Why can’t some couples have a baby?
To have or not to have a child is a choice that we make as a couple… Unfortunately for some, even if the desire is present, the pregnancy does not happen.
Determining the cause of infertility allows us to consider solutions, but everything is not so simple.
No, fertility is not automatic
Contrary to the myth of “they lived happily ever after”, reproduction is not always as easy as expected. After stopping contraception, it can take several months for the body to “get back on track”.
And depending on age, even in good health, the chances of getting pregnant at each cycle can drop from 25% to about 12%, which makes in vitro fertilization procedures very popular.
In short, the fact that a woman does not get pregnant after a few months of trying should not worry. It is also good to ask about the couple’s habits:
“When someone comes to consult me on this subject, I start by asking: do you have regular intercourse? Sometimes it’s a simple question, but people just don’t have sex at the time of ovulation.
It becomes worrisome when no pregnancy occurs after two years of unprotected intercourse. This is not uncommon: about 10 percent of couples would be affected.
Infertility in men
Infertility in couples can be caused by many factors, and both partners can be the cause.
In men, there are two main causes of infertility.
disorders of spermatogenesis
These are disorders of sperm quality, quantity and/or motility.
Some men simply do not have any sperm (which has nothing to do with the appearance of the sperm, which is still very normal). This can be due to many factors, such as (among others) a chromosomal abnormality, a mumps infection or hormonal disorders.
Some are born with this problem, others develop it later in life…
An alteration of the genital tract
An alteration of the genital tract that prevents the spermatozoa from making the necessary journey.
As in the previous case, the causes can be numerous and can be present all the time or acquired after an infection or disease.
Infertility in women
In women, the main causes of infertility are even more numerous. To begin with, age is a determining factor in a woman’s fertility. It is estimated that the peak is reached at about 20 years of age and that it then decreases year after year until the menopause, which signals definitive infertility.
Ovarian disorders
Ovarian function disorders are said to be the cause of half of all cases of female infertility, outside of age. In concrete terms, the body has difficulty or is unable to produce a fertilized egg.
In this category, we find disorders such as polycystic ovarian syndrome, ovarian insufficiency or early menopause. In a quarter of women, infertility is due to an alteration of the fallopian tubes where the meeting between the egg and the spermatozoon normally takes place.
There are many other causes of infertility in women, such as endometriosis, certain STIs and STDs and the consequences of an ectopic pregnancy. A uterine or cervical malformation can also cause infertility. Finally, in rare cases, genetic syndromes are associated with infertility.
There is no shortage of causes of infertility and there are many avenues to investigate.
Daily and environmental causes of infertility
In addition to the many causes of infertility mentioned, lifestyle and environment are important factors. Regardless of gender, it is best to avoid tobacco, alcohol, and drug use. Similarly, pesticides and prolonged exposure to cell phones should be avoided.
For women, being overweight or underweight, stress and lack of sleep are risk factors. Similarly, intensive sports can cause secondary amenorrhea and thus the temporary cessation of ovulation. For men, regular exposure to heat sources is not good for spermatozoa.
In short, to maximize your chances, you must live as healthily as possible, and in a relaxed manner. Advice that is sometimes complicated to follow on a daily basis.
If you are worried about your fertility, the first step is to go see your gynecologist. We go through an interview, and I try for the first few months to reassure and explain what can be put in place to promote fertility, like taking vitamin B9. Then, many tests can be prescribed to diagnose infertility.
In women, a gynecological exam and cycle observation including an ovarian reserve test, cervical mucus exam, and a karyotype will be performed first. Ultrasound and laparoscopy may also be performed.
For men, a spermogram is often the first test to be performed. In addition, a hormone test, testicular ultrasound, or testicular biopsy can be performed.
In spite of these numerous tests, many couples remain in the dark: a quarter of infertility cases remain unexplained.
Psychological causes are sometimes put forward, even though we often just don’t know where it comes from.
In all cases, solutions can be proposed, such as assisted reproduction and IVF, even if they imply long and more complicated procedures. Keeping hope alive is sometimes difficult, but fortunately, happy endings do exist.
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