If you're having sex when you're ovulating but you're still not pregnant, you might start to worry why it's not happening for you. But when should you start to worry?
Childcare expert Fi Star-Stone shares her experience of fertility struggles as well as her advice for women hoping to conceive.
A romantic dinner, a few drinks, and a little, ahem, ‘quality time’ with my husband, were exactly what I had in mind when it came to trying for a baby, but after 12 months of negative pregnancy tests, heartache and stress, my romantic notions came to an abrupt end.
Fertility investigations revealed it was unlikely we’d conceive without a little help, as I had endometriosis. This condition results in small pieces of the womb lining, known as the endometrium, to start growing in other places, such as the ovaries.
At first I felt incredibly alone in my struggle to conceive until researching revealed I was far from alone. Around one in seven couples have difficulty conceiving, that’s an incredible 3.5 million people in the UK struggling to conceive.
Common causes of female infertility
Fertility problems can be down to a huge range of things, but some of the potential reasons you might be struggling to conceive are listed below.
Age
Over 35? Welcome to the geriatric mothers club.
With more women having babies later in life, more are finding it trickier to conceive. As women get older, the number and quality of egg cells that are produced by the ovaries declines.
The simple fact is, women generally become less fertile as they get older and may be monitored more for 'high-risk' pregnancies.
The medical term used for women over this age who are trying to conceive or are pregnant is referred to as advanced maternal age.
Uterine Fibroids
Fibroids are non-cancerous growths made up of muscle and fibrous tissue and vary in size. They’re found in or around the womb and cause symptoms such as heavy or painful periods, abdominal pain, lower back pain, constipation and pain or discomfort during sex.
Some women can have fibroids with no symptoms at all and will only discover they have them after an ultrasound scan.
Pelvic Inflammatory Disease
PID is an infection of the female upper genital tract, including the womb, fallopian tubes and ovaries. There are no obvious symptoms but some women may have mild symptoms that may include one or more of the following:
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Pain around the pelvis or lower abdomen (tummy)
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Discomfort or pain during sex that's felt deep inside the pelvis
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Pain during urination
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Bleeding between periods and after sex
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Heavy periods
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Painful periods
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Unusual vaginal discharge, especially if it's yellow or green.
Endometriosis
A condition where small pieces of the womb lining, known as the endometrium, start growing in other places, such as the ovaries. Symptoms vary from person to person, and some women have no symptoms at all, but the most common symptoms include:
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Painful periods or heavy periods
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Bleeding between periods
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Pain during and after sex
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Pain in the lower abdomen, pelvis or lower back.
Scar Tissue/Adhesions
Pelvic surgery can sometimes cause damage and scarring to the fallopian tubes making it difficult to conceive.
Ovarian Cysts
These are fluid-filled sacs that can sometimes grow on the ovaries which can prevent eggs from developing or being released.
Cervical mucus defect
When you are ovulating, the mucus in your cervix becomes thinner so that sperm can swim through it more easily. If there is a problem with your mucus it can sometimes make it harder to conceive.
Polycystic Ovarian Syndrome
PCOS is a condition that affects how the ovaries work. Approximately 1 in 10 women have PCOS, and it's the most common cause of infertility. Symptoms can vary from person to person but include:
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Irregular periods or no periods at all
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Difficulty getting pregnant as a result of irregular ovulation or failure to ovulate
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Excessive hair growth (hirsutism)
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Weight gain
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Thinning hair and hair loss from the head
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Oily skin or acne.
Male infertility issues
The most common cause of male infertility is a sperm disorder, such as low sperm count (oligozoospermia,) slow sperm motility, or a deficiency in forward progression (the sperm's quality of movement). Sperm disorders are caused by various factors include:
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Although sperm count may not decrease with age, it starts to lose motility around the age of 40.
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Immune problems and illness can impact sperm motility and its ability to implant itself in the egg.
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Sperm function can be affected due to weight issues, (both over or underweight issues.)
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Untreated STDs can have an impact on sperm transportation, but this often improves dramatically with STD treatment.
How long does it take to get pregnant?
Unless you are super lucky and strike baby gold the first time trying, those baby making skills can often take a lot more effort than you think.
Some women can become pregnant pretty much right away, whereas others can take up to a year. As a general guide, most couples (about 84 out of every 100) will get pregnant within a year if they have regular sex and don’t use contraception.
It's a good idea to use an ovulation calculator to work out the day's when you're ovulating so you make sure you have sex on your most fertile days.
When should I worry?
It’s pretty common to start obsessing after just a month or two of trying to conceive without success, but most doctors suggest you shouldn't really worry until after 12 months of regularly trying. With every movie suddenly appearing pregnancy related and every TV break filled with baby-related adverts, it’s hard not to become baby obsessed.
However, worrying won’t help the baby-making situation. In fact, stress can contribute to baby-making delays so try not to make conceiving your absolute every thought.
If you’ve been actively trying to conceive for 12 months or more with no luck, or if you have concerns about either you or your partner’s reproductive health during that time, then it’s worth going to your GP who will be able to run some tests and give you some advice.
Is it me or him?
I’m not going to lie: facing fertility problems can be an emotional rollercoaster and put a strain on even the strongest of relationships. So it’s important, before any investigations take place, to start as you mean to go on. You’re in this together.
Whatever the results may be, it is pointless blaming each other at a time when you need to support each other. So make a pact before any results come in that you will support each other fully.
Coping with a fertility problem
If you receive the news that one of you has a fertility problem, it can be an enormous blow. Give yourself permission to cry and to feel angry. Don’t ignore your feelings or shut them away - this won’t help you or your partner in the long run.
It’s OK to be angry. Don’t feel guilty about negative or angry feelings when others announce their pregnancy news. You have every right to feel sad, so let it out (although maybe not at their baby shower).
Communication is key. Keep communicating with your partner. It is so important that you keep talking to your partner about how you feel or how you want to proceed after having your news. Remember that your partner may feel and cope differently than you and that’s OK. Everyone deals with things differently so don’t feel angry if they don’t seem as upset as you.
Keep a journal. Writing down your feelings can be really helpful. Keeping a journal of your hopes and your fears, your appointments, your tries and fails, will all help to keep a level head in the journey toward trying to become a parent.
Think about what you want. Talk about the next steps with your partner and look into the options available to you. Perhaps you want to take a break from trying, perhaps you want to look into fertility treatments or consider adoption? Whatever you decide to do, ensure you are both ready for the next step as it can often be a rollercoaster of emotions.
What treatments are available?
If you discover there is a problem, please don’t feel it is the end of the baby line. There are lots of options and help available for those struggling with infertility including:
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Medical treatment for lack of regular ovulation
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Surgical procedures – such as treatment for endometriosis
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Assisted conception – which may be intrauterine insemination (IUI) or in-vitro fertilisation (IVF)
The treatment offered will depend on what is causing your fertility problems and what is available.
Private treatment is worth considering but can be very expensive and no guarantee it will be successful. You can also try a number of natural ways to boost your fertility.
Try to stay positive
From a mum of two who went through three years of fertility worries and stress, please try to keep a positive head when you feel like your world is caving in around you.
As much as babies take up your head space, try to focus on other things so your whole world doesn't revolve around conceiving. Book a holiday, plan an event or join a group to learn a new skill. This will help you have a new perspective and often results in you becoming more relaxed and less stressed.
Have hope that in the majority of fertility problems there is a happy ending. After endless tests, stress and emotional battles, our first little miracle, Betsy, was conceived on our third round of the fertility drug Clomid.
Less than a year later (with no fertility help at all) her brother, Oscar was born.