Why pregnancy does not occur: how to quickly find out the reason?

Infertility is a disease that affects approximately one in six couples.

When couples fail to conceive after a year, both partners must undergo a comprehensive physical and medical evaluation. Tests for female infertility and sperm analysis should not be delayed, because in many cases of infertility, even a few days can be decisive.

Since male factors account for approximately 50% of all cases of infertility, it is important to evaluate both partners. In this case, you need to start with a man, since he will only have to take one test - it’s cheap and fast. But a woman can be examined endlessly.

Will any spermogram give accurate results?

There are two options for performing a spermogram: with manual counting and automatic analysis. The second analysis in everyday life is called “express spermogram”. An experienced urologist will never draw conclusions based on the results of a rapid test.

This option is good only for initial diagnosis. Those. You can take such an analysis for one purpose - to understand in 1 hour whether a man is completely infertile or not. If something confuses the doctor as a result, he will still send the man for an extended spermogram.

There is ovulation, but pregnancy does not occur: reasons

Reasons why ovulation occurs but pregnancy does not occur:

• poor quality oocyte,
• bad spermogram;
• genetic inferiority of the zygote

Conditions that are necessary for pregnancy with preserved ovulation:

• The oocyte must be mature and ready to fuse with a sperm. Unfortunately, the egg becomes overripe and ages, as a result of which the quality of the genetic material of the reproductive cell suffers. The window during which an oocyte can be fertilized lasts on average 24-48 hours. The period can vary in one direction or another for several hours, depending on the characteristics of the woman’s body.
• Mature, motile sperm, i.e. the spermogram is normal. The conditions of modern life negatively affect the quality of sperm, although men mostly do not accept this fact and insist that everything is fine with them. If there is no pregnancy for six months, it is worth carefully examining not only the woman, but also her spouse.
• The “meeting” is not just a male and female reproductive cell, but a genetically complete sperm and egg. If there is a breakdown in the genetic code of the fertilized egg, the embryo most often dies on the fourth day and is released with menstrual flow, and the girl does not even suspect that in fact there was a pregnancy, but implantation did not occur. In the human population this occurs in 30% of cases. This is the main reason why pregnancy does not occur if all possible tests, including hormones, are normal, both partners are healthy, the tubes are patent and the spermogram is normal.

If there is ovulation, but pregnancy does not occur, this is not yet a cause for concern. It is not always possible to conceive a baby the first time, but more on that later.

Is it possible to do a spermogram at home?

Many men are embarrassed and don’t want to get tested in a clinic, so they wonder if it’s possible to do a spermogram at home. Home tests to check the quality of male fertility have not yet been created, so you will still have to go to the clinic. But you can actually take the test yourself at home.

There are kits for collecting sperm analysis at home. Home kits allow men to feel more comfortable collecting material in the privacy of familiar settings. But it is very important to deliver the biomaterial to the laboratory literally within 15-20 minutes, otherwise the result will be doubtful.

How is fertility testing done in women?

The first step in diagnosing a fertility problem is to visit your doctor. As practice shows, some problems are solved literally at the first appointment.

The following questions are discussed with the doctor:

• use of contraceptives;
• menstrual cycle history;
• the course of past pregnancies, if any;
• current and past sexual relationships;
• medications used;
• surgical history;
• health problems;
• lifestyle, professional activity.

The gynecologist performs a complete physical examination. Attention is paid to the condition of the thyroid gland, breasts and hair growth. A gynecological examination in combination with a gynecological smear is the most important part of assessing female fertility.

At the first visit, the doctor prescribes an initial examination. This testing evaluates factors such as whether ovulation occurs, when it should occur, and the function of the ovaries and uterus during the ovulation process.

It’s great if at this point a woman is already starting to track her ovulation through temperature monitoring. Because usually one of the first questions regarding female fertility is whether ovulation occurs or not.

Why it takes a long time to get pregnant: problems in women

Many reasons why you can’t get pregnant are somehow related to women’s health. There are plenty of options. The most typical ones look like this:

• age; • disorders of the reproductive system; • bad habits.

Of course, doctors can offer many more different options. But they often coincide in one way or another with those presented above.

