How to get pregnant [ALARM Signs]

Welcome to the second video in the series on how to get pregnant, with Dr. Liliana de la Rosa, Creafam fertility expert. In the previous video we reviewed the most common mistakes we make… But assuming that we are not making any of those mistakes, now we are going to focus on the 10 warning signs that may indicate infertility and in the next video we will analyze various treatment options .

We will go from the most obvious but less common to the most frequent but perhaps more difficult to detect. Remember that knowledge is power.

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Infertility sign 10: Having had a high-risk pregnancy

We receive many patients who when they were girls managed to get pregnant easily but now have not been able to and when we ask them about their age or the number of pregnancies or other complications we begin to suspect that they were operated on to no longer have children even without their consent.

Pregnancies are considered high risk when you have had several cesarean sections or if you had any bleeding or even if you got pregnant as a teenager. Teenage pregnancy is one of the main causes of death and complications related to pregnancy because the woman’s body is not yet completely ready for these changes, for this reason it is considered high risk and when the patient is a minor or if she is unconscious due to bleeding or anesthesia, in some institutions it may happen that parents, guardians or partners request that she be sterilized and then have her tubes tied without warning.

To confirm if the woman has undergone surgery, you can talk to her parents or guardians, request medical records from the institution where she gave birth, perform a hysterosalpingography in an x-ray laboratory or here in the same fertility consultation we can perform a hysterosonography.

Infertility Sign 9: Excessive or irregular bleeding

Having bleeding between periods or excessively heavy periods can indicate that there are hormonal imbalances or problems inside the uterus, such as endometriosis or tumors, but the main problem is that most women do not know exactly if our bleeding is within the limits. that could be considered normal or not.

Each woman is unique but periods should arrive every 28 days. If your period arrives every three weeks or takes more than six weeks to arrive, it is not normal and menstrual bleeding should last a minimum of three days and a maximum of seven. Outside of these ranges, it is not normal. It’s something normal. What is more complicated is determining if the volume is normal because the huge problem is that in order to sell more, the producers of feminine towels give their products pretty names and so we have towels with names like “mega plus night max-intense absorbent “ultra safe” that have a capacity of up to 100 milliliters. But throughout the entire period, from the beginning to the end, the woman will lose between 50 and 100 milliliters of blood in total. Please pay close attention! The total for the entire period should be between 50 and 100 milliliters. It is normal that in the first days there is more bleeding and it decreases at the end of the period, but if you are using two or three pads of more than 50 milliliters in a single day, then it is already It’s not something normal.

Please imagine that those ultra-absorbent towels, instead of having some nice name that normalizes excessive flow, will be called towels for medical use or for abnormally abundant flow.

Sign number 8: Pain during sexual intercourse

Pain during sexual relations is known as dyspareunia and of course it is not normal. The most common cases that come to consultation are women who have never had pain but a couple of years ago they started with mild pain and little by little they have increased until They can no longer stand it and it is usually some type of inflammation, endometriosis or tumors that have been growing inside the uterus. Some can be treated with medication, others with surgery depending on how much the case has worsened.

But we also received patients who had had pain all their lives but since the first time they thought it was normal, until a doctor checked them or until they had a new partner who realized that “something didn’t feel right.” and these cases are usually related to Müllerian malformations, that is, women who since birth had a smaller than normal uterus or no cervix or even cases of double uteruses.

Please, if you frequently have pain during sexual relations, go for a consultation.

Sign number 7: Secretion of milk or fluid from the breasts

When a woman breastfeeds her baby, the pituitary gland secretes the hormone prolactin, which helps the mother produce milk. Therefore, as long as the mother continues to breastfeed her baby, she will continue to produce milk and when she stops breastfeeding, in a few weeks she will stop breastfeeding. However, in addition to promoting milk production, prolactin can also cause missed periods and is a hormone that is naturally found in low levels in both men and women.

High levels of prolactin in men can cause anything from decreased sexual desire to impotence, and in women the breasts can produce slight discharges of milk or yellowish-white liquid, which is a clear sign of risk of infertility.

Sign number 6: Infertility in men

Healthy semen usually has a white and semi-transparent color with a liquid but slightly gelatinous consistency. Just as an apple changes color as it oxidizes after taking a bite, semen also begins to oxidize upon contact with air and may turn a slightly yellowish, creamy color after a few minutes. It is important to mention that both excess alcohol and tobacco consumption can promote the oxidation of semen before ejaculating, so if since the man ejaculates the semen comes out yellow, it is possibly oxidized, even if it is only a few spots. .

If you have green spots, it is very possible that there are infections, although it can also happen when deworming medications are taken. Red or brown or other colored spots are never normal and the semen must have a uniform consistency and texture. It is not normal for it to have differences in texture, nor for lumps to form or for there to be variations in color intensity or transparency. In the event of any of these signs, it is worth performing a sperm analysis.

Another sign that is often ignored in men is known as a varicocele. The testicles are supported by a kind of cluster full of very small and intertwined veins and arteries. Normally it is very difficult to see or even feel where these veins pass, but in men with varicocele the veins can become inflamed to the point that it is It is possible to see the bulge where the veins pass under the skin of the scrotum, that is, the skin that covers the testicle and in general, in both men and women, noticing swollen or varicose veins in the genital area is not a good sign. of fertility.

