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Problems in becoming pregnant

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Only about eight out of ten women will achieve a pregnancy within twelve months of trying, and about one in eight women have difficulties getting pregnant. Fertility (likelihood of getting pregnant) drops as you get older. Fewer women become pregnant in the first 12 months when they are more than 35 years old. If you are a woman over 35, or if you think that either you or your partner may have a fertility problem, see your doctor after six months of trying.  

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There are some things that may increase your chances of becoming pregnant, including some lifestyle changes, and sometimes medical treatments. If these do not help, reproductive medicine units may be able to help in several different ways.

When a couple are having trouble getting pregnant,

  • about 40% of the time there is some problem with the woman
  • about 40% with the man
  • and in about 20% of couples no cause can be found.

Problems that make it harder for women to become pregnant

These symptoms or situations may indicate that you may have a problem getting pregnant - the information is on the Victorian Government website 'Better Health Channel':

You may also have more difficulty becoming pregnant if you smoke, or are overweight or underweight

Male infertility

New life begins when an egg from a woman is fertilised by sperm from a man. Around 20 million sperm per millilitre (ml) need to be present in the ejaculate, with enough mobility and strength to swim the journey to the fallopian tube, where conception normally takes place.

Around 40 per cent of fertility problems originate in the man. Male fertility problems include problems with sperm production or blockages in the tubes of the reproductive system.

Causes of male infertility

  • Problems with sperm production: this may cause:
    • Absent sperm - the semen doesn’t contain any sperm.
    • Low sperm count
    • Abnormal shape of sperm
    • Poor motility (movements) of sperm.
  • Blockage of sperm transport from the testes
  • Sperm antibodies
  • Sexual problems such as impotence - the inability to get or maintain an erection sufficient for sexual intercourse
  • Hormone problems

For more information

Improving your chance of becoming pregnant

You are most likely to become pregnant if you have intercourse around the time the woman ovulates, which is when an egg is released.

  • Ovulation usually occurs about 14 days after the beginning of the previous period.
  • If your menstrual cycle is regular and around 28 days long, then you will usually ovulate around 14 days before your next period starts.
  • Some women can tell when they are ovulating because their cervical mucus becomes more plentiful and slippery.
  • Some women also experience a sharp pain low down on one side of their stomach.
  • Many women find that their libido (desire for sex) increases around the time they ovulate.

This ovulation calculator might help you work out when you could be most fertile.

Things that might help

There are several simple steps that you can take to increase your chances of becoming pregnant, these include:

  • Become aware of your cycle so you 'get the timing right' 
  • Stop smoking
  • Exercise regularly and moderately
  • Eat a healthy diet and lose some weight if you are overweight
  • Reduce coffee (and other caffeine drinks), alcohol and drugs
  • Reduce exposure to toxins, heavy metals, chemicals, organic solvents
  • Find ways to reduce stress and to relax
  • Try to get 6–8 hours sleep every night.

Stopping smoking and losing some weight if you are overweight are two of the most important steps you can take to improve your fertility. Even if a woman stops smoking, there may still be problems getting pregnant if her partner continues to smoking.

Why you should not smoke

Your baby deserves to begin his or her life without being exposed to smoke, either in your womb or in the home. Quitting smoking can improve your fertility and reduce the chance of many other problems.

Women who smoke:

  • May be about 25% less likely to become pregnant in the first 12 months of trying if they smoke 20 or more cigarettes per day. This returns to normal if a woman stops smoking.
  • Have poorer results with fertility treatments
  • Have a higher miscarriage rate
  • Have an earlier onset of menopause (the age when monthly periods stop).

Each cigarette you smoke while pregnant will reduce the blood flow to your uterus, resulting in less oxygen for your baby. Women who smoke are more likely to

  • have small babies,
  • have babies born early (premature)
  • have babies who die at birth (still birth)
  • have babies who die in the early weeks of life (SIDS).

To learn more about the great health benefits of quitting, and how to get support for quitting, go to the topic Smoking before pregnancy.

Trying to quit can be hard but there is a lot of support available.

  • Have a chat to your doctor, midwife or pharmacist about quitting.
  • In Australia you can also call

Men who smoke have:

  • A reduced sperm count and reduced numbers of healthy sperm
  • A higher risk of impotence (problems with erection)
  • Increased asthma in their children.

If you have a partner who smokes he can improve his own fertility and health by quitting smoking at the same time as you. It's one of the most positive things you can do together in preparing for parenthood. When you are both non-smokers you will feel so good about yourselves and the fact that you are giving your future child the healthiest possible start in life.

Overweight or underweight  

Your fertility will be best when you are close to your 'ideal' body weight - that is, you are not overweight and not underweight.

Overweight women can have:

  • More ovulation problems (ovulate less often and more irregularly)
  • Reduced pregnancy and live birth rates
  • More medical complications and are more likely to have high blood pressure during pregnancy.

If you are overweight, you can improve your likelihood of becoming pregnant by losing weight through regular exercise and by eating a healthy diet.

Research shows that overweight women who lose weight through exercise and a healthy diet before pregnancy have:

  • More regular ovulation
  • Increased pregnancy rates
  • Reduced miscarriage rates

Some research has suggested their baby may have fewer birth defects but this is not clear.

Talk to your doctor, a midwife or the staff at your community health centre for more information about healthy weight loss.

Note: dieting to lose weight during a pregnancy is not recommended.

Underweight

Women who are underweight due to a heavy exercise program and very strict diets are also more likely to have fertility problems. If they are underweight because of chronic health problems they are also less likely to become pregnant.

  • Reducing the amount of exercise done and eating a healthy and varied diet can both improve fertility.
  • If you have a chronic health problem, talk to your doctor to see if there are ways that your fertility can be improved even though you have this health problem.

When should you get help?

If you are a younger woman, you should give yourself 12 months before beginning to check why you are not pregnant. If you are over 35 years old, then six months of trying is probably long enough before getting help.

It's important to remember that both you and your partner will need to have your fertility checked - this is not just a woman's problem. If you or your partner has any obvious problems, you may want to get help earlier than this.

How can you get help?

The first step is to see your own doctor who will ask you some questions, examine you and do some tests.

Your doctor may then refer you for specialist treatment to a private obstetrician or to a reproductive medicine unit. They will work out a plan to help overcome your particular problems.

Services of a reproductive medicine unit

Reproductive medicine units deal with all forms of infertility. The services offered include:

  • A full medical check of both partners to work out the cause of infertility
  • A specialised plan for checking egg growth in women and possibly treatment with medicines
  • A range of surgery (laparoscopy, hysteroscopy and gynaecological surgery) for checking and treating female infertility
  • A specialised laboratory for checking male infertility.

Will you need assistance with becoming pregnant?

There are many different forms of treatment to help fertility including IVF (in vitro fertilization). These treatments might include surgery with a laparoscope and treatment for ovulation problems. The treatment that is best for you or your partner will depend on what is causing your problem. Sometimes simple medication will help.

Reproductive medicine units can help with many different types of reproductive technology options including:

  • IVF
  • Injection of selected sperm into eggs (ICSI)
  • Collection of sperm from the testis
  • Donor insemination
  • Freezing and storage of embryos and sperm.

Infertility is a physical, emotional and social issue that affects both partners. The staff at reproductive medicine units understand how infertility and fertility treatments can affect you and your relationship. For these reasons, the units offer specialised counselling before, during and after pregnancy.

Websites for more information

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see your doctor or midwife.

 

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