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What You Need to Know About Subfertility

Nov. 17, 2022 12:38 pm

Deciding you are ready to add to your family-whether it is your first baby or maybe baby number two-is a big step for any couple. Then, your well-meaning friends and family tell you to "just relax and it will happen." Unfortunately, now it has been a year of trying and it still hasn't happened. It may feel like everyone else around you is getting their positive pregnancy tests, which can be a very devastating and isolating time for any couple.

First, let's define subfertility: in a woman less than 35 years old, it is defined as failure to conceive after 12 months of regular intercourse. In a woman over 35, it is defined as failure to conceive after 6 months of regular intercourse. 15-20% of couples find out they are pregnant each month after regularly trying to conceive, and 80-85% of couples become pregnant after a year of trying. That leaves about one in five couples headed to their doctor for an evaluation of subfertility.

About 20% of subfertility is due to a problem with ovulation. A woman is likely ovulating if she gets regular periods. Other signs of ovulation are breast tenderness prior to a period, +LH surge, and a temperature spike on basal body temperature charting. If ovulation issues arise, medications can be given to help women ovulate. As we get older, our egg quality and quantity decline-there are blood tests that can determine egg quality and quantity.

Fallopian tubal damage accounts for about 15% of subfertility. Tubal damage can be caused by endometriosis, prior sexually transmitted infections, or pelvic adhesions. The fallopian tubes can be evaluated via different procedures. Male factor accounts for another 25% of subfertility. A semen analysis should be performed early in the evaluation of a subfertile couple.

Next, endometriosis and cervical factor each account for 6 % of subfertility. Some clues that a woman could have endometriosis are painful periods, pain days prior to a period, and pain with intercourse.

Finally, about 28% of couples are given the diagnosis of unexplained subfertility. This diagnosis is given after a thorough evaluation has been performed, but no cause has been found.

No matter the cause of a couple's subfertility, there are treatment options that the fertility specialists at Women's Care of Wisconsin can help with. Sometimes, a couple will get a positive pregnancy test with some education about timing of conception, medications to help a woman ovulate, or intrauterine insemination. Sometimes a couple needs a more specialized treatment plan with a fertility specialist (Reproductive Endocrinologist). No matter what your journey is to conceive a baby, Women's Care of Wisconsin will be there every step of the way.

The physicians at Women's Care of Wisconsin are devoted to you and your health. That means having the most advanced techniques, up-to-date educational information and a compassionate, caring staff. Our providers offer a well-rounded approach to your OB/GYN care, one that meets both your physical and emotional needs throughout every phase of your life. We call it our Circle of Care.

Meet our providers and learn more about infertility, gynecology, pregnancy care, midwifery services, procedures and surgery, incontinence, osteoporosis, menopause management and more at Or call or text us at 920.729.7105.

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