Examination by a doctor
To find out why, it’s important to look at the most common causes first. The doctor will be interested in knowing whether the woman has irregular periods or sometimes misses them altogether.
Does she experience pain during menstruation?
Perhaps the diameter of the fallopian tubes has been reduced due to a previous infection? The doctor may refer the woman to a gynecologist, who will be able to establish whether this is the case.
Regarding the man, a general examination of the sperm quality will be carried out. Is a sufficient number of sperm present? And can they swim?
However, for many couples, the doctor’s examinations will not be able to explain why pregnancy does not occur.
What is the explanation?
In order to understand your problem, it is important to think outside the box:
Fertilization of the egg almost always takes place unless the man’s sperm quality is extremely low.
The normal examination of sperm quality does not examine the DNA in the sperm cells – this is a significant shortcoming!
The latest research shows that the most frequent cause of a failed pregnancy is the early death of the fertilized egg. The calculations indicate that approximately 40 to 60% of all fertilized eggs die (Jarvis 2020).
If the egg dies before it can attach itself to the uterus, the pregnancy test will never be positive.
If the egg manages to attach itself to the uterus, but then dies, a miscarriage will occur.
Extended investigation
When a fertilized egg dies, it is mainly due to genetic damage, a large proportion of which originates in the sperm cells.
If the sperm’s DNA is fragile, it can break, which causes small changes to the DNA in the fertilized egg, which are called ‘point mutations’ (Aitken 2022). More extensive damage to the sperm’s DNA (fragmentation) may contribute to minor chromosomal changes in the egg (Marchetti and Wyrobek). Both types of damage can cause the fertilized egg to die.
To determine whether the sperm’s DNA is fragile, a sperm DNA integrity test (SDI® test) should be performed.
Your fertility journey
Fragile DNA in the sperm cells is a very frequent cause of reduced fertility and is seen in approximately half of childless couples. The problem can have a major impact on your fertility course as it also reduces the likelihood of achieving pregnancy with the various types of fertility treatment.
Some couples have experienced years of disappointing fertility treatments because of this problem. For example, you can read Søren and Mirah’s story.
An SDI® test should be considered as soon as you start to become frustrated because the desired pregnancy has not yet occurred.
In many cases, the man’s fertility can be improved once the cause has been identified. Improved fertility may mean that you can achieve the desired pregnancy naturally.