Difficulty Getting Pregnant

What Does Difficulty Getting Pregnant Mean?

Difficulty getting pregnant means conception has not occurred within the timeframe expected based on your age, reproductive history and circumstances. It does not identify a specific diagnosis or tell us which partner, if either, has a fertility problem.

Pregnancy requires several biological steps to work together. An egg must develop and ovulate, sperm must be available and capable of reaching the egg, fertilization must occur, the resulting embryo must travel to the uterus and implantation must begin. A barrier at any of these stages can make conception more difficult.

For some patients, testing identifies a clear fertility factor. Others have several factors contributing at the same time, while some patients receive a diagnosis of unexplained infertility when standard fertility evaluation does not reveal an obvious cause.

What Can Make Getting Pregnant More Difficult?

Many reproductive factors can affect the probability of conception. A fertility evaluation is designed to investigate the factors that are relevant to you rather than assuming there is one universal cause of difficulty getting pregnant.

Your fertility specialist may consider:

• Ovulation: Pregnancy generally requires the release of an egg. Irregular or absent ovulation can reduce opportunities for fertilization.
• Age and ovarian reserve: Reproductive potential changes with age, particularly because egg quantity and quality change over time. Ovarian reserve testing can provide additional information about egg quantity, although no single test can determine whether someone will or will not become pregnant.
• Fallopian tubes: At least one functional fallopian tube is generally needed for egg and sperm to meet during unassisted conception or IUI.
• Uterine factors: Certain structural conditions involving the uterus or uterine cavity may affect fertility in some patients.
• Sperm factors: Sperm count, movement, morphology and other aspects of sperm health can contribute to difficulty conceiving.
• Endometriosis and other reproductive conditions: Conditions such as endometriosis, ovulatory disorders and other reproductive or medical conditions may also be relevant depending on your history.

Sometimes more than one factor is involved, and sometimes standard fertility testing does not identify a clear explanation. Your physician can interpret the findings together with your reproductive history to determine what they mean for you.

When Should You Seek Help Getting Pregnant?

In general, fertility evaluation is commonly recommended after 12 months of trying to conceive for women under age 35 and after six months for women age 35 and older. Evaluation may be appropriate sooner when there is already a reason to suspect a fertility barrier.

You may want to speak with a fertility specialist earlier if you have irregular or absent periods, known endometriosis, a history of reproductive surgery, known fallopian tube concerns, diminished ovarian reserve, previous pregnancy loss, a known sperm-related fertility factor or another medical or reproductive condition that could affect conception.

You also do not need to wait until you are certain something is wrong. A fertility consultation can help you understand your reproductive health, determine whether testing is appropriate and decide whether continued attempts to conceive or another approach makes sense.

What Fertility Testing May Be Recommended for Difficulty Getting Pregnant?

Fertility testing evaluates several of the biological processes required for conception. Rather than producing a single “fertile” or “infertile” result, different tests provide information about different parts of reproductive health.

Depending on your age, reproductive history and circumstances, evaluation may include:

• • Ovarian reserve testing to provide information about the remaining egg supply.

• • Reproductive hormone testing based on menstrual patterns and clinical history.

• • Pelvic ultrasound to evaluate the ovaries and uterus and assess antral follicles when appropriate.

• • Evaluation of the fallopian tubes and uterine cavity to investigate potential structural barriers to conception.

• • Semen analysis when conception involves sperm, providing information about sperm count, concentration, movement and other characteristics.

No single fertility test can determine whether pregnancy will occur. Your physician interprets these findings together with age, how long you have been trying, previous pregnancies and other medical and reproductive information.

What Treatment Options Can Help With Difficulty Getting Pregnant?

Treatment depends on what your evaluation shows. Seeing a fertility specialist does not mean that you will automatically need IVF, and some patients may not need fertility treatment at all.

Depending on your circumstances, your physician may recommend continued attempts to conceive without treatment, medication to support or induce ovulation, timed intercourse, intrauterine insemination (IUI), in vitro fertilization (IVF) or another individualized approach.

For example, treatment focused on ovulation may be appropriate when irregular ovulation is the primary barrier. IUI may be considered in certain circumstances when sperm and egg can still meet within the reproductive tract. IVF may be appropriate when there is a reproductive barrier that IVF can help overcome or when age, previous treatment and other fertility factors make it a more appropriate strategy.

If standard testing does not identify a specific cause, your physician can still use your age, reproductive history and duration of infertility to discuss options for unexplained infertility.

What Comes Next When You’re Having Difficulty Getting Pregnant?

What comes next depends on your age, how long you have been trying to conceive, your reproductive history and what your fertility evaluation shows.

At Spring Fertility, your physician can review these factors together to determine whether continuing to try without treatment, addressing an identified fertility factor, IUI, IVF or another approach may be appropriate.

If testing does not identify a clear cause, that does not mean there are no options. Your physician can still use your age, treatment goals and the information available from your evaluation to help determine a reasonable path forward.

The goal is not simply to identify a diagnosis. It is to understand your individual fertility picture well enough to make an informed decision about what comes next.