Having trouble getting pregnant?

Some couples are able to conceive their baby without too much trying at all. In fact, many say they can’t work out exactly how and when conception could have happened for them. And although it doesn’t take too much imagination to connect the actual mechanics of conception, sometimes it’s the opportunity that simply slipped our minds. Busy lifestyles, work commitments and constant juggling of time means that getting together and actually having sex is often pushed down on our list of priorities.

Just do it!

So although it sounds basic, if you want to have a baby, you’ll need to have sex. From this, everything else follows. If you’re not having sex then you will not conceive, no matter how much dreaming and positive energy you invest – unless of course you’re undergoing fertility assistance, which opens up a whole new area of conception possibilities. 

How long should we wait?

The general rule is that for most fertile couples who are having regular sex and not using contraception, they can expect to conceive within 12 months of trying; though it may be entirely reasonable to extend this time frame to 24 months. Some couples are what is called ‘sub-fertile’ e.g. the man is producing sufficient, healthy sperm and the woman is ovulating regularly, though for some reason, they do not conceive as quickly as they should. Many do go on to conceive normally after another one to two years of trying and do not need fertility assistance. This same research has found it is important for couples to remain optimistic about their chances of conceiving, even if it is taking a bit longer than they expect.

But the issue is, unless couples have been checked to see that they are essentially fertile, the wait-and-see approach won’t work. If there are physical issues with the man, such as low numbers or absent sperm, or the woman has blocked fallopian tubes, then clearly, no amount of waiting will help. In fact, increasing maternal and paternal age reduces the overall chances of conceiving, and increases the risks of pregnancy complications too. 

Intensive fertility treatments are not always necessary. For many women, a short course of hormone medication can help to synchronise their ovulation patterning. But it also increases the odds of more than one egg being released each month and therefore the likelihood of conceiving with multiple babies. 

Causes for having trouble getting pregnant

In women

There can be a range of causes why women can have problems conceiving. Many relate to problems with gynaecological functioning. These include:

• Blocked fallopian tubes.
• Anovulation e.g. not ovulating. Problems with ovulation are commonly termed ‘ovulatory dysfunction’, an umbrella label, which covers just about every problem relating to egg release.
• Hostile cervical mucus, which means the sperm are prematurely ‘killed off’ by the woman’s mucus.
• Polycystic Ovarian Syndrome, which affects insulin production. 

It’s important to remember that not all causes of infertility in women are clearly understood. Many times, Unexplained Infertility is given as a diagnosis when other common causes have been eliminated. In many ways, this can be a devastating process. If we understand how and why something is happening with our bodies, then the next logical step is to try to do something about it. But in the case of ‘unexplained infertility’ there can be a great deal of soul searching and feelings of guilt for both partners in the relationship. 

How old is too old?

Maternal age is certainly a factor, which impacts on getting pregnant. At birth, a baby girl is born with all the eggs she will ever use. Over time, the quality and number of her eggs, which can be matured towards ovulation reduces. Fertility peaks in women in their twenties and declines steadily after the age of thirty five. 

In men

• Low number of sperm or absent sperm in the ejaculate.
• Trauma or surgery to the testicles or vas deferens, the tubes transporting the sperm.
• Previous history of mumps or chemotherapy, which has led to sterility.
• Vasectomy. 

What helps when you’re having problems getting pregnant?

• Build upon your understanding of how fertility and conception work. If knowledge is power, then swotting up on your comprehension of gynaecology and how babies are made can only help you. There are countless books and websites devoted to this topic. So, be an informed parent-to-be and don’t assume that just because it’s your body, you know how it’s working.
• Aim to have sex before you ovulate. The egg only has a 12-24 hour ‘window’ of time when fertilisation is most likely. This is different to sperm that can lie in wait for days. So don’t wait until one of your ovaries has released an egg. Get in early and optimise your chances of getting pregnant. Check an ovulation calculator for more information on how to tell when you’re ovulating.

