Frequently Asked Questions
Please click the tabs below to see some of the most commonly asked questions.
View the links below for some useful links and documents relating to infertility.
How common is the problem of infertility?
When should you see a fertility specialist?
The most important factor that determines the success of natural conception as well as any fertility treatment (including IVF) is the age of the female partner. A couple is advised to seek assistance from a qualified health care professional after 12 months of trial at natural conception if the female partner is less than 35 years old and after 6 months of trial if the female partner is older than 35 years.
If it’s taking longer than you expected to achieve a pregnancy, take the first step and book an appointment with Dr Karia to have some simple tests done and make a plan.
Why is the female age so important?
Women are born with all the eggs that they are ever going to have and do not make new eggs in their lifetime. Also, there is a natural process of loss of some eggs in every cycle. As age advances, there is a progressive decline in the quantity of egg reserve.
More importantly, the egg quality also keeps progressively declining with age. The chance of conception therefore reduces progressively with a simultaneous increase in the risk of miscarriages, abnormalities in the offspring and pregnancy complications as age advances.
What is ovulation?
Ovulation is the process of the release of a mature egg from a woman’s ovary. The egg is picked up by the fallopian tube, which pushes it towards the uterus.
Some important facts:
- Ovulation is a process that usually occurs 2 weeks before the start of the next menstrual cycle. (range 12-16 days)
- The egg is alive for about 24 hours after release from the ovary.
- Menstruation and ovulation can occur independent of each other.
- Some women will experience symptoms like pelvic pain or scanty vaginal bleeding around the time of ovulation.
In most cycles, a single egg will be released at the time of ovulation. Occasionally, more than one egg may be released during a cycle.
What is the right time in the cycle for a couple to try for conception?
The “fertile window” is the best time in a woman’s cycle for couples to try for natural conception. This window can vary for different women. This window begins 5 days prior to ovulation through to the day of ovulation.
Research shows that the best chance of conception is in the 3 days before ovulation. Ovulation tracking may be required to more accurately identify your “fertile window”. Find out more about this service.
Can ovulation be predicted without visiting a doctor?
- In women with regular menstrual cycles, ovulation usually occurs 2 weeks before the next menstrual period (range 12 to 16 days).
- Women with irregular cycles will find it more challenging to predict their “fertile window”.
- The nature of the cervical mucus may help to predict ovulation. The cervical mucus progressively changes from dry to progressively more sticky closer to ovulation and wet, semi transparent in nature during ovulation.
Ovulation prediction kits:
- Ovulation prediction kits are readily available and do need a prescription for purchase.
- These kits work on the principle of detecting a surge in LH (luteinizing hormone). LH is a hormone produced by a gland called the pituitary gland in the brain. It rises 24-36 hours prior to ovulation and is responsible for the final maturation of the egg prior to ovulation.
What are the other female factors apart from ovulation disorders that impact fertility?
- Blocked fallopian tubes
- Hormonal disturbances
- Abnormalities in the uterus
- Pelvic infections – pelvic inflammatory disease, sexually transmitted infections, tuberculosis etc
- Life style factors – obesity, smoking, excessive stress, eating disorders etc.
Is infertility only a female problem?
No, it is not. The male partner can be contributing to delay or inability to conceive. It is as important for the male partner to be tested for fertility issues as the female partner.
Basic evaluation of male fertility involves analysis of semen for various factors like volume, sperm concentration (count in millions per ml), motility (movement as a %) and sperm morphology (% of normal sperm). Minor abnormalities in semen will not render a male to be infertile. Sometimes your fertility specialist will recommend a repeat semen test or more advanced testing if required for diagnosis and treatment.
Do position or frequency of sexual intercourse affect fertility?
No. Usually, enough sperm will remain in the reproductive tract of the female to fertilize the egg irrespective of the position of sexual intercourse.
There is a perception that frequent intercourse reduces sperm concentration. While a slight reduction does take place, frequent intercourse during the “fertile window” in normal couples still increases the chance of conception. There is no absolute defined frequency of intercourse that is recommended for all couples trying to conceive.
Is IVF the only fertility treatment that you can have?
No. There are various fertility treatment options available for couples seeking fertility treatments depending on the factor(s) affecting their fertility. These options range from simple life style modifications and simple advice about conception to fertility procedures like ovulation monitoring, ovulation induction, artificial insemination and IVF. Fertility surgery (usually performed through key-hole procedures) is also an important option to consider in certain cases.
Some couples will benefit from a combination of various treatment modalities or very sophisticated treatment options like PGD (pre-implantation genetic diagnosis). It is important for you to discuss various treatment options with a fertility specialist before you proceed with treatment.
Find out more about this service.
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