specialist’s help. These issues often make it difficult for a person to conceive.
  • If the male has a low sperm count the couple will most likely require some help. Often times couples will not discover that this is the case until seeing a doctor. Sometimes a family doctor can provide advice on how to improve sperm quality. Yet, there may be an underlying cause of the low sperm count that only a specialist can uncover.

If any of what you have read makes you feel as though you should see a specialist, do not waste anymore time. You can tell yourself that you will address it in the next few months, but you will only continue to keep pushing it back. Seeking out information about something you desire is important, especially when there is a timestamp on it.

Fertility is something that cannot be put on the back burner. If money is the issue, fertility clinics will provide you with information on payment plans and the services that your insurance covers. A good clinic will understand your position and try to help you in anyway possible.

Do not spend anymore time wondering if there is a reason you aren’t getting pregnant, do yourself a favor and find out why.

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Topics: Fertility Journey, Fertility Myths, Fertility Specialist

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