Are you struggling to become pregnant? You are not alone. Research indicates 10 to 15% of couples in the United States experience infertility. There are several factors that can lead to infertility, but a lot of times it isn’t common knowledge. Whether you’re at the beginning of your fertility journey or navigating a high-risk pregnancy after using assisted reproductive technologies, we at Delfina want you to have all the facts.
Did you know women in their 20s have a 20 to 25% chance of achieving a pregnancy each month, while women in their 30s have around 15%?
Even more astounding, at age 35 this likelihood drops to 10% each month. With such a small margin of error, you can see how even the slightest changes in our reproductive health can have a large impact on our ability to get pregnant. Let’s investigate types of infertility, determine when to be evaluated for infertility, and everything in between.
How do I know if something is wrong, or if I should be evaluated?
That is a great question, and the answer can be different for different people. If you are under the age of 35, experts recommend seeking evaluation if you haven’t achieved a pregnancy after 1 year of having regular, timed intercourse without using any form of contraception. Once you have reached age 35 this timeframe decreases to 6 months. If you are age 40 or older, or have an underlying condition such as PCOS, talk with your OB/GYN as soon as you are thinking about trying to conceive. Your general OB/GYN should be able to do the initial work-up for your infertility, but you may also consider or be referred to a reproductive endocrinologist who is an OB/GYN with specialized training and infertility.
How do I know if I am at risk of infertility?
The most common cause of female infertility is a problem with ovulation, or the release of an egg each month, so it is important to determine if you are ovulating regularly. Female infertility could also be due to problems with the fallopian tubes or uterine cavity. The most common cause of male infertility involves problems with sperm cells and their function. Other factors to consider regarding fertility include age, lifestyle habits like being under- or overweight, and various health conditions like PCOS and endometriosis. Oftentimes, patients have what is called “unexplained infertility:” where no cause of infertility is found.
What should I expect testing to involve?
Depending on your history and physical exam, your infertility work-up may include laboratory tests, imaging tests such as ultrasound or sonohysterogram, and procedures such as hysterosalpingogram, hysteroscopy D&C, and/or diagnostic laparoscopy. It is important to note that most insurance does not cover infertility work-up. You should check with your insurance and talk to your OB/GYN provider about this prior to getting started.
You mentioned ovulation earlier. Is there a way that I can test at home to see if I am ovulating?
Yes, you can! There are several different ways to determine if you are ovulating. One option would be to track basal body temperature. Your temperature rises around the time of ovulation. You should take your temperature by mouth every morning before getting out of bed and record it on a chart or in an app. It will likely take 2 or 3 menstrual cycles for you to see a pattern. You may also track your cervical mucus. Just before ovulation, expect your cervical mucus to become thin, slippery, and stretchy like an egg white. Ovulation predictor kits are another great option. These require you to urinate on a stick, and can be purchased over-the-counter at most local grocery and drugstores.
Are there any risks to becoming pregnant after using an assisted reproductive technology like IVF?
If you successfully become pregnant through using fertility solutions like IVF, congratulations! However, you might need to think about different risks than other pregnant patients. If you do IVF, you’re more likely to have multiples like twins or triplets if more than one embryo is transferred to your uterus. Being pregnant with multiple fetuses increases the risk of preterm birth and low birth weight, and might mean you need more prenatal checkups to keep an eye on you and your babies. Maybe your fertility troubles stem from being over 35: if you become pregnant through IVF, you will be at increased risk of adverse pregnancy outcomes like gestational diabetes and preeclampsia due to advanced maternal age.
Please remember, you are not alone in battling infertility. Once you have established the cause of your infertility, whether it is explained or unexplained, you can start to move forward with a plan to help you achieve your desired pregnancy: whether by pursuing simple lifestyle changes, or more challenging options like in vitro fertilization, surrogacy, or adoption. Delfina Care’s personalized care management options are tailored to those who might be experiencing a high-risk pregnancy. With Delfina, your provider can view your symptoms as you track them, including blood sugar and blood pressure. This way, your provider is up-to-date and can use this information to inform whether they want to adapt your care plan. Whatever your pregnancy journey, we’re here to support you.