Age

The chances of conceiving a child decrease rapidly with age. For example, they are practically minimal for women over 35 years old. At this time, irreversible changes occur in a woman’s health, which reduces the likelihood of conception.

Reproductive system disorders

Any problems with the ovaries can lead to infertility. Often it is not possible to get pregnant due to being overweight or underweight. The problem also arises due to polycystic ovary syndrome and various hormonal imbalances.

Bad habits

Doctors dealing with the problems of preparing a woman for childbirth analyzed the impact of bad habits and the chance of fertilization. The picture turned out not to be the most rosy. The fact is that problems with conception among women who smoke increase by about 50%.

Why are many tests prescribed for infertility?

There are several dozen reasons that cause infertility in women. Most of them are hidden or present in a complex. Infertility can be cured only by removing all obstacles.

The most common causes of female infertility include problems with ovulation, damage to the fallopian tubes, uterus, or problems with the cervix. Age can also affect your ability to conceive.

Problems with ovulation can be caused by the following factors:

• hormonal imbalance;
• tumor or cyst;
• eating disorders such as anorexia or bulimia;
• alcohol or drugs;
• problems with the thyroid gland;
• excess weight;
• stress;
• intense exercise that causes significant weight loss;
• short menstrual cycles.

Damage to the fallopian tubes is caused by one or more of the following factors:

• inflammation of the pelvic organs;
• past infections;
• polyps in the uterus;
• endometriosis or fibroids;
• scar tissue or adhesions in the tubes or uterus;
• chronic pathologies that reduce immunity and affect hormonal levels;
• ectopic pregnancy, if it was in the past;
• birth defect.

Abnormal cervical mucus can also cause infertility because it can prevent sperm from penetrating the egg.

Pose is to blame

There is a theory that you can successfully become pregnant only in certain positions during sexual intercourse.
Sperm, entering the vagina, begin to work intensively with their tail-flagellum in order to move, so theoretically, conception is possible in absolutely any position. The sperm is released into the vagina, and millions of sperm rush into the uterus, reaching it in a matter of minutes. In this case, a significant part of the seminal fluid flows out of the vagina, which is absolutely normal. If a woman has some features in the structure of the uterus, such as bends or deviations, then adopting a certain position at the moment of male orgasm can increase the chances of pregnancy.

• If a woman presses her limbs to her stomach, then the contact of sperm with the cervical canal will be maximum, that is, the sperm will literally pour into the cervix. This will significantly simplify the transport of sperm to the uterus, and, therefore, will maximize the likelihood of getting pregnant.
• If the partner has a uterine curve, then the position when the husband is behind will ideally help the couple to conceive.
• If you lift your pelvis up immediately after ejaculation, sperm will not flow out of the vagina, which means more sperm will penetrate into the uterus.

While listing effective ways to get pregnant, one cannot help but talk about the recommendation after sex to stand in the birch tree position or lift your legs up. There is no need to rush about household chores immediately after intimacy; lie down, relax, and enjoy the pleasure you receive.

Diagnosis of female infertility

At the beginning of the examination, the medical history is analyzed regarding potential factors that may contribute to infertility.

In complex cases of infertility, examination to assess fertility includes:

1. A urine or blood test to look for infections or hormone problems, including a thyroid function test.
2. Gynecological examination and examination of the mammary glands.
3. Taking samples of cervical mucus and tissue to determine whether ovulation is occurring.
4. Inserting a laparoscope into the abdominal cavity to view the condition of organs and identify patency of tubes, adhesions or scar tissue.
5. An HSG is an x-ray used in combination with a colored fluid injected into the fallopian tubes to help check for patency.
6. Hysteroscopy. A micro-camera is used, the image from which is transmitted to the monitor, so it can be determined whether there are abnormalities in the uterus.
7. Ultrasound to examine the uterus and ovaries. Can be done vaginally or abdominally.
8. A sonohistogram combines ultrasound and a saline solution injected into the uterus to look for abnormalities.

Tracking ovulation will help your doctor assess a woman's fertility status.

