What is infertility?

Infertility is a disorder of the reproductive system that is diagnosed when the couple has not achieved pregnancy after one year having regular unprotected sex or if the woman has not been able to carry the pregnancy to term.

 

Is sterility a problem for women?

Sterility is a health problem. Around 35% of infertility cases are due to a woman's problem, while another 35% correspond to a male factor. In the other cases, either the cause is never clarified or the sterility is due to a problem of both members of the couple.

 

How long do you have to try a pregnancy before going to the doctor?

In general, if a woman has not reached the age of 35 and has been trying to conceive for more than a year, it is a good idea to consult an infertility specialist. If you have already reached 35, you should see a doctor after trying it for 6 months. However, if the woman has reasonable suspicions that she is sterile - for example, if she has had pelvic inflammatory disease, painful periods, miscarriages, irregular periods, etc. - or if the man knows that she produces few sperm, do not delay the consult the specialist. Many couples find it difficult to recognize that they may have an infertility problem, but it is important to know that many times there is a solution.

 

Who is the infertility specialist?

Reproductive endocrinology is the specialty of medicine that studies all the processes related to sterility. First of all, this specialist is studying obstetrics-gynecology university training, for which he must pass a 4-year residency. Subsequently, the subspecialty in reproductive endocrinology is carried out, very focused on the diagnosis and treatment of infertility and endocrine disorders in women. The final step is certification as a reproductive endocrinologist, which is awarded by passing a series of oral and written exams. In Mexico it is also called Biology of Reproduction.

 

In the field of male sterility, the most suitable experts are urologists with a subspecialty in andrology (2 years) and the corresponding specialty certification.

 

At what time of the month is the woman most fertile?

The most fertile time in a woman's cycle is the day of ovulation or the day before. Ovulation usually occurs two weeks before your period begins, so you have to count backwards from the expected date to determine the time of greatest fertility. We take the number of days that the usual cycle has (between the start of one period and the start of the next) and subtract 14. For example, if the woman has a 32-day period, she will ovulate around day 18 (32 - 14 = 18), while if your period lasts 28 days, you will ovulate on day 14 (28 - 14 = 14). We recommend having sex every 48 hours around ovulation days, that is, days 12, 14, and 16 if the woman has 28-day cycles.

It is better for intercourse to take place before ovulation than after, that is, the woman who ovulates on day 14 will conceive more easily if she has intercourse on day 13 or 14. If the woman has irregular cycles, it is advisable to have intercourse every 48 hours for more days.

If the rules are irregular, ovulation tests can also be done, which you can buy without a prescription at the pharmacy. The test consists of a test strip that is put in contact with the urine in the days around ovulation; the strip changes color depending on the result. There are also electronic tests that detect ovulation according to the levels of two hormones (estrogen and luteinizing hormone) by analyzing urine from the first day of the menstrual cycle. Both the test strip and the urine ovulation detector are very sensitive and accurate methods, so the results are reliable.

 

How does a woman know that she is ovulating?

The easiest and cheapest way to determine the approximate time of ovulation is to take your basal temperature (your body temperature at rest) each morning and record it on a graph. A basal thermometer can be purchased at the pharmacy. The graphs must be reviewed with the doctor and with three or four months taking the temperature is enough. If the temperature is higher after the middle of the menstrual cycle, the woman is most likely ovulating normally. In general, ovulation occurs two days before the temperature rises.

 

How often do you have to have sex?

A good idea is to have intercourse every other day (day yes, day no) around ovulation. Keep in mind that each woman is different and that not all of us ovulate exactly on the 14th. In the same way, having ovulated on the 14th of a month does not mean that it will be the same the following month. It is better to have sex every other day than every day, because that way the man has time to make more sperm. To facilitate conception, there is no need to wash the vagina or put on lubricants before intercourse.

 

What tests will the specialist do to evaluate my infertility?

Most likely, your doctor will order the following tests:

• In women, blood tests to study hormones related to reproduction: estradiol (E2), progesterone, follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid hormone, prolactin and also androgens.

• In men, a complete spermiogram (semen analysis).

• Hysterosalpingography (HSG): An X-ray to check the patency of the fallopian tubes.

• Ultrasound to verify that the uterus and ovaries are normal.

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How do smoking, consuming alcohol, and caffeine affect fertility?

We know for a fact that tobacco, alcohol, and caffeine are harmful to reproduction.

Alcohol and tobacco have been shown to alter the reproductive capacity of both men and women; In addition, tobacco has especially harmful toxins that affect a woman's fertility by damaging the eggs. In men there is a direct effect on the quantity, quality and functionality of sperm. In general, we advise women to consume less than 150 mg of caffeine per day, the equivalent of two small cups of coffee. Remember that sodas and tea also contain caffeine. In addition, it is recommended that women stay in the best possible physical shape while trying to conceive, always with a view to transmitting life to a healthy baby.

 

Is it true that hot tubs are bad for men?

Yes. High temperatures can damage sperm. That is why the scrotum is located outside the body, acting as a kind of "refrigerator" and keeping the sperm cooler. It is advisable for men to refrain from taking saunas, steam rooms and hot tubs while they are trying to conceive.

 

What else can I do if I want to get pregnant?

Learn as much as you can about infertility.

• Read quality information (not popular magazines) provided by the doctor, the library, or trusted friends or family.

• RESOLVE and the American Fertility Association (AFA) have more than 60 fact sheets on various infertility-related topics and run support groups on many topics.

• Other entities with interesting information on their websites are the Mexican Society of Reproductive Medicine, the Mexican College of Specialists in Gynecology and Obstetrics, the American Society of Reproductive Medicine (ASRM), the Society of Assisted Reproductive Technology (SART), the College of Obstetricians and Gynecologists (ACOG) and the Centers for Disease Control and Prevention (CDC).