Having difficulty falling pregnant? Part 1

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Having difficulty falling pregnant? Here are 3 common conditions that need to be ruled out first: (Part 1)

It is well known that the stress and anxiety of not knowing why you are not falling pregnant can further affect and slow down your chances of becoming pregnant. If you and your partner have been actively trying for a baby for the last 6-12 months and you have not been successful, you will want to find the root cause as soon as you can. This is especially important in women in their mid to late thirties as fertility generally decreases significantly from the age of 34 onwards. In many cases diagnosis and treatment can be straightforward. As some conditions may require an extended treatment time, early diagnosis is vital so you can get the treatment you need.

If you’re having difficulty becoming pregnant, you’re not alone. Around 15% of couples haven’t been able to conceive after trying for 12 months. That’s 1 in 6 couples so it is very common. Often the causes of infertility are not what they seem. Infertility can be due to a combination of factors affecting the female, male or a combination of both partners. Not all couples that have difficulty falling pregnant require IVF – only 3 out of 10 couples that are not able to conceive will need to progress onto IVF treatment.

The following are the 3 most common reasons couples are not able to fall pregnant that should be ruled out before you go any further in your investigations:

  1. Endometriosis
  2. Polycystic ovaries
  3. Sperm abnormalities

We will investigate these in this 2 part series.


Endometriosis is a common condition affecting women in their reproductive years. It is a very common condition affecting between 10-15% of all women. The symptoms can be quite vague and the average time to diagnosis can be prolonged at 8 years or more, but it doesn’t have to be this way.

Endometriosis may run in families and therefore will be sometimes diagnosed in young women in their teenage years who present with increasing period pain or pain with intercourse. Overall the incidence of endometriosis appears to be increasing as more patients delay their pregnancies. Symptoms are often hidden by the use of the pill or other hormonal contraception.

Women of any age who present with difficulty falling pregnant, or who have problems with their periods such as pain or heaviness as well as pain with intercourse need investigation to exclude endometriosis. Symptoms can often be confused with those of irritable bowel syndrome.

Polycystic ovaries (polycystic ovary syndrome, or PCOS)

This is a disorder where the ovary is enlarged and contains multiple small cysts which can lead to abnormal hormone production. Altered ovulation can subsequently affect the cycle and reduce the chances of falling pregnant..

This condition is commonly associated with extra weight gain, acne and abnormal hair growth. Generally, diagnosis depends on the finding of multiple small cysts in the ovary as well as abnormal hormone levels. It is important to note that this condition can still be present in a large number of girls and women who are in a normal weight range but have some acne and varying cycles. There is no typical appearance that signals the presence of PCOS.

Sperm abnormalities

Up to 40% of infertility is due to an underlying condition in the male partner. Issues with sperm count, motility and morphology (normal shape) can all affect a couple’s chance of conceiving. Diet, lifestyle and occupation, as well as any past surgery, trauma, illness, or infection can all affect the quantity and quality of sperm.

If a sperm sample has been analysed and deemed as being abnormal in some way, the first line of investigations may include genetic karyotype testing, checking levels of the sex hormones FSH, LH and testosterone, and performing a scrotal ultrasound. These tests need to be undertaken by an infertility specialist for accurate interpretation of the results.

If further investigations are necessary Y-chromosome single-gene deletions and cystic fibrosis mutations may need to be assessed.

Click here to read Part 2 of this series where we discuss some additional conditions that may be adversely affecting your chances of falling pregnant.

Don’t waste time and money until you’ve investigated the underlying cause of your infertility. Contact your GP about a referral and book an appointment with Newcastle Ultrasound for specialised infertility testing that helps get to the heart of fertility issues quickly

You are also welcome to call our patient liaison coordinator Naomi on (02) 4957 3899 to make a time for a confidential chat to discuss fertility issues and ask any preliminary questions you may have.

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