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When pregnancy does not come, many women wonder what they can do to get pregnant. Dr. Antonio González, head of the Obstetrics and Gynecology Service at the La Paz Maternal and Child Hospital in Madrid, reveals to us what the secrets of fertilization are from the physical and psychological point of view.
Nature has very clear paths. We must ensure the union of the two cells, the male and the female in the most natural and enthusiastic way possible. This is the great challenge and there is no trick. This is how physiology tells us to do things. However, common sense should be applied to the factors of fertilization. Fertilization, which starts with female ovulation, is centered on day 14 of a 28-day cycle.
Is there a trick or secret to get pregnant?
A trick to achieve a pregnancy would be to favor a rhythm of sexual intercourse around day 14, two days before and two days after. Having intercourse every 48 hours, for example, around the days surrounding day 14 of the cycle, with a previous abstinence period of two or three days, sets in motion the basic conditions for a new pregnancy to emerge. The woman also knows that when she has more flow around these days, she is in a better position to get pregnant than before or after the period. Therefore, it is advisable to direct relationships a little towards the fertile days to have them every 48 hours between days 10-11 and 14-15 of each cycle.
Why should we practice abstinence a few days before?
Because the concentration of sperm in the seminal fluid of man is much higher, if he has two or three days of abstinence. If the man does not have sexual intercourse for two or three days, the number or millions of sperm in that seminal fluid are higher than if he has intercourse every day.
To what extent does the psychological factor or stress influence when achieving a pregnancy?
Although there is no objective data to affirm it, we all fear that stress is a negative factor when it comes to getting pregnant and we always recommend women, who want to stay, to try to take things easy and get away from the stress that they themselves have for other causes, work, social, family, marriage or partner, which often adds the anguish of not staying when she wants. Fertility requires physical and mental rest good enough to promote health and ward off certain risk factors. Stress must be tried to manage and must be a concept to avoid in order to achieve a new pregnancy.
How long should we wait to achieve a second pregnancy after a miscarriage?
Having had one abortion is not the same as having several. Spontaneous abortion is a determining factor for women and a challenge for us as well. Normally, we do some general analysis, to exclude some diseases and when we do not find anything, that is, there is no disease, we usually recommend that you wait a reasonable period of three months to get pregnant again. Women who have already had more than two previous abortions should schedule their future pregnancy in advance. Before becoming pregnant again, they should undergo a general examination and tests to determine the most important causes that can lead to abortion.
What advice would you give to women who start to get impatient when pregnancy doesn't come?
If you have followed the basic advice to achieve a pregnancy and it does not arrive, today science can offer you a lot of help by applying the therapeutic and diagnostic techniques that assisted reproduction carries with it. After a year, when after the usual and natural methods, a woman does not achieve pregnancy, the most useful thing we can do for her is to direct her to an infertility consultation to study the cause of your infertility. Also in these assisted reproduction consultations the male factor is studied by examining the seminal fluid in terms of volume, sperm concentration, shapes and percentage of their mobility. All this influences because the causes can be of the man or the woman.
For which couples is artificial insemination recommended and for whom is in vitro fertilization?
The deeper the disorder, the more precise technique is required. Tubal problems, for example, can be treated with in vitro fertilization. But, if the entire genital tract of the woman is normal and what fails is the seminal fluid, we can capture sperm and promote the union with an egg through artificial insemination. It is advisable to choose the most appropriate technique for each case.
Can hormonal treatments have undesirable consequences on women's health?
The hormonal stimulation of the ovary, although we have it well controlled, from time to time is exaggerated and, sometimes, abnormal stimulation occurs and many cysts are formed in the ovary with a release of fluid in the woman's abdomen. In these cases, the woman should be admitted to have her under control and withdraw the medication, controlling the doses for a future cycle. On the other hand, lately it is becoming evident that hyperstimulation of the ovary at advanced ages can be, although it has yet to be demonstrated, a risk factor for breast cancer. Hormonal stimulation of the ovary at advanced ages can favor the development of homonodependent cancer.
Head of the Obstetrics and Gynecology Service
La Paz Maternal and Child Hospital
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