Wanting a pregnancy and not achieving it is one of the most frustrating and stressful situations that a couple can face, especially for women. However, it is much more common than you think, since between 10 and 15% of couples in our country have some kind of problem when it comes to getting pregnant . If you suspect that there may be a problem, these are the steps to follow to start looking for solutions.
How long do I have to wait?
When we want to get pregnant, we want it to be as soon as possible, but so that this situation does not cause anguish, it must be clarified that getting a pregnancy the first time is really difficult, since human fertility is really low.
At the time of maximum fertility for women, which is between the ages of 20 and 30, the success rate is only 25% in each cycle , and there is no alternation in fertility, either in the case of the woman or the male. man. Furthermore, female fertility declines with age.
According to data from the Spanish Society of Gynecology and Obstetrics (SEGO), from the age of 32 it begins to decline, this decrease becomes very noticeable from the age of 35-38 and after the age of 40 the probabilities of becoming pregnant in the first year are less than 10%, even with non-assisted reproduction treatments. 13% is exceeded. Taking these data into account, it is important that we be patient, as it is normal for getting a pregnancy to take a few months.
What is the Assisted Reproductive Clothing method and in which cases is it indicated?
If after a year of having unprotected sex we have not achieved the desired pregnancy, it is time to consult a specialist. In case the woman is over 35 years old or there are previous problems (genetic problems, repeated abortions, previous pelvic surgery, polycystic ovaries, endometriosis …), this consultation should be done when a pregnancy has not been achieved in six months.
What specialist do I have to consult?
If you decide to go to public health, the first step is to go to your family doctor, who will refer us to the gynecologist. It will be this specialist who, after doing an ultrasound, will refer us to the assisted reproduction unit of the hospital.
The couple must attend the first assisted reproduction appointment, since the fertility study must be done on both members of the couple. Given the suspicion of infertility, we can also go directly to an assisted reproduction clinic.
In the first consultation in assisted reproduction, either in public health or in a private clinic specialized in reproduction, the medical history of both members of the couple will be thoroughly reviewed in search of any health problem that may be causing infertility and a questionnaire on their habits, since the lifestyle – bad eating habits, stress, addictions … – also influences the possibility of conceiving a child.
What tests are you going to put us through?
After this first consultation, a fertility study will be recommended.Depending on the medical history, they may be more specific tests, but, in general, a basic fertility study is carried out in principle, and depending on the results, they can get additional tests. The basic reproduction study consists of:
The quality of the ovules begins to decrease after the age of 30, with a more pronounced decline after the age of 35.
What is ovarian reserve and when should it be evaluated?
In the case of women:
• An ultrasound of the ovaries and uterus , looking for cysts, fibroids, malformations, ovulation problems, etc. that may be making pregnancy difficult. If we have gone before the gynecologist, it is likely that we have already done this test.
• Hormonal analytics. These tests are decisive, because through various blood tests at different times of the cycle, the different hormones that influence ovulation, determine ovarian reserve, etc. are analyzed. These hormones are FSH, LH, estradiol, antimullerin hormone, thyroid profile, progesterone, etc. Taking advantage of these analytics, serological tests are performed to rule out infections such as rubella, HBV, HCV, syphilis, HIV …).
• Hysterosalpingography. It is an x-ray that, by introducing a contrast, analyzes the patency of the fallopian tubes and the shape of the uterus. They can also be complemented with a hysteroscopy, which is the introduction of a camera inside the uterine cavity that will visualize the uterus from within, study the morphology of the endometrium and take biopsies if necessary.
In the case of men :
• Seminogram with REM , where the quantity, quality and mobility of sperm are analyzed. In case this is altered, additional tests will be carried out.
And after the results?
After performing these tests, the cause that causes infertility should be found, which is usually in 35% female, 35% male and in 20% of cases a combination of fertility problems of both members of the couple . Depending on the cause, one treatment or another will be recommended, but the most common are artificial insemination and in vitro fertilization , even in cases where the cause of infertility is not found, which is 10% of them. ,
Thanks to advances in assisted reproduction , the success rate is increasing and most couples achieve their goal with one or more attempts. Furthermore, 20% of couples with infertility eventually achieve pregnancy without treatment.