Often a young couple believes that getting pregnant is something natural and taken for granted. But in reality, not everything is as simple as it seems at first glance. For fertilization to occur, ovulation must occur, sexual intercourse must take place approximately at the time the egg leaves the ovary or several days before it (5 - 6 days per month), sperm must be in large quantities and of good quality, and the fallopian tubes must be passable and healthy.
The ovulation phase must be supported by adequate progesterone production. It is worth remembering that the egg is viable (and can be fertilized) for 12 to 24 hours after release. Sperm can remain alive and active in the body for up to 5–6 days after ejaculation. For these reasons, there is no strict need to have sexual intercourse precisely at the moment of ovulation, but you should still focus on the “correct” days.
It is believed that a young and fertile couple has approximately a 25% chance of becoming pregnant if they have intercourse on the “right” days . On average, it turns out that theoretically a woman can become pregnant within 4 months, but these are theoretical statistics, and the reality is somewhat different. If fertilization does not occur or the fertilized egg does not implant into the lining of the uterus, the egg is destroyed, the endometrium sloughs off and menstruation occurs.
In fertile couples who do not use contraceptives and have regular sexual intercourse, that is, every 2–3 days, statistically pregnancy occurs within a year. Most of the remaining 20% of couples become pregnant after two years of trying. There are couples in which one or both partners may develop more or less serious problems with the reproductive system. Statistics say that infertility affects about 15% of couples, in which there are : male infertility - 29.3%, female infertility - 37.1%, male and female infertility -17.6%, idiopathic infertility - 15.1%, genetic factor – 0.9%.
Fertility decreases with age. At age 35, approximately 95% of women become pregnant within three years; from the age of 37, during the same time, 75% of women become pregnant. Problems usually arise due to the quality of ovulation, changes in the reproductive system, infections and other reasons. In men, the relationship with age and fertility is less clear, but lifestyle influences the chances of conceiving, in particular smoking, being overweight or underweight.
When to see a doctor?
If pregnancy does not occur within two years of regular unprotected sex, then fertility problems can be suspected. If you're worried about not getting pregnant, you don't have to wait that long. After trying to conceive for more than a year, it makes sense to conduct targeted in-depth research.
You can consult a fertility specialist MC " Bogolyuby " and take diagnostic tests to adequately assess your reproductive potential.
The first step to check female fertility is a blood test to detect hormonal imbalances through: FSH (follicle stimulating hormone), AMH ( anti-Mullerian hormone), LH ( luteinizing hormone), estradiol , prolactin, in the case of polycystic ovaries also testosterone and DHEA, progesterone. Ultrasound of the pelvic organs is necessary for a visual assessment of the reproductive system (for example, when looking for signs indicating polycystic ovaries, cysts, fibroids, etc.). A vaginal smear for chlamydia is useful , an infection that can be complicated by obstruction of the fallopian tubes and thereby interfere with conception. Finally, if there are no positive results in attempts to conceive, hysterosalpingography is performed - a more invasive but useful test to directly check the patency of the tubes.
To assess fertility in men , at least initially, a semen analysis is sufficient to identify any problems with sperm quality or quantity. Then, if necessary, hormonal tests are performed. The next step depends on the test results. If your results are normal and you have been trying to conceive for less than 18 months, your doctor may suggest you make some lifestyle changes and continue trying to get pregnant, or seek help from modern reproductive technologies.
