Child Desire: When Pregnancy Delays Coming: You have just learned that you are not pregnant. The delay in menstruation that made you believe in pregnancy had another cause, usually a late ovulation or a cycle without ovulation. This is familiar and commonplace, and your cycles, after this small incident, should usually resume their regularity. However, this does not prevent the disappointment and anxiety that this pregnancy that does not come from generates.
If you are disappointed not to be pregnant, be aware that pregnancy is less easy or longer in some women than in others. To remove the IUD, to stop taking the pill does not mean that you will be pregnant in the next cycle. It just implies that one gives oneself the possibility of conceiving. This notion of possible waiting is certainly contrary to the often general idea that birth is easily programmed, but things are less straightforward. “A child if I want, when I want to,” this slogan that had its celebrity time can mislead couples and destabilize them: “I passed the aggregation without a problem, and I will not get to have a child? ”
The impatience of couples to have a child as soon as they wish is understandable; It is often the greater, the longer the period of non-desire. It is increased by the years that pass: the biological clock is there, the women know that the possibility of conceiving has only time.
When pregnancy is delayed, it is advisable to consult after one year – a year and a half in women under 30, and after one year in those who are over 30 years old. During this consultation, to which you will be accompanied by your spouse, you will be informed of the possible factors of infertility and the means and treatments that can remedy it.
Child Desire: When Pregnancy Delays Coming: “Regular” sexual intercourse
This first condition is obvious, but it is necessary to have “regular,” which in the current way of life is not always easy. Spouses are often separated professionally, and the meeting may only take place on weekends; If, moreover, these weeks are set after ovulation, the pregnancy can delay coming. This is called “social” infertility as opposed to “medical” infertility, which is a medical intervention.
What does “regular” mean? Not once a month but not either several times a day! For this obsession with pregnancy that is late in coming and which imposes too frequent sexual intercourse can end up wearing the spouse and disrupting the effective life of the couple. Let us say that a “normal” sexuality (2 to 3 reports per week) – although it ‘s hard to speak of a norm in this field – should lead to pregnancy in the next six months for at least a quarter of the couples of Less than 30 years. However, it is not uncommon to wait a little longer. But who says pregnancy does not always say delivery: a miscarriage is possible, and it is all the more poorly lived that the pregnancy was much awaited.
This condition is usually simple to verify. If menstruation occurs regularly, for example between 26/28 and 30/32 days, it is almost certain that ovulation works well; It is not necessary to be forced to make temperature curves for months or expensive ovulation tests. Indeed when cycles are regular, ovulation is usually normal.
Some women are very naturally aware of the time of ovulation: a few hours, or even a day before, they apparently feel pain when the follicle breaks and the egg are expelled. The pain may be necessary but still short: the ovulatory disorder, sometimes accompanied by a drop of blood.
In the case of irregular cycles, ovulation disorders are likely. It may be useful to locate the time of ovulation.
The doctor may advise you to be a temperature curve to clarify if there is ovulation and when it occurs. During the cycle, there is a period of low temperature and then a period of high temperature: ovulation occurs at the time of the temperature shift.
In the case of an apparent disorder of ovulation, the doctor will prescribe hormone assays; Then, according to the results, a suitable medical treatment.
The ovulation tests: there are tests available in pharmacies that identify oneself ovulation. Their principle is to detect the appearance in the urine of a hormone manufactured by the pituitary (called abbreviated LH), responsible for triggering ovulation that takes place 24 to 36 hours later. Practically, it is best to do a test every day in the period before ovulation. As soon as the test becomes positive, you know that ovulation will take place within 24 to 36 hours.
A little-known notion: fertility
It is the probability that the egg that is “laid” is fertilizable. This probability decreases with age. Fecundability is stable up to 30 years and then decreases slightly after 30 years to fall sharply after 35 years.
The younger you are, the more you have regular sexual intercourse, and the more they take place in a fertile period, that is, before ovulation, there is a greater likelihood of pregnancy. It is considered that in the absence of medical intervention, the majority of women under 30 will have the desired pregnancy in the year. After 35 years, it will be less easy.
Moreover, yet the number of women wishing to have a child over 30 years of age increases steadily. They are then confronted with the force, almost with the urgency of their desire and with difficulty to realize it. To you who are over thirty and want to be pregnant, we say not to wait and not idealize the best time to have a child: “It will be better later, we will be better settled”, “My professional situation will be Better “,” We will really feel ready to welcome our baby “. The figures are there: the older the age, the lower the fertility.
A uterus and functional horns
In the absence of previous pregnancy, this is harder to know without a complete gynecological examination, followed by similar studies to assess the proper condition of the uterus and the fallopian tubes.
Among these exams, hysterosalpingography occupies a prominent place, at least as much as the ultrasound often requested first. It consists in injecting by the neck a product which will make opaque the cavity uterine then the tubes and make it possible to appreciate their permeability – that is to say the possibility of allowing the penetration of the spermatozoa. If they are obstructed or poorly permeable, such as gynecological infections or peritonitis, such as appendicitis, pregnancy will be delayed.
This examination may be followed by others, such as hysteroscopy (to have a view of the uterine cavity) or laparoscopy (which requires hospitalization and is performed under general anesthesia). Laparoscopy gives a complete picture of the entire maternal pelvis. In the case of anomalies on the tubes, for example, adhesions, laparoscopy can make the diagnosis and at the same time remove them. This examination is justified only if infertility does not fall within the two notions mentioned above (sexual intercourse and ovulation); And, above all, this laparoscopy will be indicated if the sperm does not present abnormalities.
Finally, the only laparoscopy can reveal endometriosis, which seems to be increasingly responsible for infertility. Endometriosis is caused by the migration of fragments of the uterine mucosa which can be fixed in the maternal pelvis, especially in the ovaries. Each cycle then develops nodules, sometimes adhesions, which cause persistent pains that are not those of ovulation, especially at the time of menstruation, and difficulties in becoming pregnant. In cases of proven endometriosis and fertility disruption, it is often preferable to consult a gynecologist specializing in reproductive disorders.
Sperm must not have abnormalities
This is not always the case and is today one of the first causes of infertility of the couple, hence the need to consult with two. Indeed all the studies devoted to sperm are concordant and show that the number of spermatozoa and their quality have deteriorated for 50 years. Probably due to a combination of factors: tobacco, alcohol, drugs, environment (industrial pollution, endocrine disruptors, pesticides, etc.), etc.
For these reasons, the assessment of infertility must begin with a spermogram, long before the woman undergo equivalent examinations unpleasant such as those mentioned above. In the case of abnormalities of the sperm, there is, unfortunately, no effective treatment, and it will be necessary to have recourse to a physician specializing in the reproduction.
The complete results showed that everything was normal: sexual relations, ovulation, uterus and tubes, sperm. However, the pregnancy continues to be delayed (2 years, even three years) and the age advances. Some couples then choose to turn to AMP (Medical Assistance to Procreation), while knowing that the use of medicine to wait for a child is a long journey.