How Long Does It Take to Get Pregnant. Part 2

The textbook definition of infertility is the inability to conceive after one year of regular, unprotected intercourse. Problems can be caused by a variety of things. For example, sometimes the mature egg never makes it out of the fallopian tube and into the uterus because the tube is damaged or blocked with scar tissue from a previous infection. If that egg is fertilized but remains in the tube, it may result in a tubal pregnancy, a type of ectopic pregnancy which can be life threatening to the woman — and must be terminated.

In addition, pelvic inflammatory disease (PID) can increase the risk of infertility as well as the risk for ectopic pregnancy. “The problem with PID is that you don’t necessarily know you have it — or had it,” Chervenak said. “When you sleep with someone, you sleep with everyone they’ve ever slept with.”

One of the key players in PID is chlamydia, an infection that is a common cause of PID. In fact, about 75 percent of women who have chlamydia don’t even realize it. Chlamydia can cause scar tissue and cause the fallopian tubes that need to contract to move the egg along to remain stuck in place. “Chlamydia is the ultimate love bug,” Chervenak said. “You get it. It does the damage. And it goes away — often silently.”

In about 35 percent of infertile couples, the problem is with the man’s sperm. For example, he may not produce enough or they may not be active enough to reach the egg and fertilize it. “An interesting difference in the reproduction system of men and women is that men make new sperm throughout their lifetime but women are born with the number of eggs they’ll have in their lifetime,” Chervenak said.

“In fact, during the time our mothers were six months pregnant with us is when we had our greatest number of eggs. We’ve been losing eggs ever since,” she said. “In our 30s and 40s, we have far fewer eggs than we had in our teens and 20s. As a result, as we mature it may be more difficult for some women to achieve pregnancy.”

About 15 percent of infertility can’t be medically explained, says Parsons. Generally, most physicians advise patients to seek the help of a fertility specialist after one year — especially if you are 35 or older.

“But sometimes, the patient doesn’t want to wait that long,” Chervenak said.

In that case, the physician may try ultrasound to get a clear picture of the fallopian tube and determine whether it is functioning. For example, doctors can inject saline into the woman’s reproductive system to see if it travels effectively through the tubes. They can also get a look at the follicle to determine just when it’s going to release the eggs. That way, the patient is better able to time intercourse.

Experts have mixed opinions on just how often couples should have intercourse during ovulation. Some say every other day for the week that ovulation is expected to occur. More frequently, they say, reduces the concentration of the sperm. Others disagree.

“I tell my patients to have intercourse as often as they like,” Copel said. “The last thing I want them to think is that there are rigid rules to follow or they won’t get pregnant.”

Most experts agree that, if you think there is a problem, seek help. “It’s much better to rush in sooner rather than later,” Parsons said. “There are ways we can help and things we can do before we try fertility drugs without prescription.”

So is there any truth to the myth that all a woman simply has to do is to relax to conceive?

“I really don’t think so. Everybody has a story of someone they know who tried and tried without success to get pregnant, adopted, then got pregnant,” Copel said. “They say it’s just mind over matter. She finally relaxed and that’s how she got pregnant. Well, tell that to an infertile woman and you’re liable to get your head taken off. For most of these couples, getting pregnant is a matter of statistics catching up with them.

“Really, if getting pregnant was as simple as mind over matter, we wouldn’t need contraceptives or fertility drugs,” Copel said. “If you want to have a baby, don’t get discouraged. Keep trying.”

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