Reasons for not being able to carry a baby full term

What Causes Infertility in Women?

Infertility affects an estimated 10 percent of women. Studies have found that about a third of infertility cases are due to female infertility, another third to men, and the rest to issues affecting both partners or a cause that may remain a mystery.

Many factors can contribute to female infertility. Understanding them is the first step toward resolving them.

Female Infertility: Ovulation Problems

Problems with ovulation are the most common cause of female infertility. Without an egg being released — the very definition of ovulation — you can’t have a pregnancy. A lack of ovulation is frequently due to:

  • Polycystic ovarian syndrome: An imbalance of hormones causes a disruption in the regular ovulation process.
  • Primary ovarian insufficiency: With this condition that affects women under 40, your ovaries aren’t functioning as they should be during your fertile years.

Female Infertility: Blocked Fallopian Tubes

A blockage in your fallopian tubes can prevent a released egg from being fertilizing by sperm and from progressing on its journey toward your uterus. Blocked fallopian tubes can be traced to:

  • Pelvic inflammatory disease
  • Endometriosis, the condition characterized by the growth of endometrial tissue outside of the uterus
  • Surgery for an ectopic pregnancy

Female Infertility: Uterine Conditions

Infertility in women may be due to problems with the uterus itself or with unwanted growths within the uterus, such as uterine fibroids or polyps. Uterine fibroids, for instance, are typically benign but can grow on the uterine walls. Fibroids and other physical abnormalities of your uterus can make it difficult to conceive or carry a baby to term.

Female Infertility: Symptoms

Some common symptoms that may indicate female infertility include irregular menstrual periods, not having any periods at all, or extreme pain associated with your periods.

If you have any of these symptoms, if you know that you have a condition that can affect fertility like endometriosis or pelvic inflammatory disease, or if you have been trying unsuccessfully to get pregnant for one year (or for six months if you are 35 or older), it’s time to talk with your doctor. He or she can give you a physical exam, review your medical history, and perform tests to determine if you have female infertility.

Female Infertility: Diagnosing the Problem

Some of the more common tests used in the diagnosis of infertility in women are:

  • Ovulation tracking. The first step in assessing your fertility is often tracking when you ovulate. To assess your ovulation, your doctor may instruct you to keep a record of your menstrual cycles, chart your body temperature, use a urine test kit, or have periodic blood tests; he or she even may monitor your follicle growth via ultrasound.
  • Hysterosalpingogram. In this procedure, a liquid is injected into your cervix and an X-ray is used to track its flow to detect a blocked fallopian tube or uterine abnormality.
  • Laparoscopy. A small surgical instrument called a laparoscope — a tube fitted with a small camera — is inserted in your abdomen so that the doctor can visualize any problems affecting your fallopian tubes or uterus.
  • Hormone testing. Your doctor may order blood tests to check for abnormal levels of hormones that play a role in fertility issues.
  • Ovarian reserve test. This simple blood test can give your doctor an idea of how many eggs you have and how healthy they are.

Female Infertility: Treatment

Advances in infertility treatments may help many women get pregnant. Options include:

  • Medication, such as fertility drugs
  • Surgery, such as removing endometrial growths or fibroids
  • Artificial insemination
  • Other assisted reproductive techniques such as in vitro fertilization (IVF)

Female Infertility: Reducing Your Risk

In many cases, you cannot control how fertile you are, but you can increase your chances of being able to have a healthy baby by:

  • Not smoking
  • Avoiding excessive alcohol use
  • Managing your stress
  • Maintaining a healthy diet and a healthy weight
  • Protecting yourself against sexually transmitted diseases

Being unable to conceive can lead to a rash of emotions, including frustration. Infertility experts have developed many different treatment options. Talk with a doctor to see what might work best for you and your partner.

When I think back to that time, I recall an almost constant sense of grief. Every 28th day represented another failure, another loss. All around me my friends were having their second and then third babies. My son looked at his classmates with their siblings wistfully, he wished with every birthday candle for a brother or sister and one day he asked, “Can you play tig on your own?”

West states that the “hardest thing about secondary fertility issues is that you want a sibling for your child.” Fiona, who has a son of five and has been trying to conceive a second child for two years, says she can no longer look out of the window at her son playing in the garden. “It breaks my heart. He just looks so alone out there. All I want is a sibling for him but I don’t think it’s going to happen.”

I found that I couldn’t avoid the sense that we were not yet all here, that there was a person missing. In one of those strange confluences, I was, at the same time, writing a novel about a woman who had just given birth. I was spending my days at the fertility clinic and my evenings writing about the strange, shadowy world of early motherhood. My husband, coming into my study and finding me in tears again, laid his hand gently on the manuscript and said, “Do you ever think that writing this book might not be helping?” But you don’t choose the books; they choose you. And if I couldn’t bring a baby into being in real life, I was damn well going to do it in fiction.