Types of ovulation testing

Ovulation assessment can be carried out using several methods:

1. Ovulation tests.
   You can confirm whether ovulation is occurring or not by looking at temperature graphs, as well as using an ovulation kit predictor and the results of blood tests and ultrasound - folliculometry.
2. Ovarian function tests
   . They allow you to see how hormones function and work during the ovulation cycle. Tests include day three FSH (follicle stimulating hormone measurement), estradiol (day three), estrogen measurement), ultrasound (to confirm ovulation has occurred), and blood tests to measure inhibin B levels.
3. Luteal phase testing.
   Testing includes progesterone levels, more extensive hormone testing, and possibly an endometrial biopsy.
4. Hormonal tests
   . Most of them will be based on thorough research.

Additional examination

If both the semen analysis and the tests listed above give normal results, the following tests are recommended:

1. Hysterosalpingography
   is an x-ray in which dye is injected through the cervix into the uterus and fallopian tubes, allowing the radiologist to see if there is a blockage or other problem.
2. Hysteroscopy.
   A procedure that determines possible deviations. The hysteroscope is inserted through the cervix into the uterus, allowing the fertility specialist to see any abnormalities, growths or scarring in the organ. The hysteroscope allows the doctor to take pictures that can be used for future reference.
3. Laparoscopy
   is a procedure performed under general anesthesia that involves the use of a narrow fiber-optic telescope. A laparoscope is inserted into a woman's abdomen to provide a view of the uterus, fallopian tubes, and ovaries. If any abnormalities are found (endometriosis, scar tissue or adhesions), they can be removed using a laser. Before carrying out it is necessary to exclude pregnancy.
4. Endometrial biopsy.
   Involves scraping a small amount of tissue from the endometrium before menstruation. This procedure is performed to determine whether the membrane is thick enough to allow a fertilized egg to implant and grow. Before the procedure, a pregnancy test is required, which is a contraindication for this examination.

These tests are not mandatory in combination; each woman will have her own set of studies. The type of examination is determined by the gynecologist.

From the first time with IVF

Couples with various problems, including incompatibility, resort to artificial insemination. This procedure is quite time-consuming and requires preparation of both partners. And it’s not always possible to get pregnant even with IVF. There can be many reasons. Physiological problems include:

• Hormonal disbalance;
• Endometrial pathologies;
• Adhesions on the fallopian tubes;
• Ineffective hormonal therapy for IVF;
• Fetal rejection due to an aggressive immune system reaction.

In in vitro fertilization, any little thing can lead to a negative result. At the fixation of the fertilized

egg production can be affected by a woman’s unhealthy lifestyle, psychological stress, excess weight and non-compliance with medical recommendations before and after the procedure. With IVF, it is not possible to get pregnant due to the low quality of biomaterials (egg and sperm), the presence of chromosomal abnormalities in them and the non-viability of the embryo itself. There is also the possibility of medical error; an unqualified specialist may draw up an incorrect IVF protocol plan. The procedure itself is carried out poorly or with violations.

In any case, a married couple should not despair after the first attempt and give up the dream of becoming parents. The main thing is to identify the reason for the inability to get pregnant the first time and try to correct the situation. Even pathological conditions in the body that prevent the conception of a child can be cured in the early stages with timely consultation with a medical specialist.

Chart of main signs of fertility

The basic form of the chart involves simply collecting and recording information related to the two main signs of fertility: basal body temperature and cervical mucus quality.

Waking temperature.

The main indicator is body temperature during rest. Until ovulation, your basal body temperature (BBT) will be relatively low. But immediately after this process, the hormone progesterone begins to be produced, which has a warming effect and increases the level of BT.

This temperature shift is very small - less than 0.5 degrees, but if you record your waking temperature every day throughout the entire cycle, you can notice this shift and determine exactly when ovulation occurred.

To track your basal body temperature, you need a digital or glass basal thermometer and a notepad to record your readings. For best results, take your temperature at the same time every day, immediately after waking up and before getting out of bed.

Cervical mucus

- another significant sign of fertility that will help determine fertile days in the cycle.

Cervical mucus (cervical fluid) is a substance secreted by the cervix. Mucus production is regulated by the hormone estrogen, so the consistency and amount of mucus changes throughout the menstrual cycle in response to the ups and downs of estrogen production.

Immediately after menstruation, cervical mucus production is low and many women experience vaginal dryness. As you progress through your cycle, estrogen begins to build up, causing more cervical mucus to be produced and may have a “creamy” appearance.

