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Fertility and infertility

Fertility is a word to describe whether someone is capable of making a child. For a woman this refers to the health of your eggs and ability to get and stay pregnant.

For men, fertility refers to whether your sperm is healthy and potent. Most healthy people who want to get pregnant can.

Only when a woman ovulates during her menstrual cycle is there an unfertilised egg waiting for a sperm cell. Once an egg comes into contact with sperm, it becomes fertilised and attaches itself to the womb. This starts the conception process and you become pregnant.

If you have sex before you ovulate, sperm can hang around for days in your fallopian tube waiting for an egg to pop out. If you have sex after you ovulate, the egg will be ready and wait for the sperm to arrive.
But remember, having sex only at other times of the month is not a reliable way to avoid getting pregnant!

Fertile and most fertile

What’s the difference between being ‘fertile’ and being ‘most fertile’? If you’re fertile, it means you’re able to get pregnant – you’ve reached puberty and your ovaries are working properly. You’re most fertile around the time of ovulation, so you’re most likely to get pregnant if you have sex at this time.

Ovulation roulette

You can get pregnant from the first time you ovulate, so even before you have your first period. On the other hand, just because you’ve started your periods doesn’t mean you can get pregnant.

In the first year you have your periods, an egg might only be released one in five times. By the time you’ve been having periods for six years, an egg will be released nine out of ten times.

But remember, if you don’t want to get pregnant, don’t play ovulation roulette – use contraception.

Less fertile

As you get older, especially over the age of about 30, you tend to become less fertile, and eventually, you stop ovulating and having periods. On average, women are able to get pregnant between the ages of 15 and 49.

Fertility and weight

If you’re too big or too thin it can affect your chances of getting pregnant.
To get a rough idea of whether your weight could be affecting your fertility, you can work out your BMI.

BMI the complicated way
Your BMI is your weight (in kilos) divided by your height (in meters) squared. So if you weigh 72 kilograms and your height is 1.72 metres, your BMI is 72 divided by 1.72 x 1.72 = 24.9.

BMI the easy way
All that arithmetic sounds too much like hard work? Don’t worry, just go to an online BMI calculator like this one and it will do the maths for you!

Your BMI is considered to be ‘normal’ if it’s between 18.5 and 25 – though this is only a rough guide.

If your BMI is lower than about 18.5 or higher than about 28, you could be less fertile. So it’s important to eat as healthy and varied a diet as you can, and try to get your weight closer to the ‘normal’ range.

Fertility testing

So you've been patiently trying to get pregnant for 18 months or more. And you and your partner have tried all the tips. But you're still not pregnant.

You might want to start trying to find out if there’s some medical problem that’s stopping you getting pregnant.
The easiest place to start is with the man. Men often assume that it’s the woman who’s got the fertility problem if she’s having trouble getting pregnant. But it’s just as likely to be the man.

For men, it’s pretty easy to have your sperm tested to see if you’re producing enough healthy sperm. For women it takes more trouble and detective work, involving a variety of tests. So usually it makes sense to start fertility testing with the man.

Tests for men

Fertility testing for men is pretty straightforward. You need to provide a sample of sperm, and they'll check it out for you in the lab. When you visit your health professional for a fertility test, first of all, he may well want to ask you some pretty personal questions about your sex life, and also examine your genitals. Then he’ll send off a sample of your sperm to have it analysed.

Of course, you might want to say no to any embarrassing examinations and just provide a sperm sample. Though be grateful, it wouldn’t be an option for your partner to skip uncomfortable and intimate examinations!

Providing a sperm sample

You usually provide a sperm sample just by masturbating and squirting the sperm into a clean container. And if you don’t have to travel too far to the clinic, you may well be able to produce the sample at home.

If for religious reasons you object to masturbating, you can collect the sperm in a special condom when you have intercourse. And if also for religious reasons you don’t want to use a condom, you can always prick a hole in it first.

The result

The lab will give a report on how much sperm is in your semen, and how many of them are healthy – whether they can ‘swim’ well and are able to fertilise an egg.

