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Houston Fertility Journal

    The Fertility Journey: Achieving Pregnancy One Step at a Time

    [fa icon="calendar"] Aug 5, 2019 1:30:35 PM / by Center of Reproductive Medicine   

    Center of Reproductive Medicine

    The-Fertility-Journey-Achieving-Pregnancy-One-Step-at-a-Time

    The journey to pregnancy is a winding road of hope. You may have a wishlist featuring maternity clothes, ideas about the nursery, or dreams of how you’ll spend your time with your child. Perhaps that’s why the quest to get pregnant can be so anxiety-inducing. It strikes at the very heart of who we are as human beings and calls into question our deepest wishes and hopes for the future. 

    Most people report that the two-week wait -- the two weeks between ovulation and testing for pregnancy -- is extremely stressful. Many spend hours reading about pregnancy symptoms and what to expect after ovulation. Most people get pregnant within a few months of trying. But if you are among the 1 in 8 couples who struggle to get pregnant, the months may crawl by without any signs of pregnancy. Soon you may find yourself trapped by feelings of panic, anxiety, and deep sadness. 

    Infertility can be isolating, not to mention terrifying. But rest assured, infertility is treatable. The key is getting an accurate diagnosis from an infertility specialist who deeply understands infertility.

    Knowledge is power in the world of infertility, and myths about fertility can affect your ability to get pregnant or cause you to make harmful decisions that decrease your chances of a successful pregnancy. While there are no guarantees, with the right knowledge and a skilled fertility specialist, your odds of pregnancy success are extremely high. Dig deeper to learn more about getting and staying pregnant with our help. 

    Undergoing Fertility Testing

    Should you undergo fertility testing before trying to get pregnant? Many people mistakenly assume that, because they’re young and healthy or have no serious health complications, getting pregnant will be a breeze. For most people, that’s a fair assumption. 

    Infertility is alarmingly common, and many couples will struggle to get pregnant. 

    While others will be able to get pregnant on their own without any help. You won’t know which side of the fence you fall on until you begin trying to conceive. And for many people, especially those beginning their parenthood journey later in life, not knowing their fertility status can be very stressful. 

    Fertility has a clock attached to it. So if you spend a year trying to get pregnant when you have a serious condition you don’t know about, that’s a year of potential fertility you’ve wasted. The woman’s ovarian reserve will have dropped in number and quality, and so too will the man’s sperm. There’s no benefit to delaying or waiting. That’s why fertility testing can be so beneficial. It alerts you to a problem before you get your hopes up and begin trying. You can then spend the time you would have spent trying on diagnosing and solving the problem. 

    Many fertility issues, especially issues with ovulation and sperm count or quality, are easily detected with simple, affordable, noninvasive tests. Yet often, primary care providers and gynecologists either do not offer these tests or many are not up to date on the latest practices. So consider making an appointment with a fertility specialist before you begin trying, especially if you’re in your mid-30s or older. 

    Stress and Infertility: Are they Related? 

    Stress-and-Infertility

    People trying to get pregnant hear it all the time: relax and it will happen. The results are predictable: you then begin to worry about worrying. Are you decreasing your chances of pregnancy? Is it your fault? 

    The truth is that in most cases, stress will not cause infertility. Telling women otherwise does them a profound disservice that can leave them feeling anxious, guilty, and blamed. In extreme cases of stress, it is possible that fertility may decline, especially if the stress is severe enough to affect a woman’s menstrual cycle. Stress may also cause either partner to make lifestyle choices that decrease fertility, such as drinking, drugs, or eating to excess. 

    No one deserves to feel stressed and overwhelmed when they struggle with infertility, so we urge all couples to seek help. Please keep in mind, however, that “just relaxing” is never a recipe for getting pregnant. Indeed, if you are too laid back about infertility, you might not seek treatment as quickly as one otherwise would. So by all means, relax. You don’t deserve to get yourself all worked up. But don’t ignore obvious signs of fertility issues. 

    Back to the Basics

    To successfully create a pregnancy, the sperm and egg must be healthy. While it is smart to evaluate both partners, it is usually easier and less invasive to start with the man. If there is a problem with the sperm, the chances of fertilization decrease. 

    Low sperm count means that there is a lower chance of pregnancy each month, and for men who produce no sperm at all, there is no possibility of pregnancy. Quality is also important, since unhealthy sperm may not be able to fertilize the egg, and are more likely to produce miscarriages or babies with birth defects. Finally, sperm must be able to swim to the egg. Sperm with low motility cannot swim. 

    In most cases, issues with the sperm do not completely eliminate the chances of pregnancy but do greatly reduce it. Some simple interventions can help a man get his partner pregnant faster. It’s important to also test the woman for signs of infertility, because if both the man and woman have an issue -- as is the case in about a third of couples -- the odds of a successful pregnancy plummet. 