The grief and anxiety of SI is, of course, self-perpetuating. You find yourself in a double-bind: you’re constantly told that the chances of conceiving are maximised if you can relax and eliminate stress, but it’s hard to let go of something so all-consuming, so elemental, as infertility. People were always saying to me: “If you just forgot about it, you’d get pregnant straight away.” For the record, this is the most unhelpful thing you can say to someone with fertility problems. West explains that “couples become more and more anxious about the gap “.

The NHS recommends that, after trying and failing to get pregnant for a year, you should see your doctor; if you are over 35, you should go after six months. Help is out there, if you want it, and takes many forms. West stresses the importance of investigating both the women and the men, “even if they have previously had a healthy sperm analysis because situations and lifestyles can change”. There is also the alternative therapy route: acupuncture, hypnotherapy, reflexology, meditation. Or, if all else fails, you could, like me, go for in-vitro fertilisation (IVF).

I was shocked when our consultant first suggested IVF. If there was nothing wrong with us, why did we need something so invasive? But I was also, as I’ve said, desperate. My baby girl was born last year and sometimes I still can’t quite believe she’s here.

Secondary infertility is a secret club and one, I’ve discovered, with permanent membership. I was in a supermarket the other day and ahead of me in the cereal aisle was a woman with a boy of about nine and twin babies in the trolley. As I passed, she turned and looked at us. I saw her clocking my children and their age-gap and she saw I was doing the same with hers. We looked at each other for a moment; she smiled and I smiled back and then we walked on.

• Maggie O’Farrell’s new novel, The Hand that First Held Mine, is published by Headline Review.

Infertility in men and women

Treatment will depend on many factors, including the age of the person who wishes to conceive, how long the infertility has lasted, personal preferences, and their general state of health.

Frequency of intercourse

The couple may be advised to have sexual intercourse more often around the time of ovulation. Sperm can survive inside the female for up to 5 days, while an egg can be fertilized for up to 1 day after ovulation. In theory, it is possible to conceive on any of these 6 days that occur before and during ovulation.

However, a survey has suggested that the 3 days most likely to offer a fertile window are the 2 days before ovulation plus the 1 day of ovulation.

Some suggest that the number of times a couple has intercourse should be reduced to increase sperm supply, but this is unlikely to make a difference.

Fertility treatments for men

Treatment will depend on the underlying cause of the infertility.

  • Erectile dysfunction or premature ejaculation: Medication, behavioral approaches, or both may help improve fertility.
  • Varicocele: Surgically removing a varicose vein in the scrotum may help.
  • Blockage of the ejaculatory duct: Sperm can be extracted directly from the testicles and injected into an egg in the laboratory.
  • Retrograde ejaculation: Sperm can be taken directly from the bladder and injected into an egg in the laboratory.
  • Surgery for epididymal blockage: A blocked epididymis can be surgically repaired. The epididymis is a coil-like structure in the testicles which helps store and transport sperm. If the epididymis is blocked, sperm may not be ejaculated properly.

Fertility treatments for women

Fertility drugs might be prescribed to regulate or induce ovulation.

They include:

  • Clomifene (Clomid, Serophene): This encourages ovulation in those who ovulate either irregularly or not at all, because of PCOS or another disorder. It makes the pituitary gland release more follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
  • Metformin (Glucophage): If Clomifene is not effective, metformin may help women with PCOS, especially when linked to insulin resistance.
  • Human menopausal gonadotropin, or hMG (Repronex): This contains both FSH and LH. Patients who do not ovulate because of a fault in the pituitary gland may receive this drug as an injection.
  • Follicle-stimulating hormone (Gonal-F, Bravelle): This hormone is produced by the pituitary gland that controls estrogen production by the ovaries. It stimulates the ovaries to mature egg follicles.
  • Human chorionic gonadotropin (Ovidrel, Pregnyl): Used together with clomiphene, hMG, and FSH, this can stimulate the follicle to ovulate.
  • Gonadotropin-releasing hormone (Gn-RH) analogs: These can help women who ovulate too early—before the lead follicle is mature—during hmG treatment. It delivers a constant supply of Gn-RH to the pituitary gland, which alters the production of hormone, allowing the doctor to induce follicle growth with FSH.
  • Bromocriptine (Parlodel): This drug inhibits prolactin production. Prolactin stimulates milk production during breastfeeding. Outside pregnancy and lactation, women with high levels of prolactin may have irregular ovulation cycles and fertility problems.

Reducing the risk of multiple pregnancies

Injectable fertility drugs can sometimes result in multiple births, for example, twins or triplets. The chance of a multiple birth is lower with an oral fertility drug.

Careful monitoring during treatment and pregnancy can help reduce the risk of complications. The more fetuses there are, the higher the risk of premature labor.