When you ovulate, estrogen production begins to increase, causing the mucus from the cervix to become slippery and elastic, reminiscent of egg whites. It plays an important role both as a predictor of ovulation and as a substance to protect sperm during passage through the reproductive tract.

If there is not enough cervical mucus, it is difficult for a woman to become pregnant because it becomes impossible for sperm to be quickly transported into the fallopian tube to fertilize the egg.

Together with basal body temperature, you can monitor changes in cervical discharge, recording the result of mucus quality daily.

Charting your fertility (basal body temperature and cervical mucus quality) is a fundamental part of taking care of your reproductive health.

It was not possible to get pregnant the first time on the day of ovulation

There are several days in a woman’s menstrual cycle when the likelihood of conceiving is highest—ovulation. When planning a pregnancy, sexual partners choose the first day for a successful result. But it’s not always possible to get pregnant the first time. Why does conception not occur on the first day of ovulation? Here are some reasons:

• There is a malfunction in the level of hormones in a woman’s body - there is not enough progesterone (it is impossible to get pregnant);
• Pathology of the fallopian tubes;
• Thinned uterine mucosa;
• A woman has a bent uterus from birth;
• Inflammatory processes in the genital organs;
• Gynecological infections and diseases;
• Incorrect calculation of ovulation.

There is nothing to worry about if you fail to get pregnant the first time on the day of ovulation. In a healthy body, the menstrual cycle goes through the menstrual cycle 1-2 times a year without ovulation. But if conception does not occur during unprotected sex for a long time (more than a year), then there is a high probability of infertility.

How is female infertility treated?

After undergoing an examination and establishing the cause, one or more methods are used:

1. Taking hormones to correct hormonal imbalances, endometriosis, or short menstrual cycles.
2. Prescribing medications to stimulate ovulation.
3. Using fertility supplements.
4. Antibiotics to fight infection.
5. Performing low-impact surgery to remove blockages or scar tissue from the fallopian tubes, uterus, or pelvis.

Is it possible to prevent female infertility?

It is impossible to prevent female infertility caused by genetic problems or disease.

To reduce the likelihood of infertility due to other causes, a woman should:

1. Take measures to prevent sexually transmitted diseases.
2. Avoid drug use.
3. Do not abuse alcohol.
4. Observe the rules of personal hygiene and health.
5. Have an annual examination with a gynecologist.

You should contact your gynecologist unscheduled if the following symptoms occur:

• abnormal bleeding;
• abdominal pain;
• fever;
• pain or discomfort during sexual intercourse;
• soreness or itching in the vaginal area.

Pregnancy does not occur, what to do?

If pregnancy does not occur, you must do the following:

• Review your diet, normalize your routine, forget bad habits.
• Make an appointment with a gynecologist, undergo an examination, ultrasound, and take tests for infections (primarily hidden ones), hormones, and immunological compatibility with your partner.
• Maintain a break between sexual acts - 2-3 days. During this time, the required number of sperm accumulates. Regular ejaculation allows you to normalize the quality of sperm and remove congestion in the male reproductive organs.
• Change intense physical activity to moderate one.
• Start taking folic acid, vitamins E and C if indicated.

conclusions

If you suspect infertility, you should consult a gynecologist. The initial examination of a man includes a spermogram. The woman undergoes several types of examination. The most important of them: pelvic ultrasound, gynecological examination, smear for infections. Most of the problems leading to infertility are treated quickly if identified at the initial stage.

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Second child

According to statistics, only 1 out of 5 couples succeed in getting pregnant the first time. Therefore, a woman should not despair and immediately look for symptoms of infertility and other diseases, especially if the attempts last only 2-3 months. Often the desire for a second child arises after 30-35 years, when the peak of reproductive function has passed. At this age, a woman needs to carefully prepare for conceiving a child and not give up trying after the first failure. The chance of getting pregnant the first time decreases in women who had a hard time with their first pregnancy and had a long labor with complications. It can also occur in those who become pregnant spontaneously for the first time. At the same time, women lament why the first “flight” was accomplished without any effort at all. There may be a simple explanation for this - a completely healthy woman’s body makes it easy to get pregnant.