Trouble Getting Pregnant ?

Diagnosing infertility is not difficult, but determining why someone is having trouble getting pregnant can be more complicated.

For many couples, there may be more than one cause of infertility, while for other couples, no cause is evident. This latter situation is often the most frustrating as it never answers the nagging question of "why?"

Regardless of the ultimate findings, a logical evaluation of the cause of infertility may be applied to all couples. The evaluation can be broken down into four key components:

1. Eggs
2. Tubes
3. Uterus
4. Sperm

When the role that each of these plays in conception is understood, the reason for the variety of infertility tests becomes clear.

Conception

At the beginning of every month, a group of eggs in the ovaries begin down the pathway toward growth and ovulation. However, only one egg is selected to continue growing. The other eggs undergo apoptosis (programmed cell death) and are absorbed into the ovarian tissue. Once an egg is released at ovulation, it is picked up by the finger-like endings of the fallopian tube (the fimbria). The egg can survive for 12 to 24 hours and travels to a specific region of the tube to wait for sperm.

When intercourse occurs, hundreds of millions of sperm are deposited into the cervical mucus where they can survive for at least 3 days. Of those hundreds of millions, only hundreds of thousands swim into the uterine cavity. Of those sperm, only a few hundred to a few thousand ever make it into the fallopian tube where the egg is waiting. If the sperm and the egg find one another and fertilization occurs, the resulting embryo must travel back through the fallopian tube into the uterus in order to implant one week later.

Tests to determine the cause of infertility include:

1. Evaluate Ovarian Reserve: A good-quality egg must be ovulated monthly
2. Evaluate the Fallopian Tubes: The tubes must be open and functioning in order for the sperm and egg to meet
3. Evaluate the Uterine Cavity: The uterus must be a normal, favorable environment to allow for embryo implantation
4. Evaluate the Sperm: There must be enough normal sperm with good motility to assure that the sperm finds the egg and fertilizes it

Infertility is a difficult diagnosis to deal with on a number of levels. However, assisted reproductive technologies have advanced remarkably and can be successful in helping a couple become pregnant and to give birth to a healthy baby. The initial evaluation of infertility can be completed within one menstrual cycle in most cases. Though the cause of a couple's infertility is not always found during this evaluation, the results always help the reproductive endocrinologist structure a course of treatment that is most appropriate for each couple.

If you are under the age of 35 and have been trying to get pregnant without success (after 6 months for 35 and older, and after 3 months for 40 and older), consulting a fertility specialist is recommended.

The information contained in this article is presented for general educational information only and in no way is intended to be a substitute for individual medical advice. Discuss your medical situation with a qualified medical professional.