If a woman needs an HCG injection to activate ovulation and ultrasound scans show that too many follicles have developed, it is possible to withhold the HCG injection. Couples may decide to go ahead regardless if the desire to become pregnant is very strong.

If too many embryos develop, one or more can be removed. Couples will have to consider the ethical and emotional aspects of this procedure.

Surgical procedures for women

If the fallopian tubes are blocked or scarred, surgical repair may make it easier for eggs to pass through.

Endometriosis may be treated through laparoscopic surgery. A small incision is made in the abdomen, and a thin, flexible microscope with a light at the end, called a laparoscope, is inserted through it. The surgeon can remove implants and scar tissue, and this may reduce pain and aid fertility.

Assisted conception

The following methods are currently available for assisted conception.

Intrauterine insemination (IUI): At the time of ovulation, a fine catheter is inserted through the cervix into the uterus to place a sperm sample directly into the uterus. The sperm is washed in a fluid and the best specimens are selected.

The woman may be given a low dose of ovary stimulating hormones.

IUI is more commonly done when the man has a low sperm count, decreased sperm motility, or when infertility does not have an identifiable cause. It can also help if a man has severe erectile dysfunction.

In-vitro fertilization (IVF): Sperm are placed with unfertilized eggs in a petri dish, where fertilization can take place. The embryo is then placed in the uterus to begin a pregnancy. Sometimes the embryo is frozen for future use.

Share on PinterestIVF in action

Intracytoplasmic sperm injection (ICSI): A single sperm is injected into an egg to achieve fertilization during an IVF procedure. The likelihood of fertilization improves significantly for men with low sperm concentrations.

Sperm or egg donation: If necessary, sperm or eggs can be received from a donor. Fertility treatment with donor eggs is usually done using IVF.

Assisted hatching: The embryologist opens a small hole in the outer membrane of the embryo, known as the zona pellucid. The opening improves the ability of the embryo to implant into the uterine lining. This improves the chances that the embryo will implant at, or attach to, the wall of the uterus.

This may be used if IVF has not been effective, if there has been poor embryo growth rate, and if the woman is older. In some women, and especially with age, the membrane becomes harder. This can make it difficult for the embryo to implant.

Electric or vibratory stimulation to achieve ejaculation: Ejaculation is achieved with electric or vibratory stimulation. This can help a man who cannot ejaculate normally, for example, because of a spinal cord injury.

Surgical sperm aspiration: The sperm is removed from part of the male reproductive tract, such as the vas deferens, testicle, or epididymis.

Overview


Infertility

What causes infertility?

There are many possible causes of infertility, and fertility problems can affect either the man or the woman. But in a quarter of cases it isn’t possible to identify the cause.

In women, common causes of infertility include:

  • lack of regular ovulation, the monthly release of an egg
  • blocked or damaged fallopian tubes
  • endometriosis – where tissue that behaves like the lining of the womb (the endometrium) is found outside the womb

In men, the most common cause of infertility is poor-quality semen.

Risk factors

There are also a number of factors that can affect fertility in both men and women.

These include:

  • age – female fertility and, to a lesser extent, male fertility decline with age; in women, the biggest decrease in fertility begins during the mid-30s
  • weight – being overweight or obese (having a BMI of 30 or over) reduces fertility; in women, being overweight or severely underweight can affect ovulation
  • sexually transmitted infections (STIs) – several STIs, including chlamydia, can affect fertility
  • smoking – can affect fertility in both sexes: smoking (including passive smoking) affects a woman’s chance of conceiving, while in men there’s an association between smoking and reduced semen quality; read more about quitting smoking
  • alcohol – for women planning to get pregnant, the safest approach is not to drink alcohol at all to keep risks to your baby to a minimum; for men, drinking too much alcohol can affect the quality of sperm (the chief medical officers for the UK recommend men and women should drink no more than 14 units of alcohol a week, which should be spread evenly over 3 days or more)
  • environmental factors – exposure to certain pesticides, solvents and metals has been shown to affect fertility, particularly in men
  • stress – can affect your relationship with your partner and cause a loss of sex drive; in severe cases, stress may also affect ovulation and sperm production

There’s no evidence to suggest caffeinated drinks, such as tea, coffee and colas, are associated with fertility problems.

To find out more about what you can do to protect your fertility, see:

  • Protect your fertility
  • How can I increase my chances of getting pregnant?
  • How can I improve my chances of becoming a dad?

Infertility affects approximately 6.7 million women in the United States and if you’re trying to get pregnant, you know how disappointing it can be every month to get a negative pregnancy test. But before assuming that in vitro fertilization (IVF) may be your only option, it’s important to rule out some of the very common—and often treatable—causes of infertility.

Here, read on for five possible reasons why you might be struggling with infertility and what you can do about it.

