When a couple has been trying for pregnancy for more than a year without achieving it, they do not need to despair, they can still get pregnant naturally although their chances are lower. The chance of getting pregnant is 20% each month for the first year. By the end of the year, out of 100 couples who have tried, 80 have succeeded. The remaining couples have a 5% chance per month of getting it during the second year. If they pass into the third year still without getting pregnant, the probability per month drops to 3% and 2% in the fourth year.
Why does this drop in fertility occur? Usually these 20 couples without pregnancy have one or more problems that decrease their chance. The three most common are:
The first is that there is a problem with the man’s sperm. Normally when ejaculated, semen contains about 40 million sperm. Of these, about half move well and 4% are normal in appearance using strict evaluation criteria. There may be difficulty in achieving pregnancy when semen does not meet these criteria. The test that is done to find out this situation is called a spermogram or sperm count. To do this test, the man must take a semen sample by masturbation in a clean container and take it to the laboratory within 1 hour. Abstinence of no less than 2 days and no more than 6 days is recommended.
sperm under the microscope
The second frequent problem is with the woman’s ovulation. It may happen that the woman is not completing the process of maturation of the eggs. This is usually reflected in irregular menstrual cycles but can also occur in regular cycles. To make the diagnosis, ultrasound of the ovaries is used and also the blood measurement of the hormones produced by the ovary. An important recommendation for any woman, whether or not she is trying to get pregnant, is to check if her menstrual cycles are irregular, or very long (more than 35 days) or very short (less than 20).
Finally, problems with the fallopian tubes (blockage) or uterus (fibroids or polyps) can occur. To evaluate this, an X-ray of the uterus and tubes (hysterosalpingogram) or a laparoscopy is used, which is a minimally invasive surgery in which a telescope with a camera is inserted into the abdominal cavity.
Once these three tests are had, the cause of infertility can be known and treated appropriately.
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GroupArticle for the blog of El Colombiano Hablemos de Fertilidad
