Struggling To Get Pregnant? These Are Your Next Steps

In the second part of our series on fertility, Avril Flynn discusses some of the practicalities of what to do when you are having problems.

In the second part of our series on fertility, Avril Flynn, our resident experton all things pregnancy related, discusses some of the practicalities of what to do when you are having problems.
So you’ve been trying, and trying some more and still everyone else in the world seems to be pregnant except you or your partner... so what next?
First things first, and this is so important... you may be feeling incredibly lonely and believe that no one else is going through this but you are not alone.
Infertility, that is trying and NOT getting pregnant affects 1 in 6 couples in Ireland; so you know people that are feeling just like you… we just don’t talk about it enough.
Practicalities first… if you feel like you are struggling, what can you do?

First step (before booking an appointment with a fertility clinic) is that you and your partner head to your GP. As I covered in the first of my fertility series, there are many reasons why things might not have happened yet, and you need to address and understand these. Your GP can run several blood tests. For women, your GP can do blood tests at different parts of your cycle, for example on day 3 (3rd day of your period) and day 21 to check that your hormone levels are normal and that you are ovulating when you think you are.
On a personal note, and to give real hope to those of you that may be struggling: I had an ectopic pregnancy and had emergency surgery, which significantly reduced my chances of a natural conception. In fact, after my surgery, my periods went from a normal cycle of 30 days to totally non-existent! I had no idea when I was ovulating, or even if I was at all. I knew that my chances were hugely limited due to my history. 
By getting my bloods done with my GP I was able to make sure I was in all other ways healthy. Although we were never able to identify when I was ovulating, I got huge comfort knowing that I was doing something about it! And then I had my miracle. I very surprisingly, and magically got pregnant (actually it was neither: I had sex and was incredibly lucky!). So if you are struggling and have been given a bleak chance: there is always hope!
So for the female partner, a GP visit can identify that you are ovulating and that your baby-making hormones are within normal range. They can also check other things, for example, your thyroid function (TFTs) and other hormones (which can affect your ability to conceive). For the male partner again they can do blood tests to make sure your general health isn’t interfering with anything. They can also arrange to check a sperm sample.
Some of these tests your GP can arrange or they might refer you to a fertility clinic.
Sperm Samples
Although everything might seem normal, a semen analysis can identify any issues. In basic terms, a sperm sample is checked for the number of sperm, whether they are the right size, shape and swimming correctly.
Unlike the eggs women are born with, men produce new sperm constantly. If you are a man, looking after your health, cutting down on alcohol and not smoking can all improve sperm quality. Getting a sample checked can ensure that all is in working order and rule out any of those issues which, unless a laboratory checks them, you might be totally unaware of.
If all appears healthy, the next step is a more specific fertility examination. Some of these tests your GP can arrange or they might refer you to a fertility clinic.
Egg Reserve
AMH stands for Anti-Mullerian Hormone. It’s a blood test which basically gives a value on a scale; taking into account your age, and is the approximate value of the number of eggs that might be in your ovaries. This is called your egg reserve. So for example, if you are 35 and your AMH result gives a value within the normal range, this is a reassuming test to say there are plenty of eggs available.
But it is not in any way predictive, as in, people who get very low values still get pregnant and people with very reassuring values still struggle! The AMH blood test gives an indication that if you have a very low value, you might need some help.
Ultrasound Scan (USS)
Alongside an AMH blood test your GP, or normally a fertility clinic, can arrange an USS of your reproductive organs. This scan can identify that a woman’s ovaries are both present, in the right place, and can count the number of follicles (the possible number of eggs). The scan can also check your womb. There are also scans that can check if your fallopian tubes are not blocked.
Fertility Clinics
Your GP, after checking various things, might refer you to a fertility clinic. There are some absolutely wonderful fertility clinics in Ireland, but it is very important to note that the regulation around fertility medicine in Ireland is not what it should so do your research!
Find a clinic you trust, that is convenient for you and your partner to get to, that is upfront about the costs and is staffed by well-qualified and experienced fertility experts. Remember you are a consumer, you might be spending a lot of your money, time and energy with this clinic so make sure it is worth that investment.
Next week I will explain the various different fertility options that can help you get or your pregnant and I’ll also explain some of the jargon that makes it seem so complicated.

Avril Flynn

Avril is a Registered Midwife, Childbirth Educator, Hypnobirth Practitioner, Podcast and Live Event presenter and mother of one.

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