You’ve decided that it’s time to start a family. You wait with growing excitement and impatience for signs that you’ve conceived. If nothing happens within six months you’ll probably start to worry. Is something wrong?
Couples who decide that they want a baby may assume that if they stop using contraception, pregnancy will soon follow. But it doesn’t always happen so quickly and easily. Only one in four couples will achieve a pregnancy in the first month of trying. After six months, about six out of ten will have conceived; nine out of ten after 18 months.
The medical definition of subfertility is failure to conceive after 12 months of regular sex without contraception. Primary subfertility describes those couples who have never had a pregnancy; secondary subfertility is used when a couple has had one or more children but has trouble conceiving again.
These days the term ’subfertility’ is used because no couple is assumed to be infertile until a cause that can’t be corrected is found. Advances in knowledge of reproduction and in medical skills now make it possible to help most couples who have problems with conception. But discovering that they can’t have a baby without medical help can have a profound effect on many aspects of a couple’s life. Having children is bound up with strong instincts, a sense of self-worth, life goals, plans and dreams, the attitudes oft, friends and society, and the con relationship.
Discovering subfertility may be a blow. One young woman lamented:
When we married, having children was a definite part of our plans. The question was not if
but
when. We worked hard to buy a house and establish ourselves financially so that everything would be right for us to start a family. But
the children we presumed we would have never arrived. Our dreams were shattered.
Reactions to the first shock often hard for a couple to talk to each about the problem, let alone decide they want to do about it. Each may wondering who has the problem, and dreading knowing the answer either way.
When to get help
There is no set time for starting to for the reasons and possible remedies subfertility. Twelve months is often quoted, but couples wanting children will have become worried about their fertility a year is up; for many, after a few months every period is a major disappoint. Probably the best time is when you feel you have waited long enough for nature to take its course and you want to know whether there’s a problem that could be corrected. Ideally you should both attend the first visit to the doctor.
Some reasons for consulting a doctor earlier rather than later may be:
• when you are over 30 and feel that you have limited time left
• if you have irregular periods (which means you’re not ovulating regularly)
• if there’s anything in the medical history of either you or your partner that might be suspected as a reason for subfertility.
Before going for medical help it’s a good idea to discuss how far you’re prepared to go to have a child. Some couples draw the line at surgery; others may want to try anything that could help them to conceive. You could change your mind either way after the various investigations and procedures have been explained to you.
Where to go for help
Your family doctor or obstetrician is usually the first port of call, or you may go to a fertility clinic (in all the major women’s hospitals) or a family planning clinic. There are also private clinics in the capital cities that provide special tests and treatments. Most clinics have highly trained counsellors who will give you information, answer your questions and help with any problems that arise.
Expert counselling is of great help in dealing with initial reactions. Experienced counsellors are skilled at allowing you to express your emotional reactions. Couples who understand each other’s feelings usually manage better at tackling the problem and making decisions together. Talking to other couples with the same problem may help, and most fertility clinics organize groups for this purpose. There are also community support groups for subfertile couples.
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