1. You don’t ovulate.
Polycystic ovary syndrome, which can cause irregular menstrual cycles and an increase in male hormones, affects about 5 to 10 percent of women and is one of the most common reasons women don’t ovulate. In addition, being overweight, obese or underweight, as well as having a thyroid imbalance, can affect ovulation.
What to do: One of the best ways to improve your fertility is to have a healthy weight, according to Dr. Jennifer Hirshfeld-Cytron, a reproductive endocrinologist with Fertility Centers of Illinois.
It’s also important to be screened for polycystic ovary syndrome and rule out other medical conditions. If you already know you don’t ovulate, talk to your doctor as soon as possible about treatment.

2. It’s his problem.
Male factor infertility is responsible for up to a third of infertility cases. If your guy is overweight, obese or a smoker, it could be affecting your chances of getting pregnant. An infection or inflammation of the prostate glands might also be the cause, according to Dr. Mark Surrey, co-founder of the Southern California Reproductive Center.
What to do: Losing weight and quitting smoking are key, but it’s also important for your guy to see his doctor for a physical and a semen analysis. Medication, Intrauterine insemination (IUI) or IVF are options depending on the problem.

3. You don’t have enough healthy eggs.
You’re born with a fixed number of eggs but the number and health of your eggs declines as you get older. In fact, a healthy and fertile 30-year-old has only a 20 percent chance of getting pregnant each month, according to the American Society for Reproductive Medicine.
What to do: Optimizing egg health is key, so get to a healthy weight and if you smoke, quit now, Hirshfeld-Cytron said. Talk to your doctor about IUI, IVF, and or using a donor egg.

4. Endometriosis.
Endometriosis is a disorder that causes the lining of the uterine cavity to appear in the abdominal cavity, which can cause painful periods, heavy bleeding, and infertility in 30 to 50 percent of women.
What to do: Getting pregnant is already a challenge with endometriosis, so seek treatment as soon as you plan to get pregnant, Hirshfeld-Cytron said. If your fallopian tubes are open, Clomid, a medication that causes you to ovulate in combination with IUI, is the best approach. If you’ve been trying for 3 months or your tubes are blocked, IVF might be the best option.

5. Your fallopian tubes are blocked.
When the fallopian tubes are blocked or damaged, tubal factor, which accounts for about 35 percent of infertility, occurs. Tubal factor infertility can be caused by a previous surgery, endometriosis or an STD. “Sexually transmitted diseases, especially chlamydia, years later will contribute to tubal factor infertility,” Hirshfeld-Cytron said.
What to do: “We have to make sure that the tubes are open, otherwise there’s no way for sperm and egg to communicate,” Hirshfeld-Cytron said. Your doctor can screen for tubal factor with an x-ray and if the tubes are blocked, IVF is the best treatment.

Common Conditions of Infertility

Image Source/ Veer

You’ve missed your period again, and you’ve purchased another at-home pregnancy test. Something tells you that you’re finally pregnant (fingers crossed). But after enduring a wait that feels like forever, you check the stick, only to find disappointing results once again. You’re learning what many other women already know — getting pregnant isn’t always as easy as having unprotected sex.

A medical reason could be to blame for your struggle to conceive. With the help of infertility psychologist and Parents advisor Alice Domar, Ph.D.; Jane L. Frederick, M.D., a reproductive endocrinologist with HRC Fertility in Laguna Hills, Ca.; and Corey Whelan, program director for the American Fertility Association, we pinpoint the most common infertility issues, how they’re caused, and how they’re treated.

Premature menopause is when a woman’s period stops before she turns 40. The cause is usually genetic, and it doesn’t necessarily mean you can’t get pregnant if you’re in this situation. “Some women can still get pregnant with their own eggs,” Dr. Domar says. “But for many, their only option for pregnancy is with egg donation.” (This condition is not to be confused with Premature Ovarian Failure (POF), in which ovaries stop functioning normally in a woman who is younger than age 40.) Symptoms include having no or irregular periods, as well as menopausal symptoms such as vaginal dryness, hot flashes, and irritability. “A woman with premature ovarian failure has a greatly reduced chance of getting pregnant, but pregnancy is still possible,” Dr. Domar says. In either case, Dr. Domar suggests seeing a reproductive endocrinologist.

Anovulation means there is no egg released from the ovary and, according to Dr. Frederick, this can be the cause of infertility in up to 40 percent of infertile women. Ovulation induction medications like Clomid can successfully treat this condition.

Endometriosis occurs when the tissue that lines the inside of the uterus enters other organs of the body, such as the abdomen and fallopian tubes. “When this happens, the misplaced tissue develops into lesions that respond to the woman’s menstrual cycle,” Whelan explains. “Outside of the uterus, the tissue has nowhere to go and backs up, causing internal bleeding, inflammation, adhesions, pain, and eventually, for many, infertility.” Women suffering from this condition are advised to see a reproductive endocrinologist who may recommend surgery or another form of treatment.

