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Blame Nature: It's Hard to Get Pregnant!


a blog by Gina Paoletti-Falcone, RN, BSN, July 1, 2010

One of the things I enjoy most about being an infertility nurse is being the tour guide through the mysterious world of reproduction. Sex education has focused on practicing “safe sex,” both to avoid unwanted pregnancy and sexually transmitted disease. But there's never been much emphasis on “how to make a baby.”

Most people assume that if they have unprotected sex, egg and sperm will get together and make a baby. So by the time you get to a fertility specialist there’s a lot of disappointment and confusion and you really need some information!

It's reassuring to realize that, as a species, human beings reproduce very inefficiently. We were not meant to conceive every time that egg and sperm are in the same place at the same time. So what do you think the chances are if you have sex at just the right time?

You may be surprised to hear that at age 30, a healthy woman has about a 20% chance of conceiving each month and by 40 her chances drop to about 5% each month.

It’s reassuring to know that in the 21 years that I’ve worked as a fertility nurse, we've discovered new information about human reproduction, developed tests that provide more information, drugs that are easier to use and laboratory techniques that have made it possible for more patients to have babies, one way or another.

One dramatic example is treating men who have no sperm in their semen sample, none, zero, nada.

In 1989 we would repeat the semen analysis, finding no sperm a second time and then have the donor sperm conversation. Today we know that some azoospermic men (no sperm in the semen) actually make sperm, but not in great enough numbers to get into their seminal fluid or have some obstruction along the way that prevents them from making it into the semen.

Urologists can now surgically extract sperm from testicular tissue (I know it sounds painful, but anesthesia is a wonderful thing!) and embryologists can wade through that tissue under the microscope and find sperm. These sperm can be “injected” into an individual egg after an IVF egg retrieval in a process called ICSI (intracytoplasmic sperm injection), allowing these men to be the biological fathers of their children.

So I hope that each of my blogs is an informative tour of one of the many topics that you might be worried or wondering about. I hope you find reassurance in my explanation and, with that, reassurance that if you hang on to the hope, you won’t be stuck here in my world forever. You will move on to bigger and better things.

If you have a question for me, you can ask it here. Perhaps I'll answer it in an "Ask a Fertility Nurse" column!

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Comments (4)

My hubby and I are trying for baby from last 3 months..I'm ovulating on time my periods are regular..v both having inter course at right time..but still I can't conceive..he has good sperm count..pls reply..

Hello Ayesha, the good news is you have a regular period and that you've been tracking your ovulation and trying to conceive at the correct time. How old are you? How old is your husband? If you are under the age of 35 it is recommended that you actively try to conceive for at least 12 months while tracking your ovulation. It is a common misconception that we conceive the first month we try. This can take time. If you are concerned and would like to discuss this further please don't hesitate to email me directly at and I will be more than happy to assist.

my wife n I have been trying to have a baby for about 5 monthes now. We have tried every thing and still no luck. One thing that hits me weid is that my wife gets her period every 2 months instead of evey month, can that affect us having kids?

Absolutely! The time from one period to the next is the length of the menstrual cycle and women get their period about 2 weeks after they ovulated an egg if that egg did not fertilize. A "normal" cycle length is between 26 and 32 days on average. If your wife only gets her period every 2 months, about 60 days, that means that you do not have a chnace for pregnancy every month because she is not ovulating an egg every month. This is a reason to see a fertility specialist to investigate why she doesn't have regular cycles. This would involve doing some blood work and can be treated fairly easily, all things being equal, by taking fertility drugs to make her ovulate.
There are other things that need to be evaluated too, like her uterus and fallopian tubes and your semen sample. But clearly having periods every 2 months is having a negative impact on your ability to get pregnant and is worth investigating so that you aren't still "trying" a year or two from now.

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