Dr Sophie Langham is a Medical Doctor with a Degree in Psychology and Diploma in Women’s Health. She works as a GP and blogs at Squawk Health.
Sophie specialises in nutrition with a focus on disease prevention. She gives the honest medical advice that you’d hear if you were sat next to a doctor at a dinner party!
She lives in Cheshire with her husband and Coco the Maltese Terrier. Her post below on what to do when you’re struggling to get pregnant, will help many.
Are you struggling to get pregnant? Well, you’re not alone with 1 in 7 couples now reporting problems conceiving. My first piece of advice would be not to worry or put too much pressure on yourself. Over 80% of couples will be pregnant after one year and 92% by the second year of having regular sex.
I understand waiting for over a year to get pregnant can seem like a lifetime. This can be especially hard when everyone around you seems to get pregnant ‘on the first go’ and your Facebook feed is filled with ultrasound scans and baby photos.
Infertility simply means difficulty in becoming pregnant despite having ‘regular sex’ without contraception. Regular sex is considered to be two to three times a week. There is no definite cut-off point to say when a couple is infertile but fertility treatment is usually considered after 2 years. Tests or treatment may start earlier if you are older, or if there is a clear medical reason why you or your partner cannot conceive.
You don’t need to wait to see a specialist to try and find out why you’re not getting pregnant. There are tests your GP can do to rule out some common causes of infertility. You can also make some simple lifestyle changes to improve your chances of conceiving.
When to see your doctor?
Doctors are happy to talk through any fertility difficulties that you may have. It’s a great part of the job to help someone start their family.
If you haven’t conceived after one year of trying you should see your doctor. Women over 36 years or anyone with a history of fertility problems should be seen after 6 months. The decline of fertility is greatest after your mid-30s.
Some medical problems such as diabetes, thyroid problems or medications can affect your fertility and may need close monitoring during pregnancy. Seek medical advice when you’re planning to get pregnant if you’re unsure.
Tests and Investigations
Your family doctor will usually start with some basic tests to try and find out why you’re struggling to get pregnant;
- History and examination for both partners.
- 21 Day Progesterone Level. A blood test taken 7 days before your period to check that you are ovulating. The hormone progesterone is high just after ovulation.
- Other Hormones including FSH, LH, Oestradiol, Testosterone, DHEA, sex hormone binding globulin, Prolactin. This blood test taken during your period can check for hormone imbalances, problems such as Polycystic Ovarian Syndrome and early menopause.
- An ultrasound scan can be used to check your ovaries, womb and fallopian tubes.
- A urine test for chlamydia, a known cause of infertility in women and men.
- Semen analysis. Sperm may be reduced in number, less mobile or abnormal in their form.
The following lifestyle changes have been shown to improve your chance of conception:
- Eat a well-balanced diet and maintain a healthy weight. You should aim for a body mass index (BMI) between 20 and 30
- All women trying for a baby should take 400mcg of folic acid a day.
- Exercise regularly. Moderate exercise, 30 minutes for 5 days a week, helps to maximise your fitness and keep your weight in check.
- Stop Smoking, this applies to men and women.
- Reduce your alcohol intake. Women trying to get pregnant should drink no more than one or two units of alcohol a week. Men should stick to a daily limit of three to four units.
Sex and fertility
Try and avoid timing when you have sex with expected ovulation. This often causes anxiety and can lead to stress and problems in your relationship. Having sex two or three times a week should be sufficient if you are trying to conceive. You may want to have sex more often, which is fine, but it probably will not increase your chance of conceiving.
The more relaxed and spontaneous your sex life is, the more likely that you will get pregnant.
Referral to Specialist Services
If you are still struggling to get pregnant after these initial tests or specialist advice is needed your doctor will refer you to a Doctor in Reproductive Medicine. Referral guidelines for NHS fertility treatment can be variable depending on where you live.
You can check your local NHS trust for their criteria.
Sometimes a cause can be found for a couple’s infertility. Some problems are treatable and normal fertility can be restored. For 1 in 4 couples who are struggling to conceive no cause is ever found.
If no reason for your fertility problem is found, or the cause is not treatable, then assisted conception is often possible. The number of different fertility treatments and success rates has increased in recent years so you still have a good chance of having a successful pregnancy.
Struggling with fertility can be a very emotional experience and it’s important to reach out for support if you need it. The Human Fertilisation and Embryology Authority (HFEA) is a great resource for further information on fertility, available treatments, clinics and support groups.