A 25-year-old couple with no health issues has a 25% chance to achieve a pregnancy within the first month, a 70% chance within 6 months, an 85% chance within one year and a 95% chance within two years.

As the numbers and quality of eggs drop as women age, in the case of a woman over 35 the necessary period to achieve a pregnancy will be longer. At the same time, after this age, the risk of endometriosis, uterine fibroids and miscarriage is higher, with an impact on achieving a pregnancy. For instance, in women over the age of 38, about 50% of pregnancies end in miscarriage, as opposed to 10% in 25-year-old women.

To improve the chances of achieving a pregnancy the natural way, a couple is advised to have sexual intercourse every 2-3 days, particularly during the fertile period. Once the egg has been released by the ovary, it survives for up to 24 hours and can only be fertilised by the sperm cell during this period. There are several ways to monitor ovulation, but you don’t have to make a goal out of it, since anxiety is counterproductive and may affect your relationship with your partner.

Ovulation is associated with regular menstrual cycles at an interval of 28±5 days. If a woman has irregular cycles, we can often say she doesn’t ovulate constantly and naturally. Ovulatory dysfunctions occur because of the ovary, or the signal sent by the central nervous system to the ovary. In order to determine the origin of the ovulatory dysfunction, a series of specific tests are available.

Infertility is defined as the inability to achieve a pregnancy after one year of regular sexual intercourse without using contraceptive methods. Before a couple conclude they are infertile, they should first know the definition of “normal fertility”, i.e. a couple’s ability to conceive naturally within 2 years of regular intercourse. Of the total number of couples who have not conceived within a year, almost half will conceive naturally the following year. If the partners are young, the odds are higher. However, in the case of couples over the age of 35, one more year of waiting may be too late to start tests and any treatment. A woman’s fertility drops after the age of 35-40, and her egg reserve ages

Infertility has many causes involving the reproductive system of the woman, the man or both partners. The most frequent causes are:

• Fallopian tube problems
• uterus and/or cervix problems
• ovulation problems
• male reproductive system problems

Infertility is a couple problem: no matter which partner has a medical issue, the cooperation of both partners is essential to increase the success rate.

In about 40% of the cases, infertility is due to male dysfunctions: changes in the testicular area, obstruction of seminal ducts, prostate conditions, ejaculatory changes, erectile dysfunctions or changes in the seminal fluid.

In other 40% of the cases, infertility is due to female dysfunctions such as early menopause, endometriosis, obstructions or wounds of the Fallopian tubes, cervical or uterine anomalies, as well as ovulatory problems

After one year of regular intercourse not resulting in a pregnancy, the couple should begin to suspect that they might have some sort of dysfunction. It is recommended to see a doctor in one of the following situations:

• irregular menstruation or lack of menstruation
• history of repeated infections in the genital area
• history of complex surgical interventions
• intense menstrual pain and heavy menstrual flow
• two or more miscarriages or pregnancies stopped in evolution
• history of Chlamydia or Gonorrhoea infections in one or both partners
• trauma, accidents, surgical interventions in the man’s genital area
• mumps at adult agea
• premature ejaculation, erectile dysfunctions
• woman over the age of 35
• menopause installed earlier than the age of 40 in someone in the family (grandmother, mother or sister)

There are some natural or alternative treatments that a couple can use, depending on the fertility problems they are facing. The best known are acupuncture, homeopathy, medicinal plants, a special diet, reflexotherapy, cranial osteopathy, or stress management. We have to point out that structural problems (missing vasa deferentia, Fallopian tube conditions, etc.) that cause infertility can only be treated by using other medical techniques.

The World Health Organization estimates that, on average, one couple in six is facing infertility problems.