By Dr Ashish Das, Medical Director of City Fertility Centre Brisbane.
It is exciting when you decide the time is right to have a baby. You start thinking about all the usual things, such as what the baby will be like, how you will decorate the nursery and what type of parent you will be. So you start trying to fall pregnant and for some people, it happens straight away, while others don’t have success in the first few months.
Rest assured, the truth is that 80 per cent of couples in the general population will fall pregnant within 12 months of trying to conceive. So the best thing to do is keep calm and keep trying. Eat well, exercise and make sure you are fertility fit.
However, for some, falling pregnant seems to begin to feel as though it is taking forever and even becoming a little elusive, so when is the right time to seek help?
I recommend you seek advice from a specialist to guide you if you are experiencing any of the following concerns or conditions:
1. You Have Been Trying to Fall Pregnant but Haven’t Been Successful yet
You should seek help if you are under 35 years of age and have not fallen pregnant within 12 months of unprotected intercourse, or if you are over 35 and have not fallen pregnant within six months of trying. For women aged 40 and over, I recommend further investigations be initiated after three months of trying to fall pregnant, as female age is one of the most important predictors of whether pregnancy will be achieved.
2. Irregular Menstrual Cycles
Irregular cycles may suggest a problem with ovulation and can impact on your ability to conceive. The average length of the menstrual cycle is 28 days, but can range between 25 and 35 days. The menstrual cycle is determined by a complex interaction of hormones, so any hormone imbalance can make your period irregular. Although most cases of irregular cycles are not dangerous, it is important to determine the cause of the irregularity sooner rather than later.
3. Medical Conditions
- Polycystic Ovarian Syndrome (PCOS): This is a condition whereby the ovaries secrete abnormally high amounts of androgens (male hormones), which often cause problems with ovulation.
- Endometriosis: Endometriosis results when endometrial-like cells (from inside the uterus) grow outside the uterus. Distortion of the anatomy due to endometriosis can block or change the function of the fallopian tubes and prevent the sperm from reaching and fertilising the egg.
- Fibroids: These non-cancerous masses are found in the uterus or cervix. Uterine fibroids are found in one out of every four or five women in their 30s and 40s. Fibroids can cause tubal blockages, prevent the embryo from attaching to the uterine wall and lead to miscarriage. The impact the fibroids have on fertility depends upon their size and location.
- Blocked fallopian tubes: When fallopian tubes are blocked, the egg can be prevented from meeting the sperm.
- Premature menopause: Premature Ovarian Failure (POF) is also called early menopause and refers to a condition whereby the ovary stops ovulating earlier than is normal. The average age range for menopause is between 45 and 55.
- Other medical causes: Thyroid disorders and genetic conditions.
4. Recurrent Miscarriage
After three or more miscarriages (known as recurring miscarriages), tests are commonly done to look for the cause.
5. Known Sperm Issues
Fertility advice should be sought if any of the following sperm issues are known: poor sperm morphology (abnormally shaped); poor motility (slow-moving); low sperm count; the presence of antisperm antibodies; ejaculatory problems or azoospermia (no sperm present); vasectomy.
6. If a Donor is Required
If you require donor sperm or donor eggs.
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