Updated: May 24
It is exciting when you decide the time is right to have a baby. You start thinking about all the usual things, like what the baby will be like, how you will decorate the nursery and what type of parent you will be. So you start trying to fall pregnant, and for a few, it happens straight away, and for others, they don’t succeed in the first few months. Rest assured; the truth is that 80 per cent of couples in the general population will fall pregnant within 12 months of trying to conceive. So the best thing to do is keep calm and keep trying. Eat well, exercise and ensure you are fertility fit, e.g. immune to Rubella (German measles) and taking folate supplements. However, for some, falling pregnant can feel like it is taking forever, so when is the right time to seek help?
When to see a fertility specialist
As a fertility and IVF expert, I recommend you seek advice from a fertility specialist to help guide you if you are experiencing any of the following concerns or conditions:
Having trouble conceiving
If you are under 35 years of age and have not fallen pregnant within 12 months of unprotected intercourse, or if you are over 35 and have not fallen pregnant within six months of trying. For women ages 40 and over, I recommend further investigations be initiated after three months of trying to fall pregnant, as females age is one of the most important predictors of whether pregnancy will be achieved.
Experiencing irregular menstrual cycles
Irregular menstrual cycles may suggest a problem with ovulation and can impact your ability to conceive. The average length of the menstrual cycle is 28 days but can range between 25-35 days. A complex interaction of hormones determines the female menstrual cycle, so any hormone imbalance can make a period irregular. Although irregular cycles are not dangerous in most cases, it is important to determine what is causing the irregularity sooner rather than later.
Have any pre-existing medical conditions
Polycystic Ovarian Syndrome (PCOS): a condition where the ovaries secrete abnormally high amounts of Androgens (male hormones) that often cause problems with ovulation.
Endometriosis: Endometriosis results when endometrial-like cells (cells from inside the uterus) grow outside the uterus. Distortion of the anatomy due to Endometriosis can block or change the function of the fallopian tubes and prevent the sperm from reaching and fertilising the egg.
Fibroids: these non-cancerous masses are found in the uterus or cervix. Uterine Fibroids are found in one out of every four or five women in their 30s and 40s. Fibroids can cause tubal blockages, prevent the embryo from attaching to the uterine wall and cause miscarriage. The impact of Fibroids on fertility depends upon their size and location.
Blocked fallopian tubes: when they are blocked, it can prevent the egg from meeting the sperm.
Premature menopause: Premature Ovarian Failure (POF) is also called early menopause and refers to a condition where the ovary stops ovulating earlier than is normal. The average age range for menopause is between 45 and 55.
Other medical issues: Thyroid disorders and genetic conditions.
Experiencing recurrent miscarriage
After three or more miscarriages (known as recurring miscarriages) tests are commonly done to look for the cause.
Known sperm issues
If any of the following sperm issues are known, fertility advice should be sought: poor sperm morphology (abnormally shaped); poor motility (slow-moving); low sperm count; the presence of anti-sperm antibodies; ejaculatory problems or azoospermia (no sperm present); vasectomy.
If a sperm or egg donor is required
If either donor sperm or donor eggs are required.
Dr David Wilkinson is Parents You've Got This Fertility and IVF Expert from City Fertility. Dr David is a fully accredited fertility subspecialist (FRANZCOG CREI PhD) with extensive experience in infertility diagnosis and treatment. Dr David presents at the Parents You've Got This Preparing for Pregnancy Masterclass.
If you are trying to start a family and want more fertility information, join our free Ready to Conceive Masterclass.