Starting attempts to create a child can cause a lot of positive emotions and excitement. You begin to pay attention to the children on the streets and listen to children’s laughter. However, if conception does not happen immediately, it can lead to feelings of loneliness and sadness that only you do not succeed. Remember, it is normal to pass a little time before fertilization occurs. However, every woman asks herself when it is appropriate to consult a doctor to find out if there is a problem and how it can be solved.
How long should you try before checking with a doctor?
All women should see their doctor for an examination even before they start trying for a child to discuss possible problems, genetic tests, and lifestyle habits that could affect pregnancy in some way.
Usually, most couples take four to six months to get pregnant. Somewhere between 85-95% have success within a year. If you have been actively trying for a year, have had frequent unprotected sex and still have no result, infertility is possible. Of course, remember that a number of factors must be taken into account in order to have successful fertilization.
If you are under 35, generally healthy and actively trying to get pregnant for a year or more, but unsuccessfully, you should make an appointment with a doctor. Women over the age of 35 should seek advice from a doctor or clinic after six months of unsuccessful attempts.
Finally, women who have recurrent miscarriages should also schedule an appointment with a doctor as soon as possible. Although miscarriages are common, re-abortions (defined as two or more in a row) are not. This may indicate a medical problem. [1, 2]
What can lead to infertility?
There are many possible causes of infertility, and fertility problems can affect any partner. But in a quarter of cases, it is not possible to establish the cause.
Common causes of infertility include:
- Lack of regular ovulation (monthly release of an egg)
- Sperm problem
- Clogged or damaged fallopian tubes
- Endometriosis – when tissue similar to that from the lining of the uterus (endometrium) is located outside the womb. [3]
What are the risk factors?
There are risk factors that can affect fertility. These include:
- Age – fertility decreases with age
- Weight – overweight or obesity (with a body mass index (BMI) of 30 or more) reduces fertility; in underweight women, ovulation can be affected
- Sexually transmitted infections (STIs) – several STIs, including chlamydia, can affect fertility
- Smoking – smoking (including passive smoking) affects your chances of conceiving and can reduce sperm quality.
- Alcohol – the safest approach is not to drink alcohol at all to minimize the risks to your baby. Consuming too much alcohol can also affect sperm quality.
- Environmental factors – exposure to certain pesticides, solvents and metals has been shown to affect fertility, especially in men
- Stress – can affect your relationship with your partner and cause loss of sex drive; in severe cases, stress can also affect ovulation and sperm production .[3]
Will fertility tests be necessary?
At your first appointment with the fertility health professional, they will review your medical history and then outline the tests that you (and your partner, if you have one) will need to do.
These will include blood tests, physical examinations and sperm analysis. Usually, the doctor appoints an ultrasound and a specialized X-ray to examine the uterus, ovaries and fallopian tubes. [4]
What to expect from the spermogram?
One major infertility test is sperm analysis (SA), in which a sample taken after ejaculation is evaluated in a laboratory. Sperm analysis looks at sperm count, sperm volume, sperm shape and movement, the presence of white blood cells (usually a sign of infection) and other factors. In addition, sperm vitality (percentage of live spermatozoa in the sample) is also determined. The pH of the sperm is also determined. If it is too acidic, it can negatively affect sperm. [4]
What is infertility treatment?
After diagnosis, treatment can already be undertaken. Depending on the cause of infertility, treatment includes:
- Medical treatment in the absence of regular ovulation
- Surgical procedures such as treatment of endometriosis, restoration of fallopian tubes, or removal of scars (adhesions) in the womb or abdominal cavity
- Assisted conception such as intrauterine insemination (IUI) or in vitro infertility (IVF).
Some infertility treatments, such as IVF, can cause complications. E.g:
- Multiple pregnancies – if more than 1 embryo is placed in the womb as part of IVF treatment, there is an increased chance of twins. This may not seem bad, but it significantly increases the risk of complications for you and your babies;
- Ectopic pregnancy – the risk of ectopic pregnancy is slightly increased if you have performed IVF. [3]
What to Consider for Fertility Medications
Medications to stimulate ovulation are an integral part of most infertility treatments. In some cases, only drugs are used (at least initially). They are also part of more involved treatments such as IVF. This type of medication also carries some risks. These include: the possibility of conceiving twins if you are older; a condition called ovarian hyperstimulation syndrome (OHSS). [4]
Everyone at some point feels the need to hug their child. For some couples, this happens almost immediately, while for others it takes time. The important thing is not to lose hope, consult a specialist and specify what prevents you from getting pregnant. Specifying the problem allows for the appointment of treatment and this greatly increases the possibility that you will hug your baby as soon as possible.
From: Polina Georgieva <[email protected]>
Sent: Wednesday, April 5, 2023 4:36 PM
To: Polina Georgieva <[email protected]>
Subject: Сайт
Suddenly stopping a cycle? Reasons other than being pregnant
The absence of menstruation (amenorrhea) can be a sign of happiness (pregnancy) on the one hand, on the other – a cause for concern if you are not aware of the cause. Amenorrhea is not always due to something scary. In the lines below you will pay attention to possible reasons other than pregnancy to stop the cycle.
What is amenorrhea (lack of cycle)?
The normal duration of the monthly cycle is between 21 and 35 days, most ladies menstruate on the 28th day. For some women, their cycle is like a clock – on any date each month, while for others it can vary by several days. Both conditions are completely normal.