• Eat a healthy diet. Having a regular intake of whole grains, lean animal protein, dairy food and fresh fruit and vegetables helps to support healthy reproductive functioning.
• Stay within a healthy weight range. Scientific evidence has demonstrated that, for both women and men, the chances of conception are reduced if one or both are overweight. One of the first recommendations made to overweight couples who are experiencing infertility is for them to lose weight. There is a natural increase in fertility as weight decreases and the Basal Metabolic Index (BMI) returns to a normal level. This is between 20-25 for most individuals who are within the childbearing years. It does seem from research that 29 is the ‘golden’ BMI number when it comes to impact on fertility. For women who have a BMI of 30 or higher, there is an incremental impact on their chances of conceiving naturally. When your BMI is higher than 35 you decrease your chances of falling pregnant by 43%! So stay within a healthy BMI range and focus on reducing this if it is too high. Similarly, if a woman is not carrying sufficient subcutaneous fat (fat under the skin) then this can reduce her chances of conceiving.
• Eating disorders and excessive exercise can impact on regular ovulation and menstrual cycles. Women who are particularly lean will often increase their chances of conceiving if they gain weight and return to a healthy weight range.
• Try to reduce your level of stress. We all deal with stress in different ways and, while it is true that some people have a very laid-back approach to life, most of us are less easy going. Insulating ourselves from all stress is unrealistic and would probably have a major impact on our motivation. Getting out of bed each morning and going to work demands a certain level of stress. But there’s a balance between swinging from one extreme to the other and sustaining high levels of stress day after day. Regular exercise, yoga, meditation, hypnotherapy and music are all ways to reduce the stress in our lives. Sometimes couples need to make major lifestyle decisions, such as quitting or changing their jobs, moving house or reducing their financial commitments, in order to reduce their stress levels and boost their chances of getting pregnant. Only you can decide what is right for you.
• Stop smoking cigarettes and/ or taking illicit drugs. Research shows that the correlation between both drug-taking and the reduction on both male and female fertility is clear. Even the occasional use of recreational drugs does make a difference.
• Reduce or stop your intake of alcohol and caffeine. 

What about complementary medicine?

Some couples find that complementary medicine in some shape or form works for them. But the truth is that there is little really clear, scientific evidence to support the claims. Acupuncture, aromatherapy, mindfulness training and naturopathy generally don’t cause any harm, but do they actually boost the chances of conceiving? That’s up to the person you speak with. 

Diet tips to help with getting pregnant

Depending on who’s serving you up the information, diet can make a huge difference in increasing the likelihood of conceiving. It seems that targeting specific foods and nutrient compounds can make a big difference. 

Try reducing your intake of:

• Saturated fats.
• Fast/ convenience type foods.
• Foods that are chemically produced.
• Animal proteins. Avoid an excessive intake of red meat.
• Refined sugars and carbohydrates. White flour and sugar, white rice and pasta have all been refined to make them more appealing and palatable. 

Try increasing your intake of:

• Foods high in monounsaturated fats. These include olive oil, avocado, fish and seafood.
• Whole grains, fresh fruits and vegetables. Bread, pasta, rice, sugar and cereals are all more complete and less manufactured if they bear more resemblance to how they were grown in the first place.
• Some fat in the diet is essential. Small amounts of full-cream dairy foods, nuts and oils help to boost the chances of conceiving.
• For men a daily intake of Zinc is beneficial for producing healthy sperm. Seafood, green leafy vegetables and red meat are rich sources. 

Just remember

It is important for couples not to leave it too late before they start trying to have a baby. Fitting in conception with educational goals, career building and financial security can be challenging. In developed countries there is a societal trend towards couples deferring having their first baby and this is having an impact on family size. 

Babies don’t always fit into their parent’s plans and conception is largely due to luck and timing. Management practices can apply to all sorts of working- and home-life scenarios, but when it comes to baby making, so much of it is out of our control.