So you want to havea baby…

The inability to conceive can exact an emotional, physical and mental toll on the best of relationships. While creating a baby takes two, many times it is the woman who is considered at fault. The pressure to conceive is likely to affect a woman’s self esteem and sense of worth, as womanhood is very often equated with motherhood. For some women, the need for a child can become obsessive. This obsession can lead to a disjointed approach in the search for answers that often times has one running around in circles. A methodical sensible approach is available, but it involves both partners.

Dr Jonas Reid, general practitioner, told All Woman that, “determining whether a couple can conceive is a pretty basic format. In a nutshell, fertility is a problem that faces the couple and not just the woman. The first thing a doctor needs to know is the general health condition of both partners”.

According to Jonas, the inability to conceive can be caused by the following factors:

– Endometriosis

– Uterine fibroids

– Pelvic inflammatory disease

– Blocked Fallopian tubes from an infection or previous surgery

– Sexually transmitted diseases such as chlamydia or gonorrhoea

– Painful or irregular periods

– Excessive facial and body hair

– Pelvic or abdominal surgery

– DES exposure in utero (a drug given to pregnant women between 1941 to 1971 to prevent miscarriages)

– Chronic illnesses such as diabetes, cancer, or thyroid disease

Or if you currently:

– Smoke

– Are more than 25 percent under- or overweight

“The doctor would need to get a medical history of both partners. One area that would be explored is whether either partner has had children before.

Even so, the man’s sperm must be tested for any changes. For the man there would be tests to determine the quality of the sperm, such as a semen analysis to determine sperm count or abnormal sperm. Then a HSG test is done on the women. This lets us know if there are blocked tubes.”

The cost of an HSG exam is in a range of $4,000.00, based on checks done at two major laboratories in Kingston. Your doctor would have to refer you and then on the first day of your period, you would call the lab for an exam appointment. Both labs pointed out that the examination fees are not covered by health insurance cards.

Now, based on the results of the HSG the doctor could require further testing or, as Dr Jonas pointed out, “if the tubes are all right, then the doctor may offer her fertility medication to assist in her becoming pregnant. If the problem lays with the man, the doctor could prescribe hormones to increase the sperm count. In addition to the fertility medication, lifestyle changes would be prescribed. Specifically the cessation of smoking and drinking. However, if this treatment is not successful, and the couple still wants to have children, Invitro Fertilisation (IVF) is considered as an option. This is basically the joining of sperm and egg in the lab. Upon fertilization of the egg, the embryo is then housed in the women. This is done at the University Hospital.”

Nurse Walters at the Family Planning Unit of the University Hospital summarised the procedure for All Woman. “The IVF procedure is the fertilisation of the egg outside of the uterus. This is done because of problems affecting the fertility of the male or female. The procedure begins with several tests. Some of them include ovarian reserve test, tests for sexually transmitted diseases (STD), blood count and for a further semen analysis. Based on the initial tests, the doctor would decide what type of Invitro technique to perform.” Walters explained that the two types of techniques revolve around the source of the fertility problem.

“The ICSI procedure is done if tests determined that the sperm count is low. In essence, they search for mature sperm to inject into the egg. If, on the other hand, that is not the problem, then the regular IVF procedure is done where the egg is exposed to any sperm.”

Currently, all of the women who have done the IVF treatment at the University Hospital have conceived. Nonetheless, the hospital takes a cautious stance and Walters states that, “at the start of the procedure, we inform couples that they have a 20-25% chance of getting pregnant.” To begin, one must get a referral from their doctor and pay the US$5,000.00 cost, up front, before treatment begins.

If fertility is a concern, the Baby Centre Website offers a worksheet of questions that a doctor may ask in the preliminary stages of treatment. Use this as a guide to direct you as you begin your path to conception.

Female fertility worksheet

Name:

Date of birth:

Partner’s name:

Partner’s date of birth:

Weight:

Height:

Current medications:

How many months have you been actively trying to get pregnant?

Have you tried charting your basal body temperature, ovulation cycle, and cervical mucus?

Do you have an irregular menstrual cycle? For example, do you have your period more or less often than once a month?

Do you have exceptionally light or heavy periods?

How many days long is your menstrual cycle?

Do you spot between periods? Or have any unexplained bleeding?

During menstruation, do you have any severe pelvic pain or cramping?

Did you get your first period after age 18?

Do you have a feeling of heaviness in your pelvis?

Have you been diagnosed with endometriosis?

Have you been diagnosed with polycystic ovarian syndrome?

Have you had any pelvic or abdominal surgery, such as an appendectomy?

Do you have a history of abnormal Pap smears?

Have you had your tubes tied (tubal ligation)? Have you had a reversal?

Do you have a chronic illness such as diabetes, thyroid disease, or hypertension?

Do you take any medications?

Have you ever been pregnant or given birth and had complications?

Have you had any miscarriages? How many have you had, and did you and your doctor come to any conclusions about the cause? Did they occur in the first 12 weeks or in the second 12 weeks of pregnancy?

Have you ever used an intrauterine device (IUD) as birth control?

Have you ever tested positive for a sexually transmitted disease? Which one?

Do you have pain during sex?

Do you spot after intercourse?

Are you a DES daughter (did your mother take diethylstilbestrol, a synthetic estrogen given to women between 1941 and 1971 to prevent miscarriages)?

Have any other members of your family had problems with genetic defects or stillbirths?

How many cups of caffeinated beverages (coffee, soda, tea) do you drink per day?

Do you drink alcohol? How many drinks per week?

Do you smoke? How many packs of cigarettes a week?

Are you under- or overweight?