If you have been trying to get pregnant without success for more than a year, or for more than six months if you are over the age of 35, it may be time to visit a fertility specialist.

Before you see a doctor, however, make sure you have done everything in your power to get pregnant.

• Are you tracking your menstrual cycles and using some method to ensure you are having sex at or around your time of ovulation?
• Does an ovulation predictor kit show that you are ovulating normally?

If this is the case, a fertility specialist should be able to help you pin down the reason you have not been able to conceive and discuss methods that will help you conceive or make a pregnancy possible. Statistics show that 85 percent of all infertility cases are curable.

Testing for Him

The doctor first will take down your medical history. Testing typically begins with the male, because his test involves a simple semen analysis. The analysis will look for sperm count, healthy movement of the sperm, and the shape and maturity of the sperm cells to determine the quality. The semen’s consistency and volume will be analyzed – approximately one teaspoon is considered normal. The pH balance will be tested – it should be slightly alkaline to survive in the environment of the cervix.

If the test results show abnormalities, a doctor specializing in male infertility will repeat the exam two times over the next three months. Many different factors – from a fever or illness to sexually transmitted diseases – can affect sperm count. Additionally, intense physical activity – and especially bicycle riding – can reduce sperm count, as can high temperatures, such as those experienced in a hot tub. Even wearing briefs instead of boxers can create a warm environment in the testes that can lower sperm count.

If the next two exams bring abnormal results, your partner will be referred to a urologist, who will perform the following tests:

• A sperm antibody test

• Hormonal blood tests

• Testicular biopies to determine if he is sterile

• Vasography which checks for any obstructions

• Fructose test

• Bovine cervical mucus test which checks the sperm’s ability to penetrate cervical mucus from cows

• Hamster egg test which determines sperm penetration strength. This test is important, because if his sperm can’t penetrate the egg, in vitro fertilization will not be successful.

Testing for Her

If your partner’s semen analysis results are normal, or if all of the tests performed by the urologist show no problems, testing begins for you. A gynecologist specializing in reproductive endocrinology can take you through this stage of fertility testing.

The doctor will first view both of your charts and review your medical history, paying particular attention to past surgeries such as appendicitis, myomectomies or fibroid surgery, and any STDs on record. He will ask about your menstrual cycle – if you’ve ever had irregular periods, etc., and he will ask about your contraceptive history. He will then conduct interviews with both of you, either together or separately.

He will ask you both questions about previous pregnancies and their outcomes, as well as how long you’ve been trying to get pregnant. He will also ask many lifestyle questions including:

• Frequency of sex

• Do you use any recreational drugs?

• Do you smoke?

• How often do you drink alcohol?

• How healthy is your diet?

• Do you exercise regularly? How often and what activities?

• Have you experienced any stressful events recently, such as a death or new job?

It may be tempting to lie when you answer some of these questions but your honest answers will help your doctor discover the cause of your infertility and make changes that will help you get pregnant.

Your exam includes a complete physical, including an internal, when the doctor will examine your ovaries for signs of problems such as PCOS (polycystic ovarian syndrome), endometriosis, and PID. An ultrasound may be performed to check the condition of the fallopian tubes and ovaries.

Additionally, blood work will be done or scheduled to check reproductive and thyroid hormone levels and to test for STDs.

A visit to a fertility specialist can be a stressful experience, but knowing what to expect and being prepared can help alleviate some of your concerns, as well as make your visit go smoothly.

How can you prepare?

• Bring a list of questions you and your partner want to ask

• Be prepared with your families’ medical histories and your own medical histories

• Be prepared with information about your menstrual cycle, including ovulation dates from charting your cycle for at least three months.

Author: Dawn Allcot

Tick, tick, tick. Is that your biological clock ticking? Are you over the age of 35 and trying to conceive a baby?

Some things that were very easy in our 20’s – losing those last 10 pounds, pulling an all-nighter and being bright-eyed and bushy-tailed for work at 9 AM, conceiving a baby – suddenly become difficult as we get older.

Why is it more challenging to conceive after 35, and even more so at or after the age of 40?

Women are born with as many eggs as we will ever have. As we age, we may have cycles where an egg is not released. These begin around the age of 35 and grow more frequent over time. The quality of existing eggs also declines, creating additional challenges. The chance of miscarriage in a woman over 35 is 20% to 35%.

Other factors that can lead to decreased fertility in “older” women are:

• Decreased cervical fluid which helps transport sperm through the cervix

• Increased chance of surgery, which created scar tissue around the cervix or fallopian tubes

• Endometriosis (which is a leading cause of infertility in women of any childbearing age)

• Heart disease, diabetes and other health problems that become more prevalent with age

It’s important to note that fertility declines gradually as we get older. It’s not like a switch flips on our 35th birthday and suddenly our odds of conceiving drop. For instance, all other factors being equal, a healthy 35-year-old woman has a better chance of conceiving than a healthy 40-year-old. This may sound depressing, but it’s actually good news. If you are over 35 and deciding on when to start trying for a child, the time is now! In fact, the March of Dimes Web site reports that 1 in 5 women has her first child over the age of 35. Women are waiting longer to begin their families, and this offers many benefits.

Women over 35 are:

• More financially stable, in general

• More established in their careers, so a break for maternity leave may not be as much of a setback

• Have done a lot more, so won’t feel as if they are “missing out” or “giving anything up” to have kids

Whether you are minutes away from menopause or years, there are things you can do to increase your odds of conception.

Be patient – While most couples conceive within 6 months, it can take a healthy couple over the age of 35 as long as one or two years to conceive. If you’ve been trying for six months with no luck, however, you may want to visit a fertility specialist for an assessment.

Have a preconception doctor’s visit – While this typically isn’t necessary in a woman under 35, a general health assessment from a professional can get you on the right track with a healthy diet and exercise program and the knowledge that there are no obvious obstacles to fertility.

Be healthy – Make sure your weight and BMI are within the healthy range, and give up bad habits such as smoking and drinking. A healthy diet can lead to an easier pregnancy for anyone, and especially for women over 35.

Track your fertility – Use any number of available methods to track your fertility so that you will know when – and if – you are ovulating. Be vigilant about having intercourse prior to and during your time of ovulation to increase your odds of conceiving during any cycle.

Take prenatal vitamins – Again, this is good advice for any woman trying to conceive, but can especially increase the odds of a rapid conception and a healthy pregnancy for a woman over 35. It is especially important to get enough folic acid, which decreases the risks of certain genetic disorders. For more tips on prenatal nutrition and exercise, read the article “Nutrition and Trying to Conceive.”

Also be aware that a pregnancy over the age of 35 carries increased risks of:

• Miscarriage

• Down’s syndrome and other genetic disorders

• premature delivery

• Twins

• Delivery by c-section

However, tests and screening can provide peace of mind that your baby is healthy, while a healthy lifestyle and positive outlook increases the odds that your pregnancy will go smoothly.

Author: Dawn Allcot