As of 2014, almost one million U.S. babies were conceived via in vitro fertilization. The number of women who have used fertility services is 7.3 million. Despite these large statistics, infertility is still a difficult and sensitive topic to discuss for many people. April 21 – 27, 2019 is Infertility Awareness Week and Dr. Alexis Greene, Westmed reproductive endocrinology and infertility specialist, is answering some FAQ’s to spread awareness about infertility, and create more open conversations about this condition that affects so many people.
Q: What is the ideal time during your cycle to try to get pregnant?
A: The best time to try and conceive is right before you ovulate. Most people ovulate 14 days before their next period. For example, in a 28 day cycle, you are most fertile on cycle days 12-14. You are most likely to get pregnant if you have sex on those days.
Q: What are some at home fertility testing options and what can they tell you?
A: When trying to conceive, you can use at-home ovulation predictor kits to help you predict your most fertile window. You can also use a thermometer to track your basal body temperature, which will increase after ovulation. These tests may not work for everyone, so if you’re having issues, you should talk to your doctor.
Q: When are you considered “infertile” when you are trying to conceive?
A: The medical community defines infertility as the inability to achieve a pregnancy after one year (or more) of trying to conceive. If you are over 35, it is diagnosed after 6 months. If you are experiencing trouble achieving pregnancy, do not be discouraged. Know that 1 in 8 couples have trouble getting pregnant or sustaining a pregnancy, so if it isn’t working for you, don’t be afraid to speak with your doctor. There are many options and treatments available to help couples conceive.
Q: What types of tests should you think about if you are having trouble conceiving and when?
A: Your doctor will work with you to assess which tests make the most sense for your personal health needs, but some of the tests that our team uses to help understand the factors contributing to infertility include:
- • Hormonal tests (such as your thyroid)
- • Ovarian reserve testing which includes an AMH level, FSH level on day 3 of your cycle, and the appearance of your ovaries through a transvaginal ultrasound
- • Fallopian tube assessment through an HSG (Hysterosalpingography – which is a form of x-ray that examines the uterus and fallopian tubes)
- • Uterine assessment (through a saline sonogram)
- • A sperm check (semen analysis)
Q: What is “male infertility” and how can females understand if it is affecting their ability to conceive?
A: Males are primarily evaluated by a semen analysis. The most important things we look at are sperm count, motility, and morphology (which is shape of the sperm). If any of these numbers are below normal levels, this is likely playing a role in your struggles with infertility as a couple.
Q: What are some common causes of infertility?
A: Some common causes of infertility are PCOS (Polycystic Ovarian Syndrome), other ovulatory disorders and male factor infertility (issues regarding the sperm). Other causes include endometriosis, tubal factor (blocked tubes), and about 15% of the time we cannot identify a specific cause (unexplained infertility).
One thing to note is that every couple’s situation is different. Statistically, for example, one third of infertility can be attributed to male factors, one third to female factors and one third of cases are caused by a combination of factors in both partners. The best way to determine a course of treatment for your individual fertility situation is to work with a fertility specialist who can provide the right level of support and answer any questions you might have.
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