Pregnancy is one of the most memorable and life-changing events in a couple’s lives.

As soon as a couple decides to start a family, they start imagining how their lives would be after the baby comes. They start planning the nitty-gritty of raising the baby.

They start looking at things differently. Certain things that they would overlook suddenly become important. Pregnancy is also a time when a lot of planning is required, in terms of what support they have after delivery, space where the child will be raised, hospitals and other amenities around the place one lives.

For some couples, the wait to get pregnant tends to be much shorter than they expect.

How many times do we hear couples saying “We had just started planning, and it happened”? While for a few others, the wait for pregnancy tends to be longer than expected.

Factors leading to delay in pregnancy-

Studies have shown that delay in pregnancy is on the rise.

When a couple tries to get pregnant for a year and yet are unsuccessful, they must decide to visit a doctor.

A year of unsuccessful pregnancy despite carefully timed sex, without the use of any kind of contraception suggests that a gynecologist needs to be consulted.

At times the factor that hinders a pregnancy is minor and can be addressed with certain medications and lifestyle changes. At other times it requires a deeper diagnosis and treatment.

Let’s look at the common factors that stop one from getting pregnant-

Age–

It is widely agreed that age is a crucial factor in deciding one’s fertility levels.

A normal, healthy 30-year-old woman has a 20% chance of getting pregnant during each ovulation cycle. This drops to 5% by the time the woman reaches the age of 40. Several factors cause this drop in pregnancy chances-

1. Atresia– This refers to the degeneration of the follicles that fail to ovulate during each menstrual cycle. This is a natural process and takes place regardless of any other factors.
2. Quantity of Eggs– The ability of a woman to produce sufficient eggs during a menstrual cycle diminishes with advancing age. The deterioration can be seen faster after 30 years of age. The quantity of egg reduces considerably as the woman reaches menopause. Other factors such as smoking, alcohol consumption, drugs, obesity and health conditions such as diabetes and PCOS contribute further to the reduction in the quantity of egg production.
3. Quality of Eggs– As a woman’s age progresses, the quality of eggs also deteriorates. This refers to the ability of the eggs to get fertilized leading to a healthy, normal embryo. A normal egg has 23 chromosomes, a normal sperm has 23 chromosomes. The resultant embryo contains 46 chromosomes. At advanced ages, eggs usually have more than or less than the required number of chromosomes resulting in either miscarriages or conditions such as Down syndrome.

Medical Complications–

Certain medical conditions in women that hinder pregnancy are-

1. Uterine Fibroids– These are a common cause of female infertility. These result in irregular and insufficient or heavy menstruation. Fibroids are of varying degrees. Usually, Submucosal fibroids, the ones that grow into the uterine cavity usually cause infertility and removal of these fibroids can increase the chances of pregnancy considerably. A physician can consult on how to tackle the fibroids. Certain medications and moreover lifestyle changes such as a healthy diet and exercise can help in counter fibroids.
2. Endometrial polyps– These are finger-like growths protruding from the uterine lining in the uterine cavity. This reduces pregnancy chances by around 50%. A simple medical procedure such as a hysteroscopy can help remove the polyps.
3. Endometriosis- This is a condition where cells similar to the uterine lining or endometrium are found in the uterine cavity. This is associated with pain during intercourse, damage to the eggs or sperms. Usually a laparoscopy of suggested after careful examination by a physician.
4. Other cervical and uterine abnormalities.

Medical conditions in men that affect pregnancy are-

1. Infections– Infections such as chlamydia, gonorrhea, mumps, and HIV can greatly affect sperm quality and motility. Sperm motility refers to the forward-moving ability of the sperms.
2. Diabetes and other lifestyle diseases– Conditions such as diabetes can greatly affect male fertility.
3. Varicocele- This refers to the enlarged veins in the testes that lead to the deterioration of sperms.

Male Infertility-

Male fertility usually is determined by the ability of the man to produce healthy, forward-moving, good quality sperms.

As the male partner advances in age, the quality and motility of sperms also deteriorate.

The process of deterioration is quicker due to lifestyle habits such as smoking, tobacco, alcohol consumption.

Certain other habits such as wearing tight clothing, heat in the groin area due to hot saunas or exposure to high temperatures further affect sperm quality.

1. Ejaculation disorders- Semen may get ejaculated in the bladder if the ejaculatory ducts are blocked. Sometimes ejaculation may take place prematurely.
2. Hypogonadism- this refers to testosterone deficiency and is a major contributor to male infertility.
3. Undescended testicles may lead to problems conceiving.

In most conditions, an IUI (Intrauterine Insemination) is recommended as a fertility treatment. A Home IUI can also be tried to make the process more comfortable and cost-effective. (Internal link)

Blocked Fallopian tubes-  

Tubal Occlusion is a major factor leading to female infertility because it hinders the sperm from reaching the ovulated egg or reaches the endometrial cavity. At times a minimum invasive treatment is required to remove the blockage. If both the tubes are blocked then an IVF (In- Vitro Fertilization) can help in treatment.

No Ovulation-

Sometimes the female partner may experience ovulation problems. Infrequent menstrual cycles, ovarian insufficiency, and certain neural issues may lead to an inability to produce the required number of eggs.

In each of these cases, it is important that the couple undergoes consultation by a gynecologist. Most of the times assisted pregnancy can be the answer to their wish of starting a family. Procedures such as IUI and IVF are time tested. The chances of pregnancy increase with every cycle of these procedures.