By amenorrhea is understood the absence of menstruation. It is primary and secondary. [1]
Difference Between Primary and Secondary Amenorrhea
Primary amenorrhea refers to the absence of menstruation in a girl who has not had a period until the age of 15. The most common causes of primary amenorrhea are associated with a violation in hormone levels, although anatomical problems can also be the cause of amenorrhea. [1]
Secondary amenorrhea refers to the absence of three or more consecutive menstruations in a girl who has already menstruated. Pregnancy is the most common cause of secondary amenorrhea, although there are many other causes of secondary amenorrhea. [1]
Main causes of sudden cessation of the cycle (secondary amenorrhea)
The lack of a cycle can be due to many reasons. Some of them are completely natural, others may be due to a medical problem.
Natural amenorrhea
The most natural reasons for abruptly stopping the cycle are:
- Pregnancy;
- Lactation;
- Menopause;
- Contraceptives – Some people who take birth control pills (oral contraceptives) may not have a cycle. Even after stopping contraceptives, it may take some time before regular ovulation and menstruation resume. Contraceptives that are injected or implanted can also cause amenorrhea, as can some types of intrauterine contraceptives. [1,2]
Medication
Some medications can cause the cycle to stop suddenly. These include: antipsychotics, chemotherapy, antidepressants, some blood medications, some antihistamines. [1]
Lifestyle factors that can lead to a lack of cycle:
- Low weight – Too low body weight interrupts many hormonal functions in the body, potentially stopping ovulation. Women who have an eating disorder such as anorexia or bulimia often have problems with their monthly cycles due to these abnormal hormonal changes.
- Too heavy training. Women who exercise too much may have a menstrual cycle stop. The reasons are low body fat, stress and high energy expenditure.
- Stress – Mental stress can temporarily alter the functioning of the hypothalamus – an area of the brain that controls hormones that regulate the menstrual cycle. As a result, ovulation and menstruation can stop. Regular menstrual periods usually resume after stress decreases. [1]
- Contraceptives – You may not have a completely regular cycle if you are taking birth control pills. This is usually not a cause for concern. Some types of contraception, such as progestogen-only pills (POP), contraceptive injection, and intrauterine IUS, can cause the cycle to stop completely. [2]
Chormonal imbalance:
- Polycystic syndrome (PCOS) – Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects 6-8% of women worldwide. Symptoms include: irregular cycle, increased hair, difficulty getting pregnant, increased weight, acne. PCOS can also lead to hyperandrogenesis when a woman has high levels of male hormones. Hyperandrogenesis often leads to amenorrhea. [3]
- An overactive thyroid gland (hyperthyroidism) or insufficient thyroid function (hypothyroidism) can cause menstrual problems, including amenorrhea. [1]
- A benign tumor of the pituitary gland can interfere with the hormonal regulation of menstruation. [1]
- Premature menopause. Menopause usually begins around the age of 50. In some women, the supply of eggs in the ovaries decreases before the age of 40 and menstruation stops. [1]
Structural problems
Problems with the genitals can also cause problems with the cycle. These include:
- Asherman’s syndrome – is a condition that occurs after curettage, dilation / method of abortion / and curettage, cesarean section or treatment of uterine fibroids. Intrauterine adhesions occur, which do not allow normal thickening and separation of the uterine mucosa. [4]
- Lack of reproductive organs. Sometimes problems arise during the development of the fetus already intrauterine, which lead to missing parts or organs of the reproductive system. There may be a lack of the uterus, cervix or vagina. Since the reproductive system has not fully developed, menstrual cycles are not possible later in life. [1]
- Structural abnormality of the vagina. Blockage of the vagina can disrupt visible menstrual bleeding. In the vagina there may be a membrane or wall that blocks the outflow of blood from the uterus and cervix. [1]
How is it diagnosed?
During the examination, the doctor will perform a pelvic examination to check for problems with your reproductive organs. If you’ve never had a period, your doctor may examine your breasts and genitals to see if the characteristic changes for puberty have begun. Amenorrhea can be a sign of a complex set of hormonal problems. Discovering the underlying cause can take time and may require more than one type of testing.
What tests are appointed?
Various blood tests may be necessary, including:
- Pregnancy test. This will likely be the first test your doctor suggests to rule out or confirm a possible pregnancy. [1]
- Measuring the amount of thyroid stimulating hormone (TSH) in your blood can determine if your thyroid is working properly. [1]
- Measuring the amount of follicle-stimulating hormone (FSH) in your blood can determine if your ovaries are working properly. [1]
- Test for prolactin. Low levels of the hormone prolactin can be a sign of a tumor of the pituitary gland. High levels of the hormone can also lead to a violation in the cycle. [1]
- If you have enlarged facial hair and a low voice, your doctor may want to check the level of male hormones in your blood. [1]
Imaging studies:
Very often, in addition to blood tests, imaging tests are also appointed. These include:
- Ultrasound. This test uses sound waves to create images of internal organs. If you’ve never had a period, it’s a good idea to do this test to check for any abnormalities in your reproductive organs. [1]
- Magnetic resonance imaging (MRI). MRI uses radio waves with a strong magnetic field to create extremely detailed images of soft tissues in the body. Your doctor may order an MRI to check if there is a pituitary tumor, for example. [1]
What is the treatment?
Treatment depends on the underlying cause of your amenorrhea. In some cases, birth control pills or other hormone therapies can resume your menstrual cycle. Amenorrhea caused by thyroid or pituitary disorders can be treated with medication. If the problem is caused by a tumor or structural blockage, surgery may be necessary.
Any interruption of the normal cycle can be very stressful. Don’t be in a hurry to panic. Very often the cause is not serious and is amenable to treatment. When something is bothering you, contact your doctor because he can most accurately determine what is wrong with you and how it can be cured.
[1] https://www.vierafertility.com/blog/length-of-time-to-conceive/
[3] https://www.nhs.uk/conditions/infertility/
[4] https://www.verywellfamily.com/before-you-see-the-fertility-doctor-2758873
