Getting Pregnant: A nightmare for some couples

Jan 07, 2018 Dr Zulfikar Bux, Features / Columnists

By Dr Zulfikar Bux: Assistant Professor of Emergency Medicine

If you and your partner are having a difficult time getting pregnant, you’re not alone. Infertility is the inability to conceive a child. It is a condition that is often misunderstood and inappropriately stigmatized in society, and it burdens couples worldwide.

A World Health Organization (WHO) study, published at the end of 2012, has shown that the overall burden of infertility in women from 190 countries has remained similar in estimated levels and trends from 1990 to 2010. The WHO also found that one in four couples is affected by infertility in developing countries.

Today I will try to answer some questions that couples are sometimes scared to talk about with their doctor.

WHY ARE WE HAVING TROUBLE GETTING PREGNANT?

Getting pregnant depends on both the woman and the man. A couple might not be able to get pregnant because of an issue with the man’s body, the woman’s body, or both.

When a couple has trouble getting pregnant, doctors often do tests in both partners to try to figure out the cause. But even with tests, doctors sometimes cannot figure out why a couple can’t get pregnant.

WHEN SHOULD WE SEE A DOCTOR?

Most doctors recommend that a couple begin having tests if they cannot get pregnant after having unprotected sex for one year. But if you are worried, talk with your doctor. He or she might recommend that you have tests done sooner. Tests are done sooner in women over 35. Tests are also done sooner in women who don’t have a period every month.

WHAT TESTS ARE DONE FOR MEN?

If you are a man, your doctor will ask you questions about your health and sex history, and do an exam. He or she will often order a test to check how many sperm you make and how healthy your sperm are.

Other tests that a man might have include:

Blood tests – Some blood tests check male hormone levels. Abnormal hormone levels can make it hard to get your partner pregnant.
Ultrasound – This imaging test creates pictures of the inside of the body and can check if a sex organ is abnormal. For example, some men have a block in a structure called the “vas deferens,” which is the tube that sperm needs to travel through.
Urine tests – Urine tests can check if sperm are moving in the wrong direction and going back into the bladder during sex instead of out the penis.
Biopsy – A biopsy might be done if a sperm test shows that a man has zero or a very small amount of sperm. During a biopsy, a doctor collects a small tissue sample from inside the testicle. Then the doctor can look at the sample under a microscope to check if sperm are present.

WHAT TESTS ARE DONE FOR WOMEN?

If you are a woman, your doctor will ask you questions about your health, monthly periods, and sex history. He or she will also do an exam.

Women might then have 1 or more of the following tests:

Blood tests – Blood tests can check female hormone levels. Abnormal hormone levels can make it hard to get pregnant.
Ovulation tests – Different tests can be used to check if a woman is ovulating. Ovulation is when an egg is released from the ovary into the fallopian tube. It needs to occur for a woman to get pregnant.
Tests to check the uterus and fallopian tubes – These tests may range from x-rays and ultrasounds to a minor surgery where a doctor looks into your belly with a small camera. Problems with the fallopian tubes and uterus can make it hard to get pregnant. For example, some women are born with an abnormally-shaped uterus; or women might have blocked fallopian tubes from past infections or surgery.

WHAT HAPPENS AFTER THE TESTS ARE DONE?

Test results might show that one or both partners have a problem that can be treated. In that case, treatment will likely be aimed at fixing that problem.

Some people might have a problem that can’t be treated. Or the tests might not show what the problem is. In these cases, there are other treatments that doctors can do to help couples get pregnant. Talk with your doctor about different treatment options so that you can choose which treatment is right for you.

WHAT ELSE CAN WE DO?

Trying to get pregnant can be tough on couples. People can feel sad, worried, angry, or guilty. It is important to get help for these feelings. You might find it helpful to learn ways to relax, or to go to a support group for people who are trying to get pregnant. Do not blame each other or show resentment to your partner. Sometimes when life does not work out as planned, we should try to remember that there is a greater force at work.

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