The road to conception
"It's important for couples to remember that they should enjoy the process of trying to conceive, rather than 'medicalising' it" ... Dr Debra Kennedy
Every set of parents have a story about how they conceived their child – and unfortunately, old wives’ tales and myths abound. We’re now much more public about the once very personal and private domains of sexuality and fertility, which means that couples who are having problems conceiving can be bombarded by information that can range from being balanced, informative and supportive, all the way through to being bizarre and completely incorrect and misleading.
Here are the facts: It’s known that, overall, the rate of conception is only around 15-20 per cent per cycle, and that around one in eight recognised pregnancies end in a miscarriage. Of couples who are ultimately proven to be fertile, around 70 per cent will have conceived after six months of trying, 85-90 per cent by 12 months, and 95 percent after two years.
Couples need to be committed to embarking on the journey together, and should be aware of what lies ahead of them
It’s also well known that as women get older, they have a lower chance of conceiving, as well as a greater chance of miscarrying (due to chromosomal abnormalities intrinsic to the embryo).
So the ‘hit rate’ – even for healthy couples with proven fertility – isn’t actually that high. Despite the fact that many young woman fear unplanned pregnancy, conception isn’t always that easy.
When it comes to infertility, in around 35- 40 per cent of cases the causes are related to male factors; in another 35- 40 per cent of cases, female factors are the cause. In the remaining 20-35% of cases, infertility is either unexplained or thought to be due to a combination of both male and female factors. So although many women blame themselves for their inability to fall pregnant, infertility isn't a predominantly female problem – males and females are equally ‘responsible’.
But attributing responsibility to one person or to one particular factor – for example, a low sperm count – isn’t especially helpful, either for dealing with the problems in conceiving or in terms of the couple’s relationship. It can result in feelings of guilt and responsibility, as well as anger and resentment in their partner.
It’s far better to talk about infertility as being ‘related to’, rather than ‘due to’ or ‘because of’, certain factors. In many cases, there may be a number of different contributing factors; even though investigations may reveal one particular problem, it’s certainly not always clear whether this is truly the ‘cause’ or only one of several factors contributing to the couple’s inability to conceive.
Couples who have been trying to conceive for over 12 months should see their GP and discuss their options in terms of initial health checks and investigations. Sometimes a relatively simple and treatable problem, such as abnormal thyroid function, may be detected, and treatment will improve chances of pregnancy. Older women should seek advice sooner rather than later, as maternal age is the single factor that’s most likely to determine the ultimate success of a couple’s attempts to conceive.
These couples need to be committed to embarking on the journey together, and should be aware of what lies ahead of them. They must be prepared to be as emotionally and practically supportive of each other as possible, particularly as they’ll need to navigate the challenging and time-consuming process of medical appointments, often painful and invasive tests, and possibly even IVF treatment. The whole process can be emotionally, physically and financially draining, and can place significant stress on even the most solid relationship.
It’s important for couples to remember that they should enjoy the process of trying to conceive, rather than 'medicalising' it to the point where it becomes an unpleasant chore dictated by ovulation kits and basal temperature charts.
Most couples will eventually conceive, with or without a little medical assistance. We should all be thankful that we’re living in a time when medical advances mean that the vast majority of couples will have the chance to reproduce if they so desire.