What if you can not conceive a child for several years in a row?

Some seemingly perfectly healthy couples stubbornly fail to become pregnant for several years. It is quite natural that one day they begin to wonder why it is impossible to conceive a baby and whether it can be changed. In this article we will explain how to act in this case.

If a couple does not protect themselves and leads an active sex life at the most favorable time for conception (in the middle of the menstrual cycle, when women ovulate), and pregnancy does not occur for a year or more, doctors talk about infertility. It can be feminine, masculine, and also mutual.

Among the most common causes of a decrease or complete lack of fertility in women are inflammatory diseases of the reproductive organs, including chronic, sexually transmitted infections that sometimes occur hidden, as well as hormonal and menstrual disorders. Lack of ovulation makes a woman infertile. An insufficient level of follicle-stimulating hormone cannot ensure the maturation of the follicles in the first half of the cycle, and an insufficient level of progesterone cannot guarantee that even the fertilized egg can adhere and the embryo begins to develop.

The reason for the inability to get pregnant may be previously performed abortions, endometriosis, fibroids, disruption of the ovaries, obstruction of the fallopian tubes. Sometimes the reason for the absence of pregnancy lies in the anatomical features of the structure of the reproductive organs or post-traumatic changes. The reason may lie in stress, psychological unpreparedness for pregnancy and childbirth - then we are talking about psychogenic sterility.

Bad habits, a frantic rhythm of life, a passion for coffee and strong tea, excess weight and unhealthy diet increase the likelihood of infertility in women of reproductive age. By the way, age itself is also an important factor. After 34 years, the likelihood of pregnancy rapidly decreases, and the quality of the eggs deteriorates.

Among the common male causes of infertility are a violation of the quantity and quality of sperm composition, genital infections, inflammatory diseases of the reproductive organs, and obstruction of the vas deferens. Men are no less than women psychogenic causes of lack of fertility. Despite the fact that the reasons for men to be infertile are less than those for women, the proportion of male and female infertility in couples are approximately equal - the share of women is, according to statistics, about 40% of cases, the share of men - about 45%.

Mutual infertility is not as common, but it represents the most difficult and complex cases. Such infertility is indicated if the fertility of both partners is impaired, as well as in the case of genetic incompatibility between husband and wife.

First of all, you need to establish the true reason for the absence of a long-awaited pregnancy.To do this, a woman needs to contact a gynecologist, and a man - to the urologist-andrologist. It is best to choose one clinic to go for an examination together. A family survey increases the chances of more accurately and quickly determining the cause or series of causes and eliminating them.

Women are prescribed a number of mandatory examinations:

• Ultrasound of the pelvic organs (allows you to set the anatomical features of the reproductive system, to identify pathological changes);
• colposcopy (allows you to establish the state of the cervix, to exclude the so-called cervical factor of infertility);
• hysteroscopy (allows the doctor to get the most accurate picture of the state of the endometrium, the walls of the uterus);
• diagnostic laparoscopy (appointed if there is suspected obstruction of the fallopian tubes or their critical narrowing);
• chest X-ray (eliminates tuberculosis);
• general blood and urine tests;
• blood chemistry;

• blood test for hormonal profile (done after menstruation, on days 5-6 of the cycle - FSH, estradiol, estrogens, thyroid hormones, TSH, testosterone, prolactin and a number of others, on days 21-22 of the cycle - progesterone). This is a very important analysis, which, coupled with the data of ultrasound of the ovaries, can give an idea of ​​whether ovulation occurs, whether the oocytes mature.
• blood test for TORCH infection;
• a blood test for HIV status, syphilis, and sexually transmitted infections;
• a vaginal smear on the microflora and infection, scraping from the cervix to abnormal cells, as well as anti-sperm antibodies;
• immunogram (allows you to determine whether infertility is immune factor).

A man also does not need to stand aside, simultaneous examination will save time and increase the chances of effective treatment. A man should not pass many tests, their list is as follows:

• spermogram (to establish the quantitative and qualitative composition of the ejaculate);
• immunogram and MAP test (allows detection of antisperm antibodies);
• general blood and urine tests;
• blood chemistry;
• blood tests for HIV status, syphilis and genital infections;
• urethral smear;
• blood test for hormones (testosterone, estrogens, thyroid hormones).

Additional tests may be prescribed by a doctor if semen results are disappointing. For example, a man who has a large number of leukocytes in his sperm is recommended to do an ultrasound of the prostate gland, testicles, and men with severe teratozoospermia (an increased number of mutated, altered spermatozoa that are incapable of normal fertilization) can be recommended to use a sperm sample. .

Treatment is prescribed depending on the cause. Drug regimens, surgery, and hormone therapy can be used to eliminate the pathology. Infertility treatment is always quite long, and the couple will have to be patient and follow all the recommendations.

In 85% of cases, treatment after identifying the causes is effective, and the couple becomes pregnant after completing the course in a matter of months. If the treatment does not give a positive effect, the pair may be recommended reproductive assistive technologies - IVF, IVF + ICSI, IMSI, intrauterine insemination.Even in the most severe cases - when a woman has no ovaries and no own eggs, when a man has no testicles, medicine will be able to offer options that will help her become parents. Reproductive techniques can be performed using a donor egg, donor sperm and even donor embryos.

2.3 or 4 years of infertility - a great enough experience, so that the couple began to look for options to overcome infertility. If childlessness lasts much more than 4 years, additional problems may arise with the treatment of “old” and “neglected” problems with reproductive health. Therefore, it is necessary to contact a doctor as soon as possible, at the stage when a woman without much anxiety just starts to think that she cannot become pregnant for a year - everything is in order with her husband.

A few simple tips will help the couple increase the chances of conceiving a child, but in no case do they cancel the recommendations to consult a doctor and be thoroughly examined.

• Pay attention to weight. Even a small weight loss of 5% of the initial weight increases the chances of pregnancy by 10%.
• Stop dwelling on planning. Stress adversely affects the production of sex hormones. The more you expect pregnancy, the higher the level of stress. The stronger and longer the stress, the less chance of conceiving a baby.

• Reconsider the lifestyle. Both partners need to get enough sleep, eat a balanced diet, take vitamins, eliminate bad habits from their lives, and reduce some exorbitant physical exertion.
• Stop blaming yourself and your partner. The complex of guilt and resentment - common reactions of partners to infertility in the family. Do not blame the other and execute yourself. It’s better to go looking for a solution together.

Women, who have been in the state of pregnancy planning for several years, have usually tried a lot - from leech treatment to massage of energy points and folk remedies. But pregnancy usually occurs only after the couple has the courage and goes to the doctor to be examined, and then begins to treat not just “infertility”, but the real disease, which has led to a decrease in fertility.

In the next video, doctor urologist-venereologist Ekaterina Makarova discusses why it is impossible to conceive a child.