It seems that everything is in order with health, for the partner too, and there is still one strip on the test. With what this may be due, says the candidate of medical sciences, associate professor of the course of private endocrinology at the Department of Endocrinology, FUV Moscow Regional Research Clinical Institute. M.F. Vladimirsky (MONIKI), endocrinologist Irena Ilovaiskaya.
The average age of a Russian woman who becomes a mother for the first time is constantly increasing and has already crossed the 26-year mark. This is associated with the desire to strengthen the financial situation and build a career. But now an education has been received, there is a good and stable job, a reliable life partner is nearby, ready to share the joys of parenthood, but the desired pregnancy does not come. And this is a reason to contact your endocrinologist and ask him at least five important questions.
1. Do bad habits, in particular smoking, negatively affect the possibility of getting pregnant?
Alas, this is not a myth, but a medical fact. Smoking is a powerful factor in reproductive disorders: the incidence of infertility among women who smoke is much higher than among non-smokers, while 10 percent of women of childbearing age in our country smoke. Under the influence of nicotine, a woman’s fertility decreases, and the aging process of eggs is accelerated. With every cigarette smoked, the chances of successful conception are reduced and the chances of early menopause increase. If you still succeed in getting pregnant, then complications are possible already during pregnancy. In addition, the baby can be born weak, with a bunch of various deviations that will remain with him for life.
“A woman planning a pregnancy should quit smoking at least 3-4 months, and preferably a year before the expected conception,” says endocrinologist Irena Ilovaiskaya.
2. I have no health problems, I lead a healthy lifestyle, but pregnancy does not occur in any way. Could constant stress at work affect fertility so much?
Modern women underestimate the fertility effects of a busy life schedule, high physical activity and stress at work. In such a situation, the organism itself, which is actually fighting for survival, turns off all secondary functions, including reproduction. The phenomenon of “wartime amenorrhea” is known – the failure of the menstrual cycle or the complete absence of menstruation due to severe shocks, exertion, poor nutrition and constant stress. Now, however, it has become characteristic of peacetime as well.
“We are increasingly faced with stressful infertility – when there are no health problems, but conception still does not occur. And it often happens like this: as soon as a couple stops harassing themselves with worries, consultations with doctors and tests, they stop “trying” and, for example, go on vacation to give themselves the opportunity to breathe calmly, everything works out! Therefore, for women who do not have health problems, but who cannot get pregnant, we recommend adjusting their lifestyle – avoiding excessive sports and workloads, walking more, admiring nature, playing with young children – “tune” their body to conception and the forthcoming motherhood, ”says Irena Ilovaiskaya.
3. Maybe it is worth having a detailed medical examination before pregnancy?
“I am not a supporter of prescribing generally healthy people without bad habits or an identified predisposition to diseases, without any complaints, too detailed examinations. In such cases, the individual characteristics of the organism are often revealed – by themselves they are not a problem or a disease, but the fact of their detection can give rise to unnecessary anxieties and cause additional psychological problems when the patient is unnecessarily fixated on his health, ”emphasizes Irena Ilovaiskaya.
If a woman decides to become a mother, she should first visit a gynecologist. He will draw up an examination algorithm and recommend specialist doctors: you have to visit an endocrinologist, cardiologist, allergist, and pass certain tests. Based on the results of the collected anamnesis, you may have to talk with a geneticist and other narrow specialists. Best of all, if the future father of the child undergoes a medical examination in parallel, the doctor will prescribe his own list of tests and specialists.
4. When should potential parents start worrying about the inability to have offspring?
If both parents-to-be are healthy and have an active sex life without contraception, doctors determine such a period as a calendar year. You should not panic in this situation, perhaps, “the stars have not yet formed”, but still, after a year of attempts to conceive a child in the absence of obvious medical problems, it is worth undergoing additional diagnostics. Perhaps there are latent endocrinological disorders.
“Today it is customary to postpone the implementation of reproductive plans, however, the older people are, the more time it takes to successfully conceive. Between the ages of 20 and 30, the likelihood of pregnancy within a year of “attempts” is 92 percent, and then it drops to 60 percent. An important milestone – 35 years old: fertility decreases critically, not only in women, but also in men, and the likelihood of genetic abnormalities in a child also increases. Therefore, future parents at this age are advised to see a doctor after 6 months, so as not to waste precious time, ”advises Irena Ilovaiskaya.
5. Does the presence of endocrine diseases really affect reproductive health?
Endocrine infertility is one of the most common causes of female infertility. Endocrine factors can lead to hormonal disorders, for example, an increased production of prolactin by the pituitary gland leads to malfunctions of the reproductive system, and menstrual irregularities can occur. Thus, if menstruation occurs less than once every 38-40 days, then there is a serious reason for hormonal examination. For example, you can donate blood to determine the level of prolactin.
“Endocrine factors are also manifested in the violation of ovulation. If, according to the results of the examination, a woman has a rare ovulation or it is completely absent, the doctor will prescribe an appropriate examination, according to the results of which an individual treatment will be selected. As a result, spontaneous ovulation will be restored or it can be stimulated. Such therapy can take from several months to a year, but the result – a long-awaited healthy baby – is worth the time and effort spent, ”Irena Ilovaiskaya is sure.