How long should you wait to seek help getting pregnant?
After having spent years taking every possible precaution to make sure you don't become pregnant, the time is finally right to start a family. It can come as a rude shock, then, to discover that conceiving a baby isn't as easy as you thought. In fact, for many couples, it can take a lot longer than they expected.
The average time it takes a woman aged 25 to get pregnant is two to three months. For a woman of 35, it's more likely to be six months. They're the lucky ones — a fifth of 25-year-olds may still not be pregnant after a year of trying; this rises to 33 percent of women aged 25-29 and 45 percent for those older than 30.
So if you've only been trying for a couple of months, don't start worrying yet. If you've been seriously trying, know that your timing is right, you don't smoke and you and your partner are living a pro-baby-making lifestyle, it's generally advised you see your doctor if you aren't pregnant after 12 months. If you're more than 30 years old, have a history of pelvic inflammatory disease, painful or irregular periods or recurrent miscarriage, it might be a good idea to seek help sooner.
Waiting only six months before having an initial consultation is recommended for women 37 years and older because if a problem is found, there's less time to solve it. If your partner has a known or suspected low sperm count, then it would also be a good idea to seek help sooner than a year.
Leading fertility expert Dr Kelton Tremellen says these waiting times are just guidelines. "But if you have no problems that you know of and are under 35, we certainly recommend waiting a year before seeking any major intervention," he says.
"If you think, for example, that you may not be ovulating because your periods are irregular, your GP should be able to determine whether you are with a simple blood test. The same goes for finding out his sperm count. These are issues which can be easily investigated earlier."
The diagnosis
Once you take the step of deciding you need help, your GP will refer you to a fertility specialist. First the specialist will want to know your medical history, including information about any previous pregnancies, period problems, infections or surgery. Your partner will be asked if he's fathered children before and if he's had any testicular injuries, infections or surgery.
The doctor will also delve into the details of your sex life, wanting to know about the timing and frequency of sex. Then there will be physical examinations and blood tests, ultrasounds and semen analysis.
What is infertility?
Infertility is usually defined as not being able to conceive after one year of unprotected, well-timed intercourse. Infertility also includes the inability to carry a pregnancy to the delivery of a live baby. Infertility is a medical condition, not a sexual disorder.
Some experts claim that as many as one in four couples is infertile, but Dr Tremellen believes that the better-known figure of one in six still holds true in the western world.
"And the reality is that many of these couples will go on to have successful pregnancies with some medical help," he says. "If one in every six couples of childbearing age has a problem conceiving, more than 80 percent of all infertile couples can be helped to achieve pregnancy with proper treatment."
Not a life sentence
When a couple first hears the word "infertility", it's understandably a shock. Most people will say that it was the one big nagging worry as they made that decision to start trying for a baby. On the one hand they expect to fall pregnant; on the other, every month they panic that they'll be among the 15 percent of couples who struggle.
Dr Tremellen, who treats hundreds of couples annually as one of the fertility specialists at Adelaide's Repromed clinic, which performs IVF, says he prefers to accentuate the positives rather than harp on the couple's problems conceiving.
"The statistics are very much on the couple's side," he says. "The strong likelihood is that if they're prepared to sign up for three IVF treatment cycles, the chances are they'll have a baby.
"But I always point out that the best preparation is to acknowledge that this is a hurdle for them and the [IVF] process will be stressful, with a lot of medical intervention, particularly for the female, and they will be on a bit of an emotional rollercoaster."
Dr Tremellen adds that some couples benefit from counselling.
Fact: Infertility is a female problem in 35 percent of cases, a male problem in 35 percent of cases, a combined problem of the couple in 20 percent of cases and unexplained in 10 percent of cases. It's essential that both the man and the woman be evaluated during an infertility work-up.
All material is © Mother & Baby: Making Babies
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