Cant Get Pregnantl Is There Anything Wrong

Victory belongs to the most persevering.

Napoleon

How Does a Pregnancy Happen?

Conception can only happen when a sperm swims up into the womb before fertilizing an egg in the fallopian tube. This allows the fertilized embryo to implant or embed itself into the womb lining, where it will grow into a fetus.

Am I Subfertile?

There is indeed a possibility that something is wrong in you or your partner if you are still not pregnant after a period of trying to conceive. An average couple in their 30s will conceive after about 6 months of trying to do so. Certainly, any couple that fails to conceive after a year of trying, should seek prompt medical attention, so that the appropriate investigations and treatment can be carried out.

In our current climate of a hectic schedule, it is important to note that regular sexual intercourse of 2-3 times per week should be happening between the couple before they can be labeled as subfertile. The most fertile period is usually two weeks before the onset of a women's period if she has a regular cycle. This is when the egg is released from the ovary into the fallopian tubes.

What can Possibly be Wrong?

It is important to remember that subfertility is never the fault of any one individual. There are varying factors that could contribute to a couple not being able to conceive. For a start, one must exclude male or female sexual dysfunction, whereby the sexual act is never carried out anyway. This can lead to a breakdown of the relationship in the long run. There can be many reasons for male sexual dysfunction and an inability to ejaculate. They include impotence, erectile dysfunction, diabetes, prostate surgery or chronic usage of medications, e.g. anti-hypertensives. In the female, vaginismus or pain during sexual intercourse is perhaps the most common cause of female sexual dysfunction.

Various tests may be carried out to further investigate underlying causes. They include:

• A sperm analysis to look out for any sperm abnormalities.

• Hormonal blood tests to confirm ovulation.

• Radiographic tests such as a pelvic ultrasound scan to assess for womb problems or growths. A hystero-salpingogram, that involves the X-ray of

Hydrotubation Pictures

Laparoscopic hydrotubation depicting Laparoscopic resection of fibroids.

free spillage of dye from both tubes.

Figure 5.1 Laparoscopic surgery.

Laparoscopic hydrotubation depicting Laparoscopic resection of fibroids.

free spillage of dye from both tubes.

Figure 5.1 Laparoscopic surgery.

Chapter 5 I Can't Get Pregnant! Is There Anything Wrong?

the pelvis after passing of a dye contrast into the womb to assess the patency of the fallopian tubes, can also be performed.

A key-hole surgical survey of the womb cavity (via hys-teroscopy) and the fallopian tubes (via laparoscopy) can also be performed and any gynecological problems may be treated at the same time.

Figure 5.2 Assisted reproductive technique.

In 20% of couples, no identifiable causes can be found (idiopathic subfer-tility). In such cases, treatment is only empirical and assisted reproductive techniques (ARTs) such as intra-uterine insemination or in-vitro fertilization (test-tube baby) can be employed to help the couple conceive. In the remaining 80%, problems can be divided into female factors, male factors or a combination of both.

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