WHY CAN’T I GET PREGNANT?
Infertility can be caused by many different things and sadly, for 1 in 4 couples in the UK, a cause cannot be identified. Infertility is defined as not able to conceive naturally after having unprotected intercourse for a minimum of twice a week for more than 2 years.
10 REASONS THAT CAN CAUSE INFERTILITY IN WOMEN
Infertility is commonly caused by problems with ovulation (the monthly release of an egg from the ovaries). Some problemsstop an egg being released at all, while others prevent an egg being released during some cycles but not others. It is often confirmed with a blood test called day 21 progesterone, which will allow the specialist to understand if ovulation is taking place or there is an issue with anovulation.
Ovulation problems can be a result of:
Other causes of infertility include the following:
Scarring from surgery
Pelvic surgery can damage and scar the fallopian tubes, which link the ovaries to the womb. Cervical surgery can alsosometimes cause scarring or shorten the neck of the womb (the cervix).
Cervical mucus problems
When you're ovulating, mucus in your cervix thins so sperm can swim through it more easily. If there's a problem with the mucus, it can make it harder to conceive.
Fibroids
Non-cancerous growths called fibroids located in or around the womb can affect fertility. In some cases, they may prevent a fertilised egg attaching itself to the womb, or they may block a fallopian tube. Fibroids are diagnosed with an ultrasoundscan, which we offer at The Medic Clinic. Fertility consultations with Miss Katimada include a scan of your uterus during your fertility screening.
Endometriosis
Endometriosis is a condition where small pieces of the womb lining (the endometrium) start growing in other places, such asthe ovaries. This can damage the ovaries or fallopian tubes and cause fertility problems.
Pelvic inflammatory disease
Pelvic inflammatory disease (PID) is an infection of the upper female genital tract, which includes the womb, fallopian tubes,and ovaries. It's often caused by a sexually transmitted infection (STI). PID can damage and scar the fallopian tubes, making it virtually impossible for an egg to travel down into the womb. (Click here to book for STI testing)
Sterilisation
Some women choose to be sterilised if they do not want to have any more children. Sterilisation involves blocking the fallopian tubes to make it impossible for an egg to travel to the womb. It’s rarely reversible – if you do have a sterilisation reversed, you will not necessarily be able to have a child.
Tilted Cervix
A tilted cervix (the narrow part or the neck of the uterus or womb) naturally occurs in many women and is not usually a causefor concern. However, several conditions can cause the cervix to be tilted or fixed and further medical investigations may be needed.
Dr Thanga Katimada has provided a detailed insight to the condition in a separate blog she wrote in August 2022, considering exactly what a tilted cervix is and how they are diagnosed. Furthermore, she looks at associated health issues, how a tilted cervix can affect pregnancy & birth and how problems are treated: https://medicclinic.co.uk/when-is-a-tilted-cervix-normal-and-when-is-treatment-required/
Medicines and drugs
The side effects of certain medicines and drugs can affect your fertility. These include:
- Non-steroidal anti-inflammatory drugs (NSAIDs) – the long-term use or a high dosage of NSAIDs, such as ibuprofen or aspirin, can make it more difficult to conceive
- Chemotherapy – medicines used for chemotherapy can sometimes cause ovarian failure, which means your ovaries will no longer be able to function properly
- Neuroleptic medicines – antipsychotic medicines, often used to treat psychosis, can sometimes cause missed periods or infertility
- Spironolactone – a type of medicine used to treat fluid retention (oedema); fertility should recover around 2 months after you stop taking spironolactone
Illegal drugs, such as marijuana and cocaine, can seriously affect fertility and make ovulation more difficult.
FIVE REASONS THAT CAN CAUSE MALE INFERTILITY
Semen and sperm
A common cause of infertility in men is poor-quality semen, the fluid containing sperm that's ejaculated during sex. We atTHE MEDIC CLINIC provide Semen Analysis which can detect any abnormalities of sperm.
Possible reasons for abnormal semen include:
- a lack of sperm – you may have a very low sperm count or no sperm at all
- sperm that are not moving properly – this will make it harder for sperm to swim to the egg
- abnormal sperm – sperm can sometimes be an abnormal shape, making it harder for them to move and fertilise an egg
Many cases of abnormal semen are unexplained. However, there is a link between increased temperature of the scrotum andreduced semen quality, but it's uncertain whether wearing loose-fitting underwear improves fertility.
Testicles
The testicles produce and store sperm. If they're damaged, it can seriously affect the quality of your semen.
This can happen as a result of:
- an infection of your testicles
- testicular cancer
- testicular surgery
- a problem with your testicles you were born with (a congenital defect)
- when one or both testicles have not descended into the scrotum (the loose sac of skin that contains your testicles (undescended testicles))
- injury to your testicles
Sterilisation
Some men choose to have a vasectomy if they do not want children or any more children. It involves cutting and sealing off the tubes that carry sperm out of your testicles (the vas deferens) so your semen will no longer contain any sperm. A vasectomy can be reversed, but reversals are not usually successful, and it is also not funded by the NHS.
Ejaculation disorders
Some men experience ejaculation problems that can make it difficult for them to release semen during sex (ejaculate).
Hypogonadism
Hypogonadism is an abnormally low level of testosterone, the male sex hormone involved in making sperm. It could becaused by a tumour, taking illegal drugs, or Klinefelter syndrome (a rare syndrome involving an extra female chromosome). These abnormalities are diagnosed with a scan of a gland located in the brain called the pituitary gland and by testing the hormones that are produced by the same gland. https://medicclinic.co.uk/blood-tests/
Please contact The Medic Clinic if you would like to find the possible cause of your infertility and for further advice and investigations with Miss Katimada (Consultant Gynaecologist & Obstetrician). You can do this through filling in this booking form or giving us a call on 01234 984065.
The National Institute for Health and Care Excellence (NICE) recommends that women with unexplained infertility whohave not conceived after 2 years of having regular unprotected sex should be offered IVF treatment.
The NICE guidance has more about unexplained infertility. Find out more about fertility tests and how problems arediagnosed,