Polycystic Ovary Syndrome (PCOS) is a hormone disorder that reduces the ovaries’ ability to mature and release eggs into the fallopian tubes. According to Dr. Domar, there is a lot of controversy surrounding possible treatments. “The standard treatment is medication, but there is recent research that shows that lifestyle changes, like weight loss, exercise, and a low-carbohydrate diet, are beneficial,” she says. Because women suffering from PCOS tend to be hungry more often, Dr. Domar suggests seeing a nutritionist to develop an appropriate eating plan.

Male infertility can sometimes be the culprit when a woman is not able to conceive. “Although infertility has historically been considered mostly a female problem, recent studies show that male infertility results in problems conceiving in almost half of couples struggling with reproduction,” Dr. Frederick says. Before women seek any type of fertility treatments, experts advise getting a semen analysis to determine whether the sperm is capable of moving through the cervix, uterus, and fallopian tubes. Both artificial insemination and IVF are viable options for women with this condition.

Uterine fibroids are benign tumors inside or outside the uterus that can result in abnormal bleeding and infertility. The placement and size of the fibroid determines whether or not the fibroids should be surgically removed. Fibroids that grow inside the uterine cavity can often be removed during an outpatient surgical procedure, which can ultimately lead to a healthy pregnancy.

Fallopian tube damage is defined as complete or partial blocking and/or scarring of the fallopian tubes. According to a report from the Advanced Fertility Center of Chicago, roughly 20 to 25 percent of all diagnosed infertility cases in the U.S. stems from a tubal factor. A dye test called a hysterosalpingogram (HSG) takes an X-ray of the uterus and the fallopian tubes to determine if they are open or closed. Tubal reconstructive surgery can repair minimally damaged fallopian tubes, but if your case is more severe, IVF can bypass the tube and help you achieve a normal pregnancy.

Low ovarian reserve is associated with a reduced number and quality of eggs, resulting in fewer embryos and lower pregnancy rates with IVF. Hormone level detection tests can determine whether infertility treatments are necessary. “However,” Dr. Frederick cautions, “these tests should be utilized to discuss prognoses with patients before infertility treatment is begun.”

  • By Pamela Brill

In This Section

  • How Pregnancy Happens
  • What are some tips for getting pregnant?

How does pregnancy happen?

In order for pregnancy to happen, sperm needs to meet up with an egg. Pregnancy officially starts when a fertilized egg implants in the lining of the uterus. It takes up to 2-3 weeks after sex for pregnancy to happen.

How do people get pregnant?

Pregnancy is actually a pretty complicated process that has several steps. It all starts with sperm cells and an egg.

Sperm are microscopic cells that are made in testicles. Sperm mixes with other fluids to make semen (cum), which comes out of the penis during ejaculation. Millions and millions of sperm come out every time you ejaculate — but it only takes 1 sperm cell to meet with an egg for pregnancy to happen.

Eggs live in ovaries, and the hormones that control your menstrual cycle cause a few eggs to mature every month. When your egg is mature, it means it’s ready to be fertilized by a sperm cell. These hormones also make the lining of your uterus thick and spongy, which gets your body ready for pregnancy.

About halfway through your menstrual cycle, one mature egg leaves the ovary — called ovulation — and travels through the fallopian tube towards your uterus.

The egg hangs out for about 12-24 hours, slowly moving through the fallopian tube, to see if any sperm are around.

If semen gets in the vagina, the sperm cells can swim up through the cervix and uterus and into the fallopian tubes, looking for an egg. They have up to 6 days to find an egg before they die.

When a sperm cell joins with an egg, it’s called fertilization. Fertilization doesn’t happen right away. Since sperm can hang out in your uterus and fallopian tube for up to 6 days after sex, there’s up to 6 days between sex and fertilization.

If a sperm cell does join up with your egg, the fertilized egg moves down the fallopian tube toward the uterus. It begins to divide into more and more cells, forming a ball as it grows. The ball of cells (called a blastocyst) gets to the uterus about 3–4 days after fertilization.

The ball of cells floats in the uterus for another 2–3 days. If the ball of cells attaches to the lining of your uterus, it’s called implantation — when pregnancy officially begins.

Implantation usually starts about 6 days after fertilization, and takes about 3-4 days to complete. The embryo develops from cells on the inside of the ball. The placenta develops from the cells on the outside of the ball.

When a fertilized egg implants in the uterus, it releases pregnancy hormones that prevent the lining of your uterus from shedding — that’s why people don’t get periods when they’re pregnant. If your egg doesn’t meet up with sperm, or a fertilized egg doesn’t implant in your uterus, the thick lining of your uterus isn’t needed and it leaves your body during your period. Up to half of all fertilized eggs naturally don’t implant in the uterus — they pass out of your body during your period.

