Problems getting pregnant: causes and solutions

If you and your partner decide to have children, most couples assume that they will be pregnant within six months or a year. Unfortunately, this does not apply to everyone. You may be infertile or have problems with your fertility. That does not mean that there is no longer any chance of having a child. IUI, IVF, ICSI, egg donation, KID and surrogacy are the most common options.
One in six couples in the Netherlands who want children takes more than a year to become pregnant . There may be several reasons why there is reduced fertility or infertility. In thirty percent of the cases the cause lies with the woman, thirty percent the cause lies with the man and in thirty percent of the cases the cause lies with both. In ten percent of all cases the cause is unknown.
Most women in the Netherlands have their first child around the age of thirty, while women already become less fertile after the age of 27. Men do not have this problem: they can, in principle, father children their entire lives. A cause of reduced fertility may therefore be due to the age of the mother.

Overweight, smoking and drinking

Another cause is if the woman is overweight, smokes a lot, drinks or uses drugs. All these things affect your hormone balance , making it harder for you to get pregnant. Other hormone disorders such as PCO syndrome, menopause or thyroid abnormality also complicate the chance of pregnancy .
A disease can also play a role in reduced infertility. Like chlamydia, the most common sexually transmitted infection (STI). This STD is treacherous, because as a woman you do not have to notice that you are a carrier of this disease. Chlamydia can cause fallopian tubes to narrow or become blocked.
Of course, there are many more causes conceivable, including in men. The cause will have to be determined by a doctor.
Then the possibilities will automatically be discussed . And there are several:


Intra Uterine Insemination. During this treatment, the sperm is processed and injected high into the uterus when the egg has entered the fallopian tube. This treatment is effective if there are no identifiable causes for the failure of the pregnancy or if the man’s sperm quality leaves much to be desired.


In vitro fertilisation. This treatment goes a step further than IUI. By means of hormone stimulation, several eggs are brought to maturity at the same time. These are then removed from the body and combined with sperm in the laboratory. If successful (fertilization of the eggs), two embryos are placed back in the uterus.


Intra Cytoplasmic Sperm Injection. This works in much the same way as IVF, but one sperm cell is injected directly into the egg in the laboratory . In the Netherlands, one in 43 children is processed via ICSI or IVF.

Egg donation

If a woman (intended mother) no longer has eggs, she can ask for a donor. That donor undergoes the same treatment as with IVF, so that several eggs are matured at the same time and can be removed from the body. The egg can then be fertilized with the sperm of the intended father, after which the embryos can be transferred to the intended mother.


Artificial Insemination with Donor Sperm. This is a solution for couples where the man has reduced fertility or is infertile. The sperm then comes from a donor and is injected into the woman’s body by a doctor.


Surrogacy can be done in two ways. The simplest way is for the intended father’s sperm to be injected into a surrogate mother, who will carry the child during the pregnancy.
High-tech surrogacy (HTDM) is only possible if the quality of the eggs and sperm of the intended parents is good, but the woman is unable to carry the pregnancy to term herself. With HTDM, fertilization takes place via IVF, after which the embryos are placed in the uterus of the surrogate mother. This means that the child is genetically related to the intended parents.

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