Women, and sometimes husbands, come in asking this question.
If they haven’t been taking preventative measures, they’ll ask “Why haven’t we gotten pregnant?” There can be many answers to that question.
The first aspect we usually ask is about timing. If you aren’t timing intercourse around the time of ovulation, then your chances of conceiving are lower. Some couple’s jobs require them to travel or work long hours, causing them to miss the window of opportunity. Women with normal monthly menstrual cycles usually ovulate 14 days before the start of their next cycle. Ovulation kits and ovulation timing apps can sometimes aid in finding the time of ovulation. Normal menstruating women, with no risk factors, have an 85% chance of conceiving in the first year. Because of these good natural odds, for women who are less than age 35 and having monthly cycles, we usually wait one year of trying before proceeding with infertility evaluation. If over 35, we usually start infertility evaluation after 6 months of unsuccessful trying.
Infertility evaluations usually look at three main causes: ovulation, male factor, and pelvic factors.
Evaluation in determining ovulation can include evaluating menstrual calendars to see if patients are having regular cycles and drawing lab if not, taking ovulation kits at home, and sometimes drawing a serum progesterone level. In women over 35, we can draw an ovarian function test at an outside lab to see if women are still producing eggs for fertilization. Male factor is evaluated by taking a history of the man’s health and a semen analysis. Pelvic factor such a fibroids, uterine polyps, endometriosis, tubal disease include test such as sonogram, hysteroscopes, hysterosalpingograms, and laparoscopes. Sometimes, there are rarer factors such as genetic chromosomal abnormalities that can cause difficulty conceiving, and unfortunately, despite all medical testing, we can’t find a source.
There are many different options we can proceed with depending on what the source we locate. If a patient is still not able to conceive, we get the help a Reproductive Endocrinologist and Infertility specialist. We are lucky to have several in the Jackson area.
So if you are asking this question, come see our gynecologists, and let us help you find the answer.