What are early pregnancy symptoms?

Many people notice symptoms early in their pregnancy, but others may not have any symptoms at all.

Common signs and symptoms of pregnancy can include:

  • Missed period

  • Swollen or tender breasts

  • Nausea and/or vomiting

  • Feeling tired

  • Bloating

  • Constipation

  • Peeing more often than usual

Some early pregnancy symptoms can sometimes feel like other common conditions (like PMS). So the only way to know for sure if you’re pregnant is to take a pregnancy test You can either take a home pregnancy test (the kind you buy at the drug or grocery store), or get a pregnancy test at your doctor’s office or local Planned Parenthood Health Center.

How do people get pregnant with twins?

There are 2 ways that twins can happen. Identical twins are made when 1 already-fertilized egg splits into 2 separate embryos. Because identical twins come from the same sperm and egg, they have the same genetic material (DNA) and look exactly alike.

Non-identical twins (also called “fraternal” twins), are made when two separate eggs are fertilized by two separate sperm, and both fertilized eggs implant in the uterus. This can happen if your ovaries release more than one egg, or during certain kinds of fertility treatments. Non-identical twins have completely different genetic material (DNA), and usually don’t look alike. They’re the most common type of twin.

What is gestational age?

The term “gestational age” basically means how far along into a pregnancy you are. Gestational age is counted by starting with the first day of your last menstrual period (called LMP).

Gestational age can be kind of confusing, since it measures pregnancy from your last period — about 3-4 weeks BEFORE you’re actually pregnant. Common knowledge about pregnancy says it lasts 9 months, and it’s true that you’re usually pregnant for about 9 months. But the way pregnancy is measured makes it a little longer. A typical full-term pregnancy ranges from 38-42 weeks LMP — around 10 months.

Many people can’t remember the exact date of their last menstrual period — that’s totally okay. Your nurse or doctor can find out the gestational age using an ultrasound.

More questions from patients:

Can you get pregnant from precum?

Your chances of getting pregnant from precum are pretty low. But it is possible.

Precum (also known as pre-ejaculate) is a small amount of fluid that comes out of the penis when you’re aroused, but before ejaculation happens. It doesn’t usually have any sperm in it. But some people’s precum does have a small amount of sperm in it sometimes. This means sperm can get into the vagina and possibly fertilize an egg.

There’s no way to know who has sperm in their precum and who doesn’t, so that’s one reason why the withdrawal method (pulling out) isn’t the best at preventing pregnancy.

If you don’t want to get pregnant, put on a condom before your genitals touch your partner’s. Even better, use both condoms and another kind of birth control together.

What are the stages of pregnancy?

Pregnancy lasts about 40 weeks. The stages of pregnancy are divided into 3 trimesters. Each trimester is a little longer than 13 weeks.

You’ll go through many changes during each trimester. Some people feel lots of discomfort. Others don’t feel much at all.

During the first trimester, you’ll probably have lots of body changes, including:

  • Tiredness

  • Tender, swollen breasts

  • Morning sickness

  • Cravings or distaste for certain foods

  • Mood swings

  • Constipation

  • Needing to pee more often

  • Headache

  • Heartburn

  • Weight gain or loss

Most of these symptoms go away when you get to the second trimester. This is when your belly gets bigger and you’ll feel the fetus move. You may also notice:

  • Body aches

  • Stretch marks

  • Darkening of your areolas

  • A line on your skin running from your belly button to pubic bone

  • Patches of darker skin

  • Numb or tingling hands

  • Itching on your abdomen, palms, and feet

  • Swelling of your ankles, fingers, or face

In the third trimester, some of the same symptoms may continue. You may also experience:

  • Shortness of breath

  • Needing to pee even more often

  • Hemorrhoids

  • Your breasts leaking a watery pre-milk called colostrum

  • Your belly button sticking out

  • Trouble sleeping

  • The baby “dropping” or moving lower in your abdomen

  • Contractions

If you aren’t sure if your symptoms are normal, call your doctor or midwife or visit your local Planned Parenthood health center.

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Myths abound when it comes to sex, sexual positions, and conception, says Donnica Moore, MD, a women’s health expert based in Far Hills, N.J.

“One common misconception is that it’s best to have all sex all the time because the greater the number episodes of intercourse, the greater the chance of conception,” she says. But that’s not true. “When trying to conceive, it’s better to have sex every other day around ovulation to give the guy a chance to recharge his sperm count,” she says.

While there are no scientific studies regarding the best sexual positions for baby-making, the missionary (man on top) position is typically considered optimal for conception, she says.

“Some people suggest that placing a pillow under the hips and keeping legs raised after sex may enhance the sperms’ ability to swim upstream,” she adds.

