How do we deal with the disappointment of not conceiving month after month?

Don’t blame yourself — or each other. If it’s taking you longer to get pregnant than you expected, feeling disappointed is natural. Building a family and parenting are, for most people, fundamental parts of life, and when they don’t come easily, it can make you feel as if something is wrong with you.

Realize and accept that you and your partner will have some ups and downs as you work at getting pregnant. For starters, talk to each other and seek out the advice of other couples who are still trying.

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If your life revolves around a strict regimen of basal body temperature monitoring and scheduled sex, consider taking a break. Make an effort to revive the love and fun that brought you together in the first place. Anecdotal stories abound of couples who conceived during vacation or when they just stopped trying so hard.

If certain gatherings or celebrations are too painful for you — all your siblings had babies two years ago, say, or you keep getting invited to baby showers — give yourself permission to avoid them when you’re having a particularly tough time. Going would only be torture.

To avoid hurt feelings, send a gift, advises Alice Domar, a Harvard University Medical School psychologist who specializes in helping couples with infertility. She recommends sending children’s books (you can order them online) to save yourself a potentially upsetting trip to the toy store or baby boutique.

And remember to pursue your other interests — or look for new ones. If you’ve always wanted to learn guitar, do that. If hiking is your thing, make sure you give it a try. Or take a class — painting, dance, or something else that’s always tempted you. Don’t forget, laughter is one of the best healers. See a funny movie, head out to a comedy club, re-read your favorite funny novel. Of course, it if makes you feel better, indulging in a good cry is just fine, too.

Finally, if you’ve been trying for more than a year, you might want to make an appointment with an infertility specialist. Many problems are relatively easy to treat, so you could end up sparing yourself a lot of further disappointment by getting diagnosed.


Common causes of infertility

No one knows for sure how many couples have difficulty conceiving, since some will decide against seeking medical help. In the UK, however, about one couple in seven does turn to doctors for help with getting pregnant.

It makes sense to go to the doctor as a couple when you first seek help with conceiving. Either one of you may have a fertility problem. Sometimes, you may both have a problem without realising.

The main causes of infertility are:

  • Male factors, such as poor quality sperm or ejaculation problems (30 per cent).
  • Ovulatory problems in the woman (25 per cent).
  • Tubal damage in the woman (20 per cent).

Endometriosis is the cause of female infertility in about five per cent of cases, as it can cause both ovulation problems and tubal damage. Other less common problems can also affect fertility, such as uterine abnormalities and problems with the lining of the uterus. Sometimes there are repeated problems at the fertilization stage or with the embryo which leave couples childless, too.

In about 40 per cent of cases problems are found in both the man and the woman. For about 25 per cent of couples the cause of infertility remains unexplained.

What causes ovulation and egg problems?

There are several different types of ovulation problem. The most common is triggered by polycystic ovary syndrome (PCOS), which can cause irregular ovulation or even no ovulation. The condition is caused by hormonal imbalances.

Possible symptoms

  • absent or infrequent periods
  • abnormally light or heavy bleeding
  • weight gain and extra body hair growth

Ovulation and egg production can be caused by problems with the pituitary gland and can also be affected by your age. Your egg quality starts to deteriorate from the age of 30 years, becoming more marked from the age of 35.

Possible solutions

  • fertility drugs
  • in vitro fertilisation (IVF)
  • the use of donor eggs

What can cause blocked fallopian tubes?

Your two fallopian tubes provide safe passage for your eggs to travel from your ovaries to your uterus. The following can lead to blockages in your fallopian tubes:

  • pelvic inflammatory disease (PID)
  • endometriosis
  • scar tissue, adhesions and damaged tube ends (fimbria)

Even if you ovulate regularly, having blocked tubes means your egg can’t get to your uterus, and your partner’s sperm can’t get to your egg.

Possible symptoms

You may have no symptoms at all. Or, depending on the cause, you may have painful periods, deep pain during sex and general pain in your pelvis.

Possible solutions

The main treatment is usually IVF. However, if the blockage is only in a small area, it may be possible to clear it with a minor operation.

Infections such as chlamydia tend to damage the whole length of the tube. This means it’s harder to repair by surgery. Your doctor can carry out a laparoscopy, which is a keyhole operation to look inside your pelvic area and at your fallopian tubes. This will help your doctor to advise the best course of treatment.

A less common cause of fertility problems is fibroids. If you’re under 30 you may have no symptoms at all. Otherwise, you may have painful and heavy periods, and a feeling of fullness in your belly. Treatments to help you conceive are not always needed, but include hormones (gonadotrophins) or surgery to remove the fibroid.

What can cause problems for men?

In men, infertility can be the result of a blockage in:

  • the coiled tubes which store and carry sperm from the testes (epididymis) or
  • the two tubes that carry sperm from the epididymis ready for ejaculation (vas deferens)

Other causes include:

  • poor sperm quality
  • sperm not moving well (poor motility)
  • not having enough (or any) sperm to begin with

Possible symptoms

There may be no symptoms at all, unless it’s something obvious, like an erection or ejaculation problem. Certain injuries may cause pain in the testicles. And some conditions, such as swollen veins in the scrotum (varicoceles) or untreated undescended testicles, may give a clue that there’s a problem.

Possible solutions

Just as women can undergo surgery to open blocked fallopian tubes, men may have an operation to clear their blocked tubes. Depending on the problem, fertility drugs may boost sperm production. Other drugs can help retrograde ejaculation, which is when sperm shoots into the man’s bladder instead of his penis. Or healthy sperm can be chosen for a course of intra-uterine insemination (IUI).

However, the option that has become most popular for the treatment of male fertility problems is intracytoplasmic sperm injection (ICSI).

ICSI involves injecting sperm directly into the egg as part of an IVF treatment. The use of donor sperm remains the best solution for some couples. However, the number of ICSI treatments has been overtaking donor insemination treatments.

How can we pinpoint the cause?

As a couple, you’ll need to have a full assessment, including hormone tests. These tests will hopefully give you answers about why you’re not conceiving. The results will also help your specialist to advise the best course of treatment.

Trying to Get Pregnant? Stress May Be Your Worst Enemy

High stress levels in women can reduce their probability of conception.

In the study, 400 women (age 40 and younger) recorded their perceived daily stress levels on a scale of 1-4. Factors such as lifestyle, behavioral factors, menstrual characteristics, contraceptive use, and intercourse frequency were included in the study.

Women who reported feeling very stressed during their ovulatory window were approximately 40% less likely to conceive during that month compared to less stressful months. Similarly, women who reported feeling generally more stressed than other women were about 45% less likely to conceive.

On the other hand, the study also found that women who conceived experienced an increase in stress at the end of the month in which they became pregnant. However, epidemiologists hypothesize that most likely the increased stress was the result of changes in hormone levels caused by pregnancy itself.

The findings of the study reinforce the need to encouraging stress management techniques for aspiring and expecting mothers. It is recommended that women who want to conceive should take active steps towards stress reduction by exercising, meditating, enrolling in a stress management program or talking to a health professional.