Times of India
02 October 2010

Not conceiving? Here’s why

If a young and healthy couple has been trying for a baby for 12 months without success, they must investigate the cause, preferably with the help of an infertility specialist. Some of the reasons that hinder conception are as follows:

Are you doing it right?
Assess if you are performing peno-vaginal intercourse in the correct fashion. A marriage may remain unconsummated due to:

• Lack of knowledge about how to perform peno-vaginal intercourse
• Lack of sexual attraction
• Mismatch in sexual orientation
• Difficulties in men, such as erectile dysfunction, premature ejaculation, an abnormal tightness of the foreskin, Peyronie’s disease, etc.
• Difficulties in women such as vaginismus - pain during intercourse, tight and unbroken hymen, narrow introitus, etc. If peno-vaginal intercourse is not the problem, the man’s semen is to be tested for sperm count and mobility.

Low Frequency
Conception happens only when sperm meets the ovum (egg). Each month one ovum is released by one of the two ovaries. This ovum remains available for about 24 to 48 hours. Ovulation occurs around 14 days before the first day of the next menstrual cycle. About five days before and after this day, including the day of ovulation is when there’s a higher possibility of pregnancy. If the frequency of intercourse is low, a couple might miss the day of ovulation. Remember, just a single session of intercourse can get a woman pregnant; however it needs to happen in and around the day of ovulation.

Artificial Lubricant
Artificial lubricants tend to trap sperms and do not allow them to swim towards the ovum. Moreover, many are also spermicidal in their composition.

Not Ovulating
In some women, ovulation either does not occur at all or occurs irregularly. This can be found out by a sonography. If ovulation is not occurring, there are several medical reasons and a gynaecologist should be consulted for a remedy.

Damaged Uterine Lining
The endometrium (inner lining of uterus) needs to be healthy for the implantation of the fertilised ovum (zygote) to occur. If the endometrium is damaged, pregnancy does not occur. Common causes of endometrial damage are infections, including STDs, tuberculosis, etc.

Blocked Fallopian Tubes
Fertilisation occurs in the fallopian tubes, from where the zygote travels to the uterus for implantation. For this, the ovum has to transported from the ovary through the fallopian tubes. If the tubes are blocked, the sperm cannot swim up to fertilise the ovum. Infections and tuberculosis are common reasons for blocked tubes.

Unable to ‘Hold On’
There are times, when sperm meets ovum and conception takes place, but the uterus is unable to hold on to the pregnancy due to a loose/lax mouth of the uterus (cervix) and a miscarriage occurs.

Combined Infertility
Both partners could have fertility issues, and hence as a couple cannot conceive without medical assistance. The cause in such cases is often suspected to be either immunological or genetic in nature.

Unexplained Infertility
There are instances when the above mentioned problems don’t exist, yet the couple is unable to have a baby. Up to 26 per cent of infertile couples have unexplained infertility. In these cases, abnormalities are likely to be present, but cannot be detected by available methods. Even the most experienced infertility specialist is unable to ascertain the reason and adoption is suggested.
— TNN