While most of us may think that when it comes down to it we’ll be able to have a baby with no trouble at all, encountering fertility problems can be a very real hurdle for a lot of couples. In fact, in about 20% of infertility cases, there can be no direct cause established (IVF can be particularly helpful in such cases).

There are some quite common issues, however, and we will cover those here. Since most people who do not have underlying fertility problems will be able to get pregnant within a year, if it’s taking you longer than that it’s a good time to contact your healthcare providers. They will be able to refer you to a fertility specialist, who will explain you how to have a baby despite these very common fertility problems.

Trouble with Ovulation

This is where it begins, because if you are not ovulating (either at all, or regularly), you simply will not get pregnant. Your healthcare provider will be able to carry out the necessary tests to find out the source of the problem and will evaluate whether or not you are suffering from any conditions that commonly cause ovulation interruption, such as Polycystic Ovary Syndrome (PCOS). PCOS causes cysts on the ovaries, which often stops eggs from reaching the fallopian tubes (wherein they would travel to your womb, and attach as a pregnancy). You may have this condition if you experience disproportionate hair growth, acne, have erratic or faint periods, or if you’ve gained a lot of weight.

Many women successfully overcome their PCOS and go on to deliver healthy babies. Your doctor will suggest a combination of weight loss, fertility drugs and treatments, and hormone therapy. Some women are good candidates for laser treatment on their ovaries. Even if your ovulation issues are not PCOS-related, your specialists will use these measures to best stimulate your ovaries into working correctly. You may be offered fertility treatments such as in vitro fertilization (IVF) or intrauterine insemination (IUI).

Whether or not you are suffering from PCOS, you may be advised to lose some weight and start living a healthier lifestyle with a balanced diet. Being overweight can greatly affect your chances of getting pregnant. You should consult your doctor to determine the ideal weight for you and take care not to become too underweight either, as it will have a similarly negative impact on your wish to have a baby.

Trouble with Sperm

Oligospermia, or low sperm count, is one of the fertility problems that can be slightly easier to overcome (as is asthenospermia, or sperm that isn’t very fast). He may find that losing a little weight and consuming less alcohol will reverse the problem. If it doesn’t, it may be the case that his problems are a little more complex than first thought. His doctor will examine a sperm sample (if ejaculation is not possible, it can be collected directly from his testes), and is then able to extract the fastest, most mobile sperm. Using IUI, his best sperm can then be injected directly into your uterus when you are ovulating. You will most likely be given a hormonal injection to give your egg the best chance of being fertilized by his sperm.

Sometimes, however, there are not sufficient healthy sperm in a semen sample to qualify for an IUI. In this case, an intracytoplasmic sperm injection (or ICSI) could be an option. It’s a difficult and lengthy process, during which the woman must undergo extensive hormone treatment to make sure she releases as many eggs as possible (which must then be harvested from her). If he does not produce any sperm at all, and is wondering, “But how can we get pregnant now?”, it may be time to consider a sperm donor.

Endometriosis

Within your uterus, there is a tissue called the endometrium. When you have endometriosis, this tissue can begin to grow outside of your womb, usually on your ovaries or the lining of your stomach. This condition can be extremely painful and is usually at its worst when you menstruate. It’s possible to have treatment to deal with the endometriosis, but this is separate from handling the infertility it can cause (though it may help). If the growing endometrium has obstructed your fallopian tubes or ovaries, IVF may be necessary to conceive.

Fallopian Tubes

When your fallopian tubes are blocked, it means that eggs cannot travel successfully from your ovaries to your womb. The blockages can have many causes: endometriosis (which we just talked about), fibroids (which we will cover in a moment), or complications from a previous procedure in that area. Since the egg cannot reach the safety of the womb, it will sometimes attach to the lining of the fallopian tubes, and if it is fertilized this will cause an ectopic pregnancy. If just one tube is obstructed, you still have a chance at getting pregnant every second month, as you still have one tube that’s open. Sometimes all it takes is a simple surgery to remove a part of the tube and restore it to function, although if it is more complicated, IVF may be the best option. In this eventuality, the sperm and egg will be extracted from the partners, mixed in a lab, and a couple of fertilized eggs are transplanted back into the woman’s uterus, thus bypassing the fallopian tubes altogether.

Fibroids

Fibroids are benign tumors in your uterus and can be extremely painful, especially during sex. They also cause excessive bleeding during menstruation, and if ignored will just continue to grow. Fibroids are not exactly the cause of infertility, but because they grow within your womb they can hinder pregnancy greatly or even prevent it completely. If you are diagnosed with this condition, you will be offered drugs to minimize the fibroids, and they can also be surgically removed.