What are the most common problems getting pregnant?

Fertility issues affect men and women almost equally. In about 30% of infertile couples, there is a male factor, in 30% there is a female factor, and in about 30% of cases, both have a problem which means that there are combined male and female factors. The remaining 10% are due to unexplained causes (unexplained infertility). 

The following 3 problems comprise about 80%-90% of all known problems:

1. Ovulation problems
2. Sperm problems/male infertility
3. Pelvic/fallopian tube problems

Ovulation issues

The No. 1 fertility problem in women is related to ovulation. You may want to start charting your fertility and do a temperature chart to see when and if you ovulate, whether your cervical mucus is fertile, and if you time intercourse correctly. In addition, especially if you are beyond age 30, you may do Cycle Day 3 testing for the following hormones: FSH, LH, Prolactin, and TSH. These tests can help in the assessment of the quality of your eggs.

It is important for both partners to understand the problems and discuss treatments with their doctor as a couple. The process used to identify fertility problems is referred to as "infertility work-up". This is not a very complicated process and involves only a handful of tests to determine exactly where the problem or problems lie so they may be appropriately treated:

• Is there a problem with ovulation? Do ovulation tests (BBT Charting, Cycle Day 3 Hormone Testing)
• Is there a sperm problem? Do sperm tests (Spermanalysis)
• Are the tubes open? Do fallopian tube tests (Hysterosalpingogram)

Tip #1: Periconception care

When you start trying to get pregnant, see your Ob-Gyn doctor right away for periconception care. You get examined, discuss any open questions and consider getting these tests even before pregnancy. Alternatively, take the Periconception Interview to help you find out your status.

Tip #2: The $200 test every TTC couple should have

Up to 50% of infertile couples have a 'male problem' and many have lost a lot of time (and many women have undergone unnecessary testing and even surgery) before they realized that the problem was with him. As soon as you start to TTC, do a sperm analysis. It's painless (how can an orgasm not be fun?), and it saves a lot of time and frustration later on. Ask your doctor where you can do the test.

Tip #3: Take this interactive test

Take our Interactive Infertility Specialist Test to help you decide whether you should see an infertility specialist right away. After finishing the questionnaire, you should be able to decide whether you need to see a specialist or whether you can try maximizing your chances of getting pregnant first by following our outline.  

Answer these questions

1. Do you have intercourse regularly at the proper time of each month and does he usually ejaculate inside your vagina?
2. Are your menstrual periods regular and are you ovulating regularly?
3. Are your day 3 hormones (LH, FSH, Prolactin, TSH) normal?
4. Is your cervical mucus fertile around the time of ovulation or is it hostile and/or does it kill off the sperm?
5. Is his sperm analysis normal?
6. Are your fallopian tubes open (were you diagnosed with endometriosis?)
7. Have you ever had PID or endometriosis? (No is good)
8. Do your ovaries produce enough progesterone to maintain a pregnancy?
9. Do you have any uterine anomalies that could make implantation difficult? 
10. Do you stay away from drugs, alcohol, and smoking? 
11. Are you obese (BMI >=30)?

If you answered "No" or "I don't know" to any of these questions, then you should address this issue and get the necessary test done right away. Your doctor or a specialist can help you get the proper fertility tests performed in usually less than six to eight weeks.

Final step

If you do not have any of the problems listed above, then you are diagnosed with unexplained infertility.There are some treatment options for couples with unexplained infertility and you may need help from an infertility specialist to help you get pregnant.