Published June 20, 2020
Dr. Abayomi Ajayi
You are over 35 years old and trying to conceive for some time but it is not happening, there are many possible reasons, ranging from ovulation irregularities, problems in your reproductive system, low sperm count of your spouse, or an underlying medical problem.
Believe it or not, one of the possible reasons you are not conceiving could be that you are not trying enough or not trying long enough. Think about it – how long have you been trying? It may feel like you’ve been trying forever and maybe you have, but it’s important to know that many couples won’t conceive right away.
Actually about 4 in 5 couples conceive after six months of trying. Approximately 90 per cent will be pregnant after 12 months of trying to get pregnant, assuming that you have well-timed intercourse every month.
The problem could be with you or your spouse, or both of you. You would carry the baby, but it takes two to tango. Twenty to thirty per cent of infertile couples discover fertility factors on the woman’s side or man’s side. Another 40 per cent find infertility factors on both sides. Infertility can have a number of symptoms such as irregular periods or severe menstrual cramps, however, most causes tend to be silent. Male infertility in particular does not usually have obvious symptoms.
If you are above 35, and your spouse is over 40, it can take longer to get pregnant. Some women assume if they still get regular periods their fertility is fine, but this isn’t true. Age impacts egg quality as well as quantity. Also, if your partner is five or more years older than you are, this can further increase your risk of fertility problems after age 35.
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It is recommended that you see a doctor about your fertility if you’re 35 years or older and have been trying for at least six months. Also see the doctor if you’re younger than 35 and have been trying for at least one year. If either of these fit your situation then see a doctor, even if you have no symptoms of a fertility problem.
Let’s begin with you. You may not be ovulating to start with. A lack of ovulation which is known as anovulation, is one of the commonest female infertility problems. To conceive, there must be an egg and sperm. If you’re not ovulating, you won’t be able to get pregnant.
A condition known as Polycystic Ovarian Syndrome is one of the commonest causes for lack of ovulation. Other possible causes include being over or underweight, primary ovarian insufficiency, a thyroid dysfunction, and excessive exercise among others.
If you are experiencing ovulation problems you may have irregular periods. If you have irregular cycles, talk to your doctor, even if you haven’t been trying for a year yet.
Also, the problem could be blocked fallopian tubes. Ovulation causes account for about 15 per cent of female infertility cases and the rest can have problems with blocked fallopian tubes, uterine structural problems, or endometriosis.
Your fallopian tubes are the pathway between your ovaries and the uterus. They do not directly attach to the ovaries. Sperm must swim up from the cervix, through the uterus, and into the fallopian tubes. Conception takes place inside the fallopian tube, where the sperm and egg finally meet. If anything prevents the fallopian tubes from working properly, or if scarring blocks the sperm or egg from meeting, you won’t be able to get pregnant.
There are many possible causes of blocked fallopian tubes. You may experience pelvic pain or no symptoms. Only fertility testing can determine if your tubes are open. An HSG is a specialised X-ray used to determine if your fallopian tubes are open.
Endometriosis, a condition when the endometrium-like tissue (the tissue that lines the uterus) grows in places outside of the uterus can cause difficulty in getting pregnant. Endometriosis is commonly misdiagnosed or simply just missed. It cannot be diagnosed with a blood test or ultrasound, but requires diagnostic laparoscopic surgery. Because of this, proper diagnosis could take several years.
You need to know that male infertility rarely has symptoms that are observable without a semen analysis, which is a test that measures the health of the semen and sperm. When you do see the doctor, make sure you are both tested.
Getting pregnant after 35 is quite possible. About 60 per cent of women conceive within a year when they start trying at age 35. After four years, 84 per cent eventually get pregnant and have a baby. Your partner’s age also matters. Getting pregnant after age 35 isn’t as easy as it is at 25, but for most women, it’s doable.
Underlying medical conditions can lead to infertility in both of you. For example, a thyroid imbalance or undiagnosed diabetes can lead to infertility, depression is also associated with infertility. Some autoimmune diseases, like lupus and undiagnosed sexually-transmitted diseases, can also cause infertility
If your partner is five years older than you, and you’re over 35, your odds for conception are lower. Time is of the essence after 35. For this reason, it’s really important you don’t delay seeking help if you can’t conceive after six months.
It is better to get fertility testing done after just six months of trying if you’re 35 or older. If there is a fertility problem found, you will be more likely to have success in treating it sooner than later. If there are no obvious fertility problems, your doctor may suggest you continue trying to conceive naturally for another few months and come back if you still don’t succeed.
Living a healthy life won’t stop age-related fertility declines. It’s true that certain unhealthy habits can increase the rate of fertility decline, such as smoking or alcoholism. However, it’s also true that even the men and women who eat well,, exercise, and stay away from unhealthy habits still experience age-related fertility decline like anyone else.
Between 10 and 30 per cent of infertile couples never find out why they can’t get pregnant. Some couples don’t get answers, however, not having answers doesn’t mean you can’t be treated. You can still receive treatment for infertility even if your diagnosis is “unexplained.”
If you’re having difficulty getting pregnant, know that there is help available. Many couples put off testing and treatment, waiting for a miracle or thinking they should just try a little longer first. This is a mistake. Some causes of infertility worsen with time. The sooner you get help, the more likely fertility treatments will work for you.
Another reason you may be tempted to delay testing because you feel that you are in perfect health. It’s true that you and your partner may have no signs or symptoms of a fertility problem but that doesn’t mean you may not have a fertility problem.
The reasons for infertility aren’t always observable to the lay person. For this reason, if you’ve been trying to conceive for some time particularly if you’re over 35 years, get help. Don’t wait.