We have sexually satisfied life , Still can we be infertile ?

Infertility is inability to conceive after one year or more with regular unprotected sexual intercourse.
Many times couples coming to infertility specialist has first question in their mind that even having normal and satisfying sexual life why can’t we able to get pregnant. Are we doing it right ? Is there any problem in technique ? Are we trying at wrong time ? So many questions usually runs in their mind.

But having proper sexual intercourse is not only requirement to conceive but there are many other factors necessary to have a baby.

First we will see how normal menstrual cycle of a female works.

With the onset of menstruation , follicles start to grow in ovaries and by 5th or 6th day , only one dominant follicle appears in either of ovaries and it grows and ruptures at around Day 14 or 15 of cycle (varies from day 12 to day 17) called OVULATION and releases oocyte which is picked up by fimbriae and transferred inside fallopian tube where it awaits for around 12 to 24 hours to get fertilized by sperm (fertilization window). Usually sperm stays alive in uterus for around 48 to 72 hours. During this period sperm fertilizes oocyte and zygote is formed which grows further to form baby. Majority of pregnancies occur when intercourse takes place within 3 days prior to ovulation.

Now we will discuss problem which usually can occur even in normal couples.

1) Timing of intercourse-

If intercourse happens at and around the time of ovulation then and then only sperm can fertilize the egg resulting in pregnancy. If couple misses that window of time for fertilization then they will loose chance of pregnancy. So timing of intercourse with respect to ovulation is most important prerequisite for normal couple to get pregnant.

2) Problems related to Sperm –

Low sperm count or low quantity of semen , absence of sperms in semen , immotile or decreased motility of sperm, abnormal morphology of sperms , highly viscous semen are various defect commonly seen in men. Usually even if a male has these problems he may have a normal sexual life. These
problems in a one way or other prevent sperm from reaching fallopian tubes and prevent fertilisation of egg and hence reduces chances of pregnancy.

3)Problems related to Ovary/Ovulation-

Various diseases affecting ovary like Polycystic ovaries , Tuberculosis , Endometriosis , low ovarian reserve , recurrent cysts hinder the process of follicle growth , maturation and ovulation which in turn decreases chances of fertilization.

4)Problems related to Tubes –

Blocked fallopian tubes ,infections in tubes resulting in hydrosalpinx/ pyosalpinx , congenital absence of tubes etc prevent fertilization of egg and sperm resulting in infertility.

5) Problems related to Uterus-

Congenital anomalies of uterus like unicornuate , bicornuate or septate uterus can also cause infertility. Other diseases like fibroid , adenomyosis , thin endometrium , polyps prevents implantation of embryo in endometrium resulting in infertility.

All these problems we discussed might not significantly impact sexual life of these couples and couple may not be aware of these problems as they are having normal sexual life. Therefore if a couple inspite of having normal sexual life, not able to get pregnant should visit infertility specialist for further investigation of their case and diagnosis of underlying problem.

Timely detection of infertility and it’s treatment can help couple to fulfill their dream of becoming parents.