What are the signs that I’m infertile?
Dear Dr Mitchell,
I am about to be 25 and I am worried about my fertility. I was just wondering if there are any telltale signs that I might be infertile.
Infertility is defined as the inability in a couple to conceive after one year of regular sexual activity two to three times per week. You are young so that is one good thing in your favour. However, in order for you to become pregnant there are some basic things that need to be in place. You need to ovulate regularly, have fallopian tubes that are not blocked and your partner should have a normal sperm count.
Women who ovulate usually have regular predictable cycles which usually range from 21 to 35 days, with an average of 28 days. There is usually some breast tenderness, bloating and some mild pelvic cramps around the middle of the cycle when ovulation occurs. When ovulation takes place there is usually some amount of menstrual period pains which tends to be pronounced on the first two days of the cycle and then decrease significantly after this. Women who have completely pain free cycles which are irregular and unpredictable tend not to ovulate.
Excessive facial or body hair growth, acne, excessive weight gain, an enlarged clitoris, deepening of the voice and hair loss with a male pattern type of baldness may suggest that ovulation is not occurring regularly. If you have had a history of pelvic infection, Chlamydia or Gonorrhoea infection then this could result in blocked tubes and failure to conceive. The male partner is just as important as the female is.
The following factors are associated with male infertility:
. Smoking, especially marijuana.
. Mumps, infection involving the testes (mumps orchitis).
. Operations on the testes.
. Undescended testes (testes in the groin).
. Small testes and penis.
. Working in conditions of high temperatures (truck drivers, chefs).
. Wearing very tight clothes and underwear.
. Taking prescribed drugs for chronic medical conditions such as hypertension or diabetes mellitus
. History of radiation to the pelvis for problems such as prostate cancer.
. History of a hydrocoele (fluid around the testes) or varicoelle (enlarged veins