Woman lying on bed hugging her knees to her chest.

You Asked: Why can’t I get pregnant?

August 20, 2015

Three minutes. You can easily spend this seemingly insignificant amount of time hitting the snooze button or scrolling through your phone. But for a couple trying to get pregnant, the three-minute wait for a positive or negative reading on a pregnancy test is agonizing.

The Center for Disease Control and Prevention (CDC) estimates 7.5 percent of men will see a fertility doctor in their lifetime–and at least 12 percent of women will struggle with fertility problems that impact conception and carrying a pregnancy to term.

Jeanne Ruiz, Ph.D., women’s health practitioner for the Texas A&M Health Science Center College of Nursing and Academy of Nursing Fellow, breaks down many common (and a few surprising) reasons why couples have trouble getting pregnant.

Infertility–not just a “woman’s condition”

 A frequent misconception about infertility is that the problem always starts with the woman. “It takes more than just a female to conceive,” Ruiz said. In fact, infertility in men is quite prevalent. In approximately 40 percent of infertile couples, males are either the sole cause or a contributing cause of infertility.

“It’s much easier to start with the males and rule out problems from there,” Ruiz said. “Males should begin testing first because they may have motility issues or not enough sperm. It’s always easiest to start with the less expensive, less painful treatment.”

Numbers matter: Especially your age and weight

For women, there are a variety of reasons that determine normal hormonal function. A woman is born with the exact number of eggs she needs for the rest of her life. With every year that passes, more eggs are used, and your ovaries become less able to release eggs.

“Age is an important factor to look at when determining potential fertility problems for women,” Ruiz said. “High blood pressure and diabetes are a risk for pregnancies and for women in general. Unfortunately the risk for these conditions increases with age. You have also have more eggs when you are younger compared to when you’re older.”

As a woman ages, her metabolism slows considerably which contributes to weight gain. “As you age you tend to gain more weight. This is a big issue. To increase your chances of conception you need to be an average weight.” Ruiz said.

Ruiz also emphasized the importance of a healthy BMI (body mass index).“BMI is a huge indicator of over-nutrition and under-nutrition. Both are important to keep in mind when maintaining a pregnancy or trying to conceive,” she said.

Around 12 percent of infertility cases result from a woman weighing too little or too much. But, there is hope. Women who have BMIs that are too high or too low can reverse their infertility by attaining and maintaining a healthy weight.

Use birth control shots? They have extended effects

According to Ruiz, women who take injectable birth control like Depo-Provera could have trouble conceiving. Injectables release a large amount of progesterone (the hormone released during pregnancy) to override a woman’s normal cycle and “trick” her body into thinking it’s pregnant.

“Unlike oral medication, which is a systematic release into the system, injectable birth control is designed to be long-lasting,” Ruiz said. “I would encourage women to stop taking injectable birth control at least six months before trying to conceive, since it takes the body a longer time to flush it from the system.”

Do your lifestyle choices put you at risk?

Smoking is bad in general, but it’s also worse for baby. Up to 13 percent of female infertility is caused by smoking. The American Society for Reproductive Medicine also found both men and women who smoked cigarettes had decreased fertility.

Stopping at your favorite coffee shop to grab a caffeine fix is a daily staple in American life. Ruiz stressed that women need to watch their caffeine intake when trying to conceive a baby. “You should have no more than one cup of caffeine a day when trying to conceive,” she said. “Caffeine increases your heart rate and adrenaline which will impact normal ovulation and hormonal function.”

A surprising culprit to blame for infertility problems are common household chemicals used for cleaning. “Bleach is just terrible,” Ruiz said. “Pesticides are dangerous, too; and chemicals like Round-Up are extremely toxic and bad for your health. Any chemical that could modify your cellular makeup should be avoided.”

Breastfeeding will release pregnancy hormones

Even women who have already had multiple pregnancies can be plagued by detours on the road to their next baby bump. “Breastfeeding mothers will often have trouble becoming pregnant again soon after giving birth, as prolactin and oxytocin – the hormones that stimulate milk letdown – are high. Women who are breastfeeding don’t have normal cycles and it can stop ovulation or cause a woman to not ovulate regularly,” Ruiz said.

Infertility is not an inconvenience, it’s a disease

 There are many diseases of the reproductive system that impair the ovaries, fallopian tubes and uterus. To improve your chances of getting pregnant, it is essential that these organs are healthy and treated for any underlying conditions.

The Mayo Clinic detailed a few of the most common conditions that contribute to infertility:

  • Ovulation disorders, which hinder or prevent the ovaries from releasing eggs. Examples include hormonal disorders such as polycystic ovary syndrome, a condition that might relate to your ovaries producing too much of the male hormone testosterone. Other underlying causes may include excessive exercise, eating disorders, injury or tumors.
  • Fallopian tube damage or blockage, which usually results from inflammation of the fallopian tube (salpingitis). This can result from pelvic inflammatory disease, usually caused by sexually transmitted infection, endometriosis or adhesions.
  • Endometriosis, which occurs when endometrial tissue implants and grows outside of the uterus — often affecting the function of the ovaries, uterus and fallopian tubes.
  • Primary ovarian insufficiency, also called early menopause, when the ovaries stop working and menstruation ends before age 40. Although the cause is often unknown, certain conditions are associated with early menopause, including immune system diseases, radiation or chemotherapy treatment, and smoking.
  • Pelvic adhesions, bands of scar tissue that bind organs after pelvic infection, appendicitis, or abdominal or pelvic surgery.

What else should you expect when you’re trying to expect? Ruiz said if future parents could pre-conceptionally tackle many of these issues they would already have a better start when trying for a baby.

“It’s imperative couples consult with a health care provider and take measures to treat many of these conditions as early as possible,” she said. “It’s always better to be proactive than reactive when it comes to your health and your baby’s health.”

— Lauren Thompson

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