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Infertility FactsTreatment
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Q.
My husband and I have an active sex life, we are both healthy and my
periods are regular. However, we have still not conceived ! Please help !
A. You need to
remember that it's not possible to determine the reason for your
infertility until you undergo tests to find out if your husband's sperm
count is normal; if your fallopian tubes and uterus are normal; and if you
are producing eggs. Only after undergoing these tests will your doctor be
able to tell you why you are not conceiving. While testing does cause
considerable anxiety, it's far better to intelligently identify the
problem so that we can look for the best solution.
Q. How can I
determine my "fertile" period ?
A. Your fertile
period is the time during which having sex could lead to a pregnancy. This
is the 4-6 days prior to ovulation ( release of a mature egg from the
ovary). Women normally ovulate 14 days prior to the date of the next
menstrual period. If you are mathematically challenged, you can use this
free online ovulation calendar .
Q.
My gynecologist has done an internal examination and said I am normal. Do
I still need to get tests done to determine why I am not conceiving ?
A. A routine
gynecological examination does not provide information about possible
problems which can cause infertility, such as blocked fallopian tubes or
ovulatory disorders. You need a systematic infertility workup.
Q. Do painful
periods cause infertility ?
A. Painful
periods do not affect fertility. In fact, for most patients, regular
painful periods usually signal ovulatory cycles. However, progressively
worsening pain during periods (especially when this is accompanied by pain
during sex) may mean you have endometriosis.
Q.
My periods come only once every 6 weeks.
Could this be a reason for my infertility ?
A. As long as
the periods are regular, this means ovulation is occurring. Some normal
women have menstrual cycle lengths of as long as 40 days. Of course, since
they have fewer cycles every year, the number of times they are "fertile"
in a year is decreased. Also, they need to monitor their fertile period
more closely, since this is delayed (as compared to women with a 30 day
cycle).
Q.
My husband's
blood group is B positive and I am A negative. Could this blood group
"incompatibility" be a reason for our infertility ?
A. There is no
relation between blood groups and fertility.
Q.
After having
sex, most of the semen leaks out of my vagin. How can we prevent this ?
Should we change our sexual technique ? Could this be a reason for our
infertility ?
A. Loss of
seminal fluid after intercourse is perfectly normal, and most women notice
some discharge immediately after sex. Many infertile couples imagine that
this is the cause of their problem. If your husband ejaculates inside you,
then you can be sure that no matter how much semen leaks out afterwards,
enough sperm will reach the cervical mucus. This leakage of semen ( which
is called effluvium seminis) is not a cause of infertility. In fact, this
leakage is a good sign - it means your husband is depositing his semen
normally in your vagina. Of course, you cannot see what goes in - you can
only see what leaks out - but the fact that some is leaking out means
enough is going in!
Q.
My colleagues at work tell me that if we
"work" hard at getting pregnant, and want it enough, we definitely will !
In fact, my mother in law is even suggesting that the fact that I am not
conceiving means that subconsciously I do not wish to have a baby (
because it may interfere with my career) and that this psychological
barrier is the reason for our infertility.
A. Unlike many
other parts of your lives, infertility may be beyond your control. Don't
blame yourself if you are not getting pregnant - it's a medical problem
which often needs appropriate medical treatment. The attitudes you are
encountering are often born out of ignorance - and are a kind of
"victim-blaming" - ignore them !
Q.
My grandmother says that if I just pray and have faith, I will definitely
conceive. How far is this true ?
A. Believing in
god can help you to maintain a positive outlook - but sheer will and blind
faith won't overcome a physical problem like blocked tubes or absent
sperms.
Q.
My husband refuses to get his semen
tested. He says the fact that it is thick and voluminous means it must be
normal.
A. Semen
consists mainly of seminal fluid, secreted by the seminal vesicles and the
prostate. The volume and consistency of the semen is not related to its
fertility potential, which depends upon the sperm count. This can only be
assessed by microscopic examination.
Q.
My sister
conceived only after 6 years of marriage. Does this mean I will also have
difficulty conceiving ?
A. If your
mother, grandmother or sister has had difficulty becoming pregnant, this
does not necessarily mean you will have the same problem! Most infertility
problems are not hereditary, and you need a complete evaluation.
Q.
