Am I sterile?
Dear Dr Mitchell,
My husband and I have been wanting to have a baby for seven months now. When we have intercourse, he always finishes inside of me, but for some reason I haven’t gotten pregnant yet. I know he can have kids because he has a son with his last girlfriend. Now my question is, is it because I cannot get pregnant? Am I sterile? What can I do?
A couple is usually said to be infertile if conception does not take place after one year of regular sexual activity (two to three times per week). The majority of couples will become pregnant within the 12-month period and up to 90 per cent will conceive within two years. The fact that you have only tried for seven months without success is not unusual and is not really cause for alarm.
The fertile period is usually 14 days counting from the first day of the last menstrual period and this usually extends up to about day 21. If your menstrual period is not on average 28 days, then this will definitely vary. If you have never been pregnant before or if your cycles are irregular, then you should still consider checking to see if you do ovulate. Some women have their monthly periods but do not ovulate.
Symptoms and signs which usually suggest ovulatory cycles include mid-cycle breast tenderness, bloating, pelvic cramps or sharp pains and also pains on the first one to two days of the menstrual periods. Menstrual periods that are totally pain-free are usually associated with cycles in which ovulation does not take place, so pain in this case is a good symptom. A change in the cervical mucus to being thick and “stretchy” is also indicative of ovulation. Simply checking your basal body temperature each morning before getting out of bed is also useful. Ovulation is usually associated with a rise in the body temperature of at least 0.5°F which persists for several days.
A blood test to check the progesterone level in the blood on day 21, counting from the first day of the last menstrual period, will definitely determine if you have ovulated. The other factor that is important is whether your fallopian tubes are blocked. If no conception occurs after one year and tests confirm that you do ovulate, then you should do an x-ray of the tubes called a Hysterosalpingogram (HSG). This will outline any abnormalities of the cavity of the uterus and tubes. If all your tests are normal, then the problem could still be due to problems with your husband. If the child he has with his last girlfriend is over two years old, he should have a semenanalysis done. This should be done even if the child is younger especially if he has not done a paternity test. In the interim, if he smokes, especially if it is marijuana, he should discontinue this. He should also avoid excessive heat (hot tubs, hot baths, tight clothing) as this lowers his sperm count.
You should try timing intercourse for your fertile period and start taking folic acid daily as this will help to prevent birth defects.
Consult your gynaecologist for further details if no conception occurs after one year.
Best wishes.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions and comments via e-mail to allwoman@jamaicaobserver.com or fax to 968-2025. We regret that we cannot supply personal answers.