    When sperm quality is very low or a man does not produce sperm, donor sperm is an option. Lifestyle strategies, treating underlying medical conditions, surgery to remove blockages, and surgery to remove sperm so that it can be implanted in the man’s partner may also be options, depending on the diagnosis and the couple’s wishes.

    Consider a Sperm Donor

    testing-eggs-on-microscope

    Is using a sperm donor right for you? Problems with a man’s sperm can make pregnancy difficult, or even impossible. While there are several options for treating sperm issues -- including surgery to remove blockages -- a sperm donor is also a great option. With donor sperm, you can select healthy sperm from a person who meets the specific criteria you select. The process is safe, and the sperm is thoroughly tested and washed before implantation. 

    Donor sperm is also a great option for women hoping to get pregnant without a partner. A doctor can inseminate the woman with intrauterine insemination (IUI), an affordable and quick procedure, or via in vitro fertilization (IVF), which is highly effective for women with unexplained infertility. 

    Using the right fertility specialist is key to getting the most out of sperm donation. That's because not everyone can benefit from donor sperm, and the right testing can determine whether you’re a candidate. 

    A skilled doctor can further increase the chances of a successful pregnancy by recommending the right treatment protocol. For example, if you pursue IVF, taking the right combination of hormones can increase your odds of success. 

    Female Fertility Testing

    So now we have gone over the men, what about the ladies? Where might one start when they aren’t sure about their fertility or reproductive health. Hysteroscopy is the inspection of the uterine cavity by endoscopy with access through the cervix.

    A hysteroscopy allows a doctor to see the inside of the uterus. It’s a great tool for diagnosing uterine issues such as adhesions and abnormal growths such as fibroids. Uterine issues may explain problems such as abnormal bleeding or implantation failure. Implantation failure is when a woman ovulates and the sperm successfully fertilizes the egg, but the egg does not implant in the uterine wall. Uterine issues may also cause repeated miscarriages. 

    A hysteroscopy is safe, and in some cases, a doctor may even be able to treat any issues they identify as part of the same procedure. But it’s not for everyone. It’s important for a specialist to evaluate your case first. For someone whose issue is with ovulation, hormones, or sperm, a hysteroscopy won’t do any good, and will simply be wasted time and effort. 

    But for someone at risk of uterine issues, a hysteroscopy can be a game changer. This is why it’s so important to work with a doctor who uses evidence-based diagnostic protocols and who knows how to conduct a reliable infertility differential diagnosis. 

    If the woman is still struggling and there is no evidence to be a problem with the man's sperm, a couple might explore the idea of using donor eggs. 

    Consider an Egg Donor

    Many women who cannot conceive on their own still want to experience the process of being pregnant, giving birth, or breastfeeding a child. Some find that these processes help them bond with a child and prepare for the challenges of motherhood. Egg donation offers a chance for a woman to go through pregnancy, even if she cannot have a baby who is biologically her own. For women with infertility, egg donation is often the fastest path to a healthy pregnancy. 

    When using donated eggs you have options. You can use your partner’s or donor sperm, -- and depending on what is best for you -- you can choose between IUI and IVF. You also have a choice in that you can have the egg implanted in your body or implanted into a surrogate. 

    These are all options that should be discussed with your partner, before considering donor sperm and/or an egg donor. You need to get aligned with your partner to make sure your values, time, and money you want to invest in this process are on the same page. 

    At this point, we’ve gone over the biggest fertility issue for men and women. And if there is no other way around their infertility an insight to each donor process. It’s time to move onto the conception procedures. IUI and IVF are the most common and popular amongst infertility. 

    There are also many myths and rumors that come along with these procedures. The most common rumor is that the IVF procedure will make you gain unnecessary weight. Let’s squash this shall we. 

    Does IVF Cause Weight Gain? 

    First of all, what is IVF? In vitro fertilization is a type of artificial reproductive technology that fertilizes the egg outside of the body. You can use you and your partner’s sperm and egg, or any combination of donor sperm or egg. Once a doctor fertilizes the egg with healthy sperm, it grows into an embryo in a safe laboratory setting. A few days later, the embryo is implanted back into the uterus, where it will hopefully implant and develop into a healthy baby.

    Back to the myth, most people considering fertility treatment have heard horror stories about fertility drugs. These stories claim that they cause weight gain, mood swings, or even cancer. The truth is more complex. While some women gain weight on IVF drugs, the weight gain is usually just 5-10 pounds and quickly melts away after the woman stops the fertility regimen. 

    A very small number of women trying IVF medications can experience a dangerous condition called ovarian hyperstimulation syndrome. This condition can cause intense bloating, as well as, rapid weight gain -- 20 pounds or more in just a week or so. This is a medical emergency and warrants immediate attention and possibly treatment. 