My doctor just did a physical examination for me, and he feels that the
reason for my infertility is that my uterus is tipped backwards, and this
prevents the sperm from swimming into the uterus. He is advising I have
surgery to correct this problem. Should I go ahead ?
A. About one in
five women will have a retroverted uterus. If the uterus is freely mobile,
this is normal, and is not a cause of infertility. This is not an
indication for surgery!
Q.
My husband says we should be having
intercourse every day to achieve pregnancy. Is this
true ?
A. Sperm remain
alive and active in woman's cervical mucus for 48-72 hours following
sexual intercourse; therefore, it isn't necessary to plan your lovemaking
on a rigid schedule.
Q.
My friends
say I should have sex exactly on the day I ovulate to get pregnant. How
can I do this ?
A. Although
having sexual intercourse near the time of ovulation is important, no
single day is critical. So, don't be concerned if intercourse is not
possible or practical on the day of ovulation.
Q.
My sister in law is advising me to keep a
pillow under my hips during and after intercourse . Will this increase my
chances of conceiving ?
A. Sperm are
already swimming in cervical mucus as sexual intercourse is completed and
will continue to travel up the cervix to the fallopian tube for the next
48 to 72 hours. The position of the hips really doesn't matter.
Q.
My mother
feels I am too tense, and that if I just relax, I'll get pregnant.
A. If pregnancy
has not occurred after a year, chances are there is a medical condition
causing infertility. There is no evidence that stress causes infertility.
Remember, all infertile patients are under stress - it's not the stress
which causes infertiliity, it's the infertility which causes the stress!
Q.
I just had a HSG ( X-ray of the uterus and tubes) done, and this shows my tubes are
blocked. I've never had symptoms of a pelvic infection, so how could my
tubes get blocked ?
A. Many pelvic
infections have no symptoms at all, but can cause damage, sometimes
irreversibly, to the tubes.
Q. My doctor has
advised me to take fertility drugs . I don't want to take them because if
I am scared that if I do, then I'll have a multiple births.
A. Fact:
Although fertility drugs do increase the chance of having a multiple
pregnancy (because they stimulate the ovaries to produce several eggs),
the majority of women taking them have singleton births.
Q.
My husband's
sperm count varies every time we test it ! How do we determine what the
"real" sperm count is ?
A. Even a normal
( fertile ) man's sperm count can vary considerably from week to week.
Sperm count and motility can be affected by many factors, including time
between ejaculations, illness, and medications. There are other factors
which affect the sperm count as well, all of which we do not understand.
Q. I have no
problems having sex. Since I am virile, my sperm count must be normal.
A. There is no
correlation between male fertility and virility. Men with totally normal
sex drives may have no sperms at all.
Q.
I don't think
infertility treatment should not be offered in India, because there are
too many babies in this country already. Why should we exacerbate the
population problem by producing more? In any case, IVF treatment is too
expensive for India to be able to afford.
A. The right to
have children is a fundamental right of every human being and a very basic
biological urge. Just because a neighbour has too many children should not
deprive the infertile couple of their right to have their own.
IVF and related technologies are undoubtedly expensive, but, then, so is
heart surgery. Yet no one objects when over Rs 1 lakh are spent to try to
salvage the heart of a 70 year old man (whose life expectancy in any case
is only about 5 years and is not extended by the surgery). Why then should
medical technology not be used to help couples in their thirties (with
their whole lives ahead of them) have their own baby? In fact, IVF is a
much more cost-effective use of medical resources than a number of other
accepted surgical procedures (such as joint replacement surgery or kidney
transplants).
Q.
My semen
analysis report shows I have no sperm in the semen ( azoospermia ). Is
this because I used to masturbate excessively as a boy ?
A. Masturbation
is a normal activity which most boys and men indulge in. It does not
affect the sperm count. You cannot "run" out of sperms, because these are
constantly being produced in the testes.
Q.
My wife is
frigid and does not enjoy having sex. Could this be the reason for her
infertility?
A. There is no
connection between sexual pleasure and fertility. Don't forget that even a
woman who gets raped can get pregnant! And don't forget that the commonest
reason women do not enjoy sex is because their husbands are unskilled
lovers ! Maybe you should improve your sexual technique, and spend more
time in foreplay and in pleasuring your wife.
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