You can, of course, get pregnant having intercourse in almost any position, but there are certain gravity-defying positions such as sitting, standing, or woman on top that may discourage sperm from traveling upstream.

“Also don’t do stupid things like douche after you have sex if you are trying to conceive,” says Moore. Douching alters the pH balance of the vagina and sperm needs the alkaline-acid levels to be more or less balanced in order to live. In addition, if you douche, you’re flushing cervical fluid out and this fluid gives sperm an easier and quicker path to the uterus and beyond.

“There is also a myth that says if you have an orgasm, you are more likely to have a male,” she says. “Who knows if that is true, but if you have an orgasm you are more likely to have fun,” Moore says. And “when people are trying to get pregnant, it can take the fun and spontaneity out of sex.”

It is possible to get pregnant on every day of a woman’s cycle.

Myth. Women’s menstrual cycles have a fertile window of about 6 days, ending in the day of ovulation. However, the fertile window may occur on different days within the cycle.

A woman is likely to get pregnant on the days right after her period.

Myth. In most menstrual cycles, there are some days between the end of the menstruation and the beginning of the fertile window; however, in some unusual cycles, the fertile window starts before her period ends. This is more common in women who are nearing menopause.

A woman is likely to get pregnant on the days right before her period.

Myth. In most menstrual cycles, there are at least 10 days after ovulation and before the next period. Intercourse during these days will not result in pregnancy. However, in some unusual cycles, ovulation and the fertile window may be delayed, so you cannot rely on counting days to know for sure when ovulation happens

A woman is likely to get pregnant around the middle of her cycle.

Myth and fact. For many women, ovulation happens around the middle of the cycle. However, in women with regular cycles, ovulation may occur as early as day 9 or as late as day 21. With an irregular cycle, ovulation may occur even earlier than day 9 or much later than day 21.

A woman is less likely to get pregnant on days when vaginal secretions are present.

Myth. In the days prior to ovulation, the cervix (the opening of the uterus) increases production of vaginal secretions. Days without noticeable secretions are less likely to be fertile, but may still have some possibility of pregnancy.

It is impossible for woman to identify the fertile window of the menstrual cycle.

Myth. By learning natural family planning, a woman can learn to identify the fertile window of her menstrual cycle.

If a woman were to have sex without birth control several times and not get pregnant, it means that she will not get pregnant from future sex without birth control.

Myth. Many women become pregnant from having sex just one time without birth control. At least 85% of women, who continue to have sex without birth control, even just once in a while, will be pregnant within one year.

A woman will only get pregnant if she as sex without birth control on the day she ovulates (releases an egg).

Myth. Sperm can live in the woman’s body for several days after sex so simply avoiding the day you ovulate will not keep you from getting pregnant. To identify the days that you are less likely to get pregnant, it is important to learn about your menstrual cycle.

If a woman has never been pregnant, it meas that she is less likely to get pregnant.

Myth. Your chance of getting pregnant are the same whether or not you have ever been pregnant.

If a woman’s partner has not gotten another woman pregnant in the past, it means that he cannot get her pregnant.

Myth. There are many reasons why your partner did not get another woman pregnant in the past. Your partner may still get you pregnant if you have sex with him without birth control.

If a woman was told by her doctor that she cannot get pregnant, she does not need to worry about pregnancy in the future.

Myth. Many women have misunderstood what health care providers have told them. Most of the time, these women find they can get pregnant just like any other woman. If you really want to know if you can get pregnant, ask for a second opinion. If you do not want to get pregnant now, be sure to let him/her know so you can start some type of birth control right away.

If a woman has an irregular period, she will not get pregnant.

Myth. Irregular periods make it hard to predict when a woman may ovulate (produce an egg) and most women with irregular periods still ovulate some of the time. This means that they can still get pregnant from sex without birth control.

If a woman’s partner withdraws before ejaculation, she will not get pregnant.

Myth. Withdrawal is not a dependable method and many couples using it still get pregnant. There can be sperm in a man’s fluid before he ejaculates. If you want to learn a more reliable method, then check out our Family Planning and Birth Control Section.

Pregnancy just happens, there is nothing a woman can do to prevent it.

Myth. While no woman has total control over whether or not she get pregnant, there are very good methods of birth control to help prevent an unplanned pregnancy. Click here to find a method that best fits your needs.

Thinking about getting pregnant? Learn more about the healthy habits you can start before you get pregnant to increase your chances of having a healthy pregnancy and baby by visiting Power Your Life Power Your Health.

What is infertility?

Infertility is when you have trouble getting pregnant or staying pregnant. Fertility problems can happen in women and men, and can have many causes.

Infertility is common.

Some people have a hard time getting pregnant or staying pregnant. You’re generally diagnosed with infertility if you don’t get pregnant after 1 year or more of trying, or if you have multiple miscarriages. There are treatments for many kinds of infertility, and many people go on to have a healthy pregnancy and a child.

