QuestionHi. My fiance and I have been having unprotected sex for the last 2 years. Although we haven't been actively trying to get pregnant, we are always hoping. So far, nothing. We have sex about 2 times per week. I've never been pregnant before, and he's never gotten a woman pregnant before. I suppose what I am trying to ask is do you think this is an infertility problem, or bad luck? If it is infertility, can we start by just getting me examined? He does not have health insurance just yet, and as we are not married yet, he can't be covered under mine. I was thinking if it's me who is infertile, we could try and solve that problem and go from there. What is your opinion? I'm about to turn 30, and I don't want to wait much longer to have a child. He's 44 and I know he doesn't want to wait either. Thanks for your time!
AnswerHello Rachel,
Thanks for your question. You are still in your most fertile years. Statistically, a woman in your age group has an 85% chance of pregnancy per year of trying. That goes up to 90% at 2 years of trying. Because of that, we recommend that you begin an infertility evaluation after one year of not being successful. You are there already.
You should check with your insurance because here in California, infertility benefits are not mandated and most insurances do not cover it. Some of the testing is not necessarily infertility specific and may get covered, however. The semen analysis, which is the only test your fiance needs to do at this point, is not covered anyways. It costs about $200 for the test. It is well worth the expense because male factor is responsible for infertility in 30% of cases.
In addition, intercourse twice per week is probably not sufficient, although chance should have worked by now. There is only a 12 hour window each month when your are fertile and achieve pregnancy. If you have regular menstrual cycles, that is between cycle day # 13-17. So what I tell my patients is the following:
1. Mark your calendar when your period starts. This is cycle day# 1
2. Count the days. For instance, the next day is cycle day #2, the day after cycle day#3, etc.
3. On cycle day # 10, stop having intercourse.
4. On cycle day #13, begin intercourse daily, only once per day and only one ejaculation per episode, until cycle day #17. This is your fertile period. After cycle day # 17 you can go back to having intercourse as you desire.
I hope this helps.
Sincerely
Edward J. Ramirez, M.D.
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