    For most women, however, stories about IVF and weight gain -- or for that matter, mood swings and other side effects -- are scare tactics. Indeed, it’s often people who have no experience with IVF telling these stories. For the right candidate, IVF is a safe and effective fertility treatment. 

    Your doctor can help you decide whether it’s right for you, and discuss options for minimizing the risk of side effects and complications. In some cases, it may even be possible to do a low-stimulation IVF cycle, which means you'll take fewer fertility drugs and have a lower risk of complications. 

    Opposite of IVF is IUI. Many people opt for this procedure because it is not as complicated as IVF and is less expensive. But so many people question what to expect and what symptoms are normal. 

    What Happens after IUI?

    Intrauterine insemination (IUI) is an artificial reproductive technology during which a doctor injects sperm directly into the woman, increasing the chances that the sperm will reach the egg. It’s a good option when a man has a low sperm count or low motility, when a woman ovulates infrequently, or when a couple has unexplained infertility. It can also be used with donor sperm, or when a woman wants to get pregnant without a partner. Some couples also opt to try IUI before trying in vitro fertilization (IVF), because IUI is less invasive and more affordable. 

    After IUI, most women do not have any symptoms for at least seven days. After about a week, when implantation is possible, a woman may begin noticing some early pregnancy symptoms. Even then, however, many women will not experience any symptoms at all, but every woman is different. 

    So while monitoring your symptoms can be interesting and help with your anxiety, the specific symptoms you experience, tell you very little about whether the IUI cycle was successful. You’ll typically take a pregnancy test in your doctor’s office on day 14, though it’s possible to get an early result 10-12 days after ovulation, depending on when the egg implants and how sensitive the test is. 

    Factors That Can Alter a Pregnancy Test

    other-factors-leading-to-infertility

    There’s nothing quite as awful as getting an endless stream of negative pregnancy tests. False positives are very rare unless you're taking certain medications. So if you get a positive test, you’re probably pregnant. If you get a negative test after a positive test, it could be a sign of an early miscarriage. So it’s important to call a doctor after a positive test, even if you’re not sure. 

    False positive pregnancy tests are so rare that, if you get a positive test, you can be reasonably certain you are pregnant. Even very powerful medications are unlikely to cause a false positive. However, some of the drugs used to treat infertility may cause a false positive test result. 

    Medications

    Pregnancy tests measure the hormone hCG, and very few things can affect hCG levels. However, certain fertility drugs can mimic the hormone. Some fertility regimens, especially in anticipation of in vitro fertilization (IVF), may even use the hCG hormone. If you are taking fertility medications or hormones, you may have a false positive pregnancy test. Talk to your doctor before testing. In some cases, you may have to undergo testing at your doctor’s office to get a reliable result.

    UTI’s  

    A urinary tract infection (UTI) can be painful, and even dangerous. Left untreated, it can spread to the kidneys. UTIs can even affect other organs, and potentially even fertility. So it’s important to take a UTI seriously. It is extremely unlikely, however, that a UTI will affect pregnancy test results because UTIs do not change blood levels of the pregnancy hormone hCG. 

    If you have a UTI, talk to your doctor about appropriate treatment, and about whether the infection may affect fertility or your overall health.

    PCOS

    Polycystic ovary syndrome (PCOS) is a hormonal disorder that can affect fertility in several ways. It may cause a woman to ovulate less frequently. It can also make her insulin resistant, decreasing the chances of a successful, healthy pregnancy. 

    PCOS does not typically cause false positive pregnancy tests. However, some women with PCOS take fertility drugs that may affect the results of pregnancy tests. Additionally, because PCOS changes the frequency with which a woman ovulates, it can make it more difficult to pinpoint the moment of ovulation, causing false negative tests. 

    Some research also suggests that PCOS increases the risk of miscarriages, especially early miscarriages. So a woman with PCOS who has a positive pregnancy test followed by a negative one may have suffered an early miscarriage. It’s important to seek treatment from a fertility specialist if you have PCOS, especially if you have a history of false positive tests. 

    Seeking Out a Solution

    When dealing with infertility the road to parenthood can be quite bumpy and difficult to navigate. The best thing to do is educate yourself and work with a qualified specialist. When you seek help it doesn’t mean failure. 

    Infertility specialists have worked with hundreds of couples who have walked in your shoes. They know how to properly evaluate you and your partner, administer the proper tests, and recommend an appropriate course of action based or your results, values, and budget. 

    Infertility doesn’t have to be a road you walk alone, let us help chart your roadmap together!

    The Infertility Journey: Your Questions from A to Z

    Topics: Fertility Journey, Infertility Treatment, Infertility Testing

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