You may find you have plenty of healthy sperm, so at least you know the problem doesn’t lie with you. But it could also be that you have relatively few healthy sperm, which makes it harder for you to get your partner pregnant.

The best thing then is to make sure you follow all the fertility tips for men – like not smoking or drinking, and keeping your testicles cool. If there are no sperm at all, then you can get medical help to find out what’s causing the problem, and see if something can be done about it.

Home testing

If you really want to avoid any embarrassment, you can now get home kits to test your sperm. These kits aren’t as reliable as a proper test in a lab. They only tell you how much sperm there are in your semen, but not how healthy they are. You can order a kit online for about $ 30 plus postage.

Tests for women

Fertility testing for women is more complicated than it is for men, basically just because there are more different reasons you could be having trouble getting pregnant. This means you might need to have various different tests.

They could include:

  • A cervical mucus test, to see if sperm can survive in the mucus at the neck of your womb.
  • An ultrasound scan to check your womb and ovaries.
  • Hormone tests to check your levels of the hormones involved in getting pregnant.
  • An X-ray of your womb and fallopian tubes to see if there is a blockage. First, some dye is injected through your cervix.
  • A hysteroscopy, when a flexible tube like a tiny telescope is inserted through the cervix to look inside the womb.

Home testing

You can also buy a home fertility test for women. This measures the level of the FSH hormone in your body, which can show how likely it is that you’ll be able to get pregnant. The test indicates how many eggs you have left in your ovaries, but it’s not necessarily very accurate.
 

Comments

Hey Liz, this can be frustrating. One of the expected disadvantage is that one won’t be able to immediately get pregnant when they stop using the injection; it may take around ten months for one to get back to your normal fertility. It is not possible to tell how long this will take for you, but going with this this maybe the time your fertility is getting back to normal and so you could get pregnant. Check out the following articles for additional information;- 

https://lovemattersafrica.com/birth-control/types-of-birth-control/shot

https://lovemattersafrica.com/pregnancy/before-pregnancy/getting-pregnant-dos-and-donts

Hi Angie, if you have been trying for over one year it is important that you now seek the services of a Specialist Gynecologist for possibly a check up and further advice. In the meantime have a look at this article for additional information;- https://lovemattersafrica.com/pregnancy/before-pregnancy/getting-pregnant-dos-and-donts

Anonymous
Tue, 06/19/2018 - 11:46
We got married in Dec of last year and we have been trying to get pregnant ever since with no success. I have never used any family planning drugs and I have never had an abortion. What other reason could be delaying me from getting pregnant. Please help, my husband really wants me to get pg.

Hello, the key to getting pregnant is getting to know when it is you are ovulating since this is the time you are most fertile hence most likely to get pregnant. Since it has been less than 12 months of trying, it should only be an issues of concern and at which point you need to consult a Specialist, if it has been longer than 12 months. Check out the following articles for more tips;- 

https://lovemattersafrica.com/our-bodies/female-body/menstruation

https://lovemattersafrica.com/pregnancy/before-pregnancy/getting-pregnant-dos-and-donts

Shikwe Tom
Mon, 07/02/2018 - 11:51
I got married to my wife about 2 years ago we have no children as of yet I am now getting much pressure from my home to bring the first born. We have tried but in vain. What can be the problem, where can we go for help?

Hey Tom, if you have been trying to get a child for longer than 12 months, it is important that you now consult a Specialist. The Specialist Gynecologist will be able to carry out tests as appropriate and then advice you on the next what to do. If you don''t know any Specialist you can go to in your location, it may help to visit a government run health facility, they will be able to refer you to one if there isn't any at the facility. We do wish you all the best. Check out this article;- https://lovemattersafrica.com/pregnancy/before-pregnancy/getting-pregnant-dos-and-donts

We have been trying to get pregnant for 9 months but I am yet to get pregnant. I am not sure what my husband thinks about this since he wanted me to get pregnant soon after marriage. Now, I overused the P2 when I was younger could this be the reason why I am not getting pregnant? What should I do?

