Feeling pregnant: what to do if your baby is slow to arrive?

Getting pregnant can sometimes take longer than expected. It’s not easy to be patient. When should we worry? To whom should we turn? What is the sterility check-up? We take a look at Dr François Olivennes, obstetrician gynaecologist (Paris) and author of the book “Faire un enfant au XI ème siècle” by Flammarion.

Step 1: Make love often

To boost your chances of conceiving, it is important to have regular sexual intercourse. Health professionals estimate that the frequency of your intercourse should be at least twice a week for about 6 to 12 months. So don’t deprive yourself of a hug with your darling….

Tips: Check your medical history with your gynaecologist. They can affect fertility. In women: a genital infection such as salpingitis (inflammation of the fallopian tubes), endometriosis, cancer, belly surgery (complicated appendicitis) or irregular cycles can be a cause of infertility. In men: STDs (sexually transmitted diseases), cancer or testicular abnormalities can also affect fertility. If this is your case, your gynaecologist will refer you to a fertility specialist to establish a sterility assessment of your couple (step 4).

Discover our 10 tips to boost your fertility

Step 2: Choose the planned sex

If you have difficulty after 6 months of regular sexual intercourse, use an ovulation test. This test allows you to detect your peak ovulation to maximize your chances of getting pregnant. Try the experiment for three or four months in addition to regular sexual intercourse.

Tips: how to calculate my ovulation date? Although the length of the menstrual cycle varies among women (28 days on average), the post-ovulation phase, the luteal phase, always lasts 14 days. To calculate your ovulation date, you must therefore subtract 14 from the total duration of your cycle. If you have a longer cycle, for example 31 days, your ovulation date will be the 17th day after the first day of menstruation, so take the opportunity to cuddle on that day, but also 2 days before and 2 days after to boost your chances!

Step 3: Still nothing… Consult

After a year of regular and planned sexual relations (6 months, if you are over 38 years old), it is time to make an appointment with a specialist with your partner. Even if a gynaecologist can take care of you, prefer a sterility or infertility specialist.

Step 4: Establish a balance sheet of the couple

The specialist will first perform a sterility test of the couple. This health check will make it possible to target the causes of possible infertility through three questions.

– Is a woman’s ovulation “normal”? To do this, the doctor prescribes an ultrasound and a hormonal dosage (blood tests) to get an idea of the state of ovarian function.

– Are women’s genital tract “normal”? To check that there are no abnormalities in the cervix and cavity of the uterus and fallopian tubes, hysterosalpingography must be performed. This is a radiological examination, which involves the genital injection of an iodine-based contrast agent that opacifies the uterine cavity and the fallopian tubes. Several radiological images are then taken as they are taken to follow the product’s progress.

– Is a man’s sperm “normal”? A spermogram will be used to reveal a possible problem. The examination is carried out in a medical analysis laboratory and aims to quantify normal and abnormal spermatozoa, study their movements and shapes.

It will take about 2 months to be sure of your couple’s situation.

Step 5: Diagnosis and possible treatments

Once the sterility test has been carried out, three categories of couples can be distinguished. New approaches can be considered to conceive a child.

– All tests are normal. This is unexplained sterility. Depending on your age, you may be redirected to assisted reproduction (ovarian stimulation, insemination or IVF).

– The tests revealed a cause that can be cured. For example, blocked tubes or an adenoma… You may have an operation or have a specific treatment to be treated. Once recovered, it is quite possible to have a natural pregnancy.

– Your couple must have recourse to medically assisted reproduction. First step, ovarian stimulation. The objective? Stimulate follicle production to optimize the chances of pregnancy. There are two types of treatments: taking tablets (anti-estrogen drugs) and hormone injections. These treatments are often recommended when infertility is related to a lack of ovulation or irregular ovulation in women or in addition to insemination. Tablet treatments are to be taken during the cycle. They will induce the secretion of FSH, the hormone responsible for the increase in follicles, thus stimulating the ovary. Hormone injections, on the other hand, directly affect the production of follicles in the ovary. You will have to inject yourself into the fold of your stomach. Hormone injections are a heavier treatment that induces increased monitoring (ultrasound scans and regular hormone dosages).

If after several cycles there has been no pregnancy, artificial insemination can be offered. It is also proposed in case of cervical abnormalities or cervical mucus (which block the passage of sperm), a decrease in sperm quality or ejaculation or erection problems. This second step consists of introducing a thin catheter into the uterus to deposit the sperm. A simple and painless gesture. The arrival or not of menstruation and the performance of a pregnancy test then make it possible to indicate whether or not the insemination was successful. Please note that there are no specific waiting times to start an insemination again.

After 4 to 6 months of medical assistance without results, in vitro fertilization (IVF) can be considered. It is the fertilization of eggs by sperm (from a spouse or donor) but outside the woman’s body, i.e. in a laboratory. One or two embryos (resulting from this fertilization) will then be reintroduced into the uterine cavity.

A book to put things into perspective

Through this comic book, discover the difficult journey of a woman for whom the desire for a child does not rhyme with immediately… Between humour, self-derision and tenderness, the author revisits the clichés about pregnancy: from irregular cycles, to difficult couple situations, to the great test of the test tube!