Infertility sign 5: Repeat abortions

One of the most complicated diagnoses to make is that of recurrent abortions because they are usually related to genetic problems with the sperm or some type of genetic incompatibility between the man and the woman, that is, she is totally healthy and he is totally healthy but when the egg and sperm are combined more with cell division and the embryo is not viable with life.

These abortions usually occur in the first weeks of pregnancy so it happens to many women that they were only a few days pregnant when something happened to the embryo and they never realized it or sometimes they do realize it… But they think that something is wrong. wrong in the uterus and that it is their fault but as I said, in reality it is something directly related to the health of the embryo.

If you have irregular periods and have had positive pregnancy tests but then your period arrives normally, it is absolutely necessary that you both go to a fertility consultation.

Sign 4: Fibroids, polyps, cysts and other irregularities

We receive many patients who have already had ultrasounds and it was detected that they have polyps, cysts or fibroids, but they are told not to worry, that it is small and they can still get pregnant but this is partly true and partly a lie because in First of all the size of these irregularities doesn’t really matter that much.

The truly determining factor is the exact location it has and secondly fibroids and polyps reduce the chances of achieving a pregnancy but also increase the risks of complications and abortions during pregnancy, so if you have already had an abortion or if you are having a hard time achieving a pregnancy and you know that you have fibroids, cysts or polyps, it would be worth considering operating on them.

Sign number 3: My tubes have already been unclugged

The tubes are very sensitive and can become blocked by anatomical malformations, infections, excess mucus or endometriosis. There are two studies that are used to see if the tubes are blocked, one of them is hysterosonography that can be performed here in the office and which is basically a vaginal ultrasound in which we introduce a little fluid into the uterus and see how far the fluid reaches. liquid, if it reaches the ovaries the tubes are permeable, that is, they allow passage and are not obstructed.

The other study is hysterosalpingography, which is more or less the same but instead of ultrasound, x-rays are used in an independent laboratory. The problem is that many people, including some radiologists, think that hysterosalpingography serves to unclog the tubes. This is an extremely common myth and I am going to explain to you what happens: When the liquid is introduced with little pressure you can see that the tubes are blocked. but perhaps the radiologist asks the patient for a little extra money to unclog her tubes and then he puts the liquid in with much more pressure, takes the x-ray and clearly shows that the tubes are already unclogged… But imagine that it is like having the nose completely blocked by the flu and someone tells them “I’m going to cure you right now, I just have to put pressure water on you with a hose.” And of course! Surely your nose is going to unblock, but it will just clog up again in a couple of minutes because that won’t cure you of the flu. So when a patient tells us “They already uncovered my tubes with a hysterosalpingography” it is a clear sign that the tubes are still blocked.

Sign number 2: Personal and family history

Considering family history sounds pretty obvious, that is, if your parents, siblings, uncles or other relatives had problems having children, it is obvious that you could have fertility problems but over the years we have discovered that sexuality and fertility It continues to be a super taboo topic even within the family itself.

We receive couples who come for the first consultation and we ask them if their relatives have had fertility problems and they tell us no, so we continue with the consultation, carry out studies, detect the problem, explain the diagnosis and provide treatment options. .. You can’t imagine the number of patients who, when they return to start treatment, tell us that they talked to their family and someone tells them “Oh! It’s the same thing your uncle had!” We have had cases in which even the parents of our patients had this problem and when they talk to them they say “I was hoping the same thing wouldn’t happen to you” or “I thought you were fine and that’s why I didn’t.” “I told you nothing.” Please talk honestly with your family and ask the specific question of whether it was difficult for them to get pregnant.

Sign number 1: We have been trying for more than six months

Finally, the most common but most ignored sign of infertility of all is having been trying for more than six months without success. We receive many patients who come and tell us “I’ve been trying for a year now” or “five years” or “I’ve been trying for ten years and I’m coming to see if I’m infertile.” But well, after six months of trying we must consider that there is a fertility problem and perhaps the problem is that we think that fertility is like turning the light on and off, that there are only two options: Either I am fertile or I am infertile, but fertility is really about possibilities.

Let’s say that the vast majority of patients have a fertility die that looks like a normal six-sided die, each month they have the opportunity to roll it once and if they get six they achieve a pregnancy. But some couples, instead of a six-sided die, have a four-sided die or they just have to toss a coin and if it comes up heads they get pregnant. Other couples don’t have as good fertility and perhaps their die has 20 sides, so it may take them several years to achieve pregnancy.

If they have been trying for more than 6 months without success, they should go to a fertility consultation. Fortunately, most of the time we discover a simple detail that can be easily fixed. See you in the next video on how to get pregnant, where we will see treatment options with which you can achieve pregnancy even in less than 40 days.

“Fortunately in the vast majority of cases, from the first consultation we can identify and resolve these signs of infertility”

Dra. Liliana de la Rosa Pérez
Dra. Liliana de la Rosa Pérez
Gynecology and Obstetrics

Reproductive Medicine Specialist
Universidad Autónoma de Barcelona

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