Hey Val, it may take upto one year for one to get pregnant. This means you are still within the expected period of time. There is evidence that the use of P2 stops one from getting pregnant in the future. However, if after one year you are still not pregnant, it will be important to visit a Specialist who will conduct tests and advice you and your partner. Check out this article;-  https://lovemattersafrica.com/pregnancy/before-pregnancy/getting-pregnant-dos-and-donts We wish you well.

marrianne
Fri, 07/20/2018 - 16:28
I use depo before i ever had a child I am not pregnant after trying for close to 7 months now. My menstruation is regular. What are some of the reasons that can make this happen?

Hi Marrianne, using Depo as a birth control method will not have an effect or stop you from getting pregnant when you stop using it. One disadvantage is that one won’t be able to immediately get pregnant when they stop using Depo; it may take around ten months to get back to normal fertility. This means the immediate following 10 months after one has stopped using Depo they may not be able to get pregnant. If you just stopped using it then this is expected. On the other hand, even in normal circumstances it may take upto one year to get pregnant. You are still within time, if after an year of trying you still don't get pregnant it will time to seek the services of a specialist. Check out this article for more tips;- https://lovemattersafrica.com/pregnancy/before-pregnancy/getting-pregnant-dos-and-donts

What medicine an I take to increase my fertility? I want to be pregnant, I have been trying for 5 months with no success, pls help..😞

If you have tried to get pregnant for more than a year without success, it is important you discuss this with a doctor or a pregnancy or fertility specialist. Usually a Gynecologist will help or atleast refer to a Specialist. This will help identify any problems and help you and your partner find ways that might make it easier to get pregnant including whether or not you should use any fertility medicines. Check out the following article for additional tips;- https://lovemattersafrica.com/pregnancy/before-pregnancy/getting-pregnant-dos-and-donts

Hey Max, Safe days are one of the most unreliable ways to prevent pregnancy, and we really don't recommend it at all.   When your safe days are really depends on the length of your cycle. Technically speaking, the first seven days before and after your period, as well as the time of your period, are relatively safe. But, if you have a shorter cycle (shorter than 28 days), or an irregular one, this will vary. Also keep in mind that sperm can survive for up to five days and longer inside the body- so even if you have sex on a 'safe' day, you can still get pregnant, because the sperm survived until your ovulation date. So you see, it's a very inaccurate. And lastly, of course this won't protect you from STDs. Only condoms will. So we really recommend a more reliable method. Check out the following article;- https://lovemattersafrica.com/our-bodies/female-body/menstruation

Hi Jean, it may take upto 12 months to get pregnant, this means you are still within what is normal time to get pregnant. Gynecologists usually provide comprehensive reproductive health services and they will be able to advice on what treatment or tests one may need. Have a look at the following article for more tips to increase your chances of getting pregnant;- https://lovemattersafrica.com/pregnancy/before-pregnancy/getting-pregnant-dos-and-donts

Wycliffe Nyamwanda
Fri, 09/21/2018 - 11:41
Hi, I want to confirm if I can impregnate my wife. Have been in a marriage for 1year and there is no signs what can be the problem...?

Hey Wycliffe, there is no way to tell what could be the problem other visiting and seeking the services of a Specialist. If you have been trying for longer than 12 months, you and your partner need to visit a specialist for a check up and further advice. Check out the following article for more information;- https://lovemattersafrica.com/pregnancy/before-pregnancy/getting-pregnant-dos-and-donts

Hi,first I had a miscarriage, two months later the gynaecologist recommended I use clomid and I have used them this was the second cycle now,am expecting my menses on 14th this month,no sign of pregnancy nor menses am just feeling my body confused. What d problem.thnkx in advance

Hi, congratulations. This really depends on you and your preference. Think about when you want to get pregnant and then discuss your options with your health provide to see what options are available for you. Check out the following articles for further guidance;- https://lovemattersafrica.com/birth-control/choosing-the-right-birth-control/how-to-choose

https://lovemattersafrica.com/birth-control/types-of-birth-control

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