Are you struggling to conceive?

Conventional wisdom says if you’ve been trying for a baby for a year without success then you should seek fertility testing. But older women or those with conditions that could potentially impact fertility (for example hormone imbalances or endometriosis) may be wise to seek medical advice sooner.

Read on as we address some of the common questions people have when struggling to conceive.

What to do if you’re struggling to get pregnant – Have you tried these lifestyle tweaks?

When you want to get pregnant, it’s common to wonder about lifestyle changes. While there are certainly no guarantees that lifestyle tweaks will result in successful conception, it’s always worth asking yourself:

• Am I eating a healthy diet? While there isn’t a straight line between nutrition and conception, healthy plates help make for healthy bodies, and healthy bodies tend to be more fertile. So have a look at what you’re eating and load up your plate with some of those foods for fertility.
• Am I mindful of over-exposure to certain plastics? There is emerging evidence regarding the affects that some plastics may be having on fertility, so you could try to avoid microwave meals and look at other means of reducing exposure, as detailed in our blog here.
• Am I very stressed? The relationship between stress and fertility is a complex one and further research is needed to understand it more fully. But studies have shown that increased stress levels are associated with problems conceiving. Of course, trying for a baby can be stressful in itself, so simply being told to ‘calm down’ can be more than a little annoying! Instead, consider if there are any ways you can simplify your life, delegate more, and take up a destressing hobby like meditation or yoga.
• Am I exercising? Exercise is one of the best ways to destress, sleep better, and stay healthy.
• Have I reduced alcohol, caffeine and other toxins? Research has shown that alcohol intake can have a negative impact on fertility, so it’s a good idea to cut drinking right down and try to avoid other toxins such as caffeine and nicotine.

Why am I not getting pregnant even though I am ovulating?

If you’re ovulating, struggling to conceive can be especially confusing. Women diagnosed with conditions that can affect ovulation (for example polycystic ovary syndrome) know that they may struggle to conceive and can often take appropriate measures in good time, but for women with no such diagnoses, struggling to get pregnant can be super puzzling. In fact, many women with conditions that affect fertility don’t know they have them. Infertility is a lot more common than you’d think – in fact NICE reports that one in seven heterosexual couples experience infertility. So if you’re struggling to conceive there could be a number of causes including:

1. An undiagnosed infection or sexually transmitted disease (STD): If left untreated, some STIs such as chlamydia and gonorrhoea can lead to infertility in both men and women. What’s more, these infections often present without symptoms, meaning they can go undetected for years. Undiagnosed infections that are mostly not sexually transmitted (such as bacterial vaginosis) can also lead to fertility problems. So if you’re struggling to conceive, it is essential you get checked. Here at The Fertility and Gynaecology Academy, when we’re assessing patient fertility, we screen for infections as standard.
2. Structural issues in the reproductive system: For example, a woman may have blocked fallopian tubes, meaning the sperm can’t reach the egg, uterine fibroids (non-cancerous growths consisting of fibrous tissue and muscle) or scarring. Other problems include endometriosis or even an unusually shaped womb. Thorough fertility testing such as that conducted here at The Fertility and Gynaecology Academy will include exacting scans to determine any such issues.
3. Hormonal imbalance: Your fertility is governed by a delicate balance of hormones such as oestrogen, progesterone and others. Hormones are essential chemical messengers that manage a variety of functions within your body, by delivering signals through the blood to organs, muscles and other tissue. So for example in fertility medicine, one of the tools we use to assess the number of eggs a woman has left is a measurement of Anti-Mullerian Hormone (AMH) through blood testing. Too little AMH could signal a low number of eggs, but very high AMH levels could signal a disorder like polycystic ovarian syndrome (PCOS).
4. Male factor infertility: Don’t forget that it could actually be the man that has the issue; indeed male factor infertility is the main problem in about 30% of all infertility cases. So if you’re a heterosexual couple struggling to conceive and you really want to get a clear picture of what’s going on, you need to opt for both female and male fertility testing.
5. Unexplained infertility: It’s worth remembering that unexplained infertility accounts for around one fourth of all cases. You may never get those answers but thankfully this doesn’t mean you’ll never get your baby. In fact, with good fertility treatment, many couples with unexplained infertility successfully conceive.
6. Age-related infertility: For women over the age of 35 and men over 40, struggling to conceive is more common and conception tends to take longer. Women often assume that if they’re still ovulating regularly, their eggs and all-round fertility must be good, but this may not be the case. When it comes to eggs, it isn’t just quantity that matters but quality. Age impacts both. It’s a harsh fact of nature but time is fertility. So the sooner you get a handle on any potential roadblocks, the more likely you are to get your baby.
7. Certain medications and health conditions: All kinds of health conditions, medications and lifestyle factors can impact fertility – from diabetes to some antidepressants. And it can be difficult for you – as a layperson with a busy life – to know what’s at play. This is why a comprehensive fertility screening package should always include thorough consultation and medical history, leaving no stone unturned. “It isn’t the patient’s job to know; it’s the doctor’s,” says Dr Anu Chawla, Fertility Consultant at The Fertility and Gynaecology Academy. “This is why so many patients find it such a relief to finally put themselves in the hands of experts, and get to the root of what’s going on.”

How to test if a woman or man is infertile

“You cannot solve a problem until you determine what it is. So for anyone struggling to conceive, fertility testing is essential,” says Dr Chawla. “Different fertility issues require different fertility treatments, so it’s really important to get a thorough picture around any potential problems for either partner.

“These days, there are basic at-home blood tests on the market measuring things like AMH but they don’t offer anything close to the full picture and can actually present false reassurance. The only way to know what’s going on is to get proper fertility screening,” Dr Chawla adds.