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Infertility FAQS from the Malpani Infertility Clinic.
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.
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. 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
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
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 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.
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 mature 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.
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 from masturbation,
because these are constantly being produced in the testes.
Contributed
By: Dr Malpani,
Malpani
Infertility Clinic, Jamuna Sagar, Shahid Bhagat
Singh Road, Colaba, Bombay 400 005. Tel: 91-22-2151065,
91-22-2151066
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