Fertility isn’t just a “woman’s problem” or an issue with age. Lots of things can lead to infertility, and it can affect people of all sexes and ages. When a couple has a hard time getting pregnant, either person (or both people) is equally likely to be the cause. That’s why both people are usually tested for infertility if a couple is having trouble getting pregnant.

There are lots of possible causes of infertility. Seeing a doctor that specializes in infertility can help you figure out what’s causing your fertility problems and find the best treatments for you. Sometimes there’s no known reason for infertility — this is called unexplained infertility. Unexplained infertility can be really frustrating, but there are still usually treatment options that you can try.

Causes of infertility in cis women

Some common reasons for infertility in cis women include:

  • untreated chlamydia or gonorrhea

  • not ovulating (not releasing eggs from your ovaries)

  • your fallopian tubes are blocked so sperm can’t get to your egg

  • poor egg quality

  • the shape of your uterus makes it hard for a fertilized egg to implant

  • endometriosis

  • uterine fibroids

Causes of infertility in cis men

The most common causes of infertility in cis men include:

  • untreated chlamydia or gonorrhea

  • low sperm count (not having enough sperm in your semen)

  • poor sperm motility (when sperm doesn’t swim well enough to reach an egg)

  • sperm that aren’t formed correctly

  • semen that’s too thick for sperm to easily move around in it

  • no sperm in your semen

Having too much or too little of some of the hormones that help your body make sperm can also lead to sperm-related problems that cause infertility.

Infertility can also be caused by a problem with ejaculation. If the tubes inside your penis or testicles are blocked, you may have a hard time ejaculating, or nothing comes out when you have an orgasm. Sometimes, ejaculation can send semen backward from your prostate into your bladder, instead of out of your penis.

If you’re trans and using hormones

Gender affirming hormone treatments and surgeries can lead to infertility, but they don’t always lead to infertility. If you want to get pregnant, talk with your doctor or nurse about your fertility options. If you don’t want to get pregnant, use birth control.

What might increase my risk of infertility?

There are certain health and lifestyle factors that can increase your chances of having fertility problems. They include:

  • being older than 35 (for women)

  • being very overweight or underweight

  • chemotherapy or radiation

  • lots of exposure to environmental toxins, like lead or pesticides

  • excessive drug or alcohol use

  • smoking cigarettes

  • not getting recommended testing for chlamydia/gonorrhea

  • a history of pelvic inflammatory disease (PID)

  • injury to the scrotum and testes

  • overheated testicles (from wearing clothing that’s too tight, or swimming or bathing in hot water often and recently)

  • having an undescended testicle

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What are your options when you can’t get pregnant?

Getting Pregnant Treatment options

Following your initial consultation and testing, you will then work with the clinic to decide which treatment is most appropriate for you. A lifestyle assessment and weight management strategy might also be implemented. Possible treatment options include:

Ovulation Induction

Ovulation induction is one of the simplest and least invasive fertility treatments. It involves taking medication to induce ovulation by encouraging eggs to develop in the ovaries and be released, increasing the chance of getting pregnant through timed intercourse or artificial insemination. Ovulation induction is most suitable for women who are producing low levels of hormones for ovulation, or who are not ovulating at all but have normal fallopian tubes, and the male partner does not have any fertility problems.

IUI or IVF treatment

Intrauterine insemination (IUI) and in vitro fertilization (IVF) are two commonly used methods of fertility treatment.

Artificial insemination or intrauterine insemination involves inserting a male’s semen through the cervix and into the uterus, close to the time of ovulation. It is a simpler, less invasive form of fertility treatment.

In Vitro Fertilisation or IVF is a process where a woman’s eggs are fertilised with a man’s sperm outside of the body, and once they are fertilised, they are then transplanted into the woman’s body. Close to one in 30 babies in Australia are conceived with IVF. You can read more about IVF here.

Freezing embryos

A frozen embryo transfer is a cycle where a frozen embryo from a previous fresh IVF cycle is thawed and transferred back into a woman’s uterus. It means the woman doesn’t have to undergo another cycle of hormone stimulation and an egg collection frozen embryo cycles can be undertaken on your natural cycle or using ovulation induction. Read more on freezing embryos.

How much does fertility treatment cost?

The cost of your fertility depends on your individual treatment plan and if your health insurance includes cover for IVF. Medibank Gold Complete hospital cover pays benefits towards some of the costs of fertility treatment. Check with your clinic and Medibank before you get started and do your research to get an idea of costs you can expect from IVF. Remember waiting periods may apply on your cover.

Where to get support

Undergoing IVF treatment can be a difficult journey both physically and emotionally. It’s important to get support if you are struggling. You can chat to your GP, a psychologist or get counselling and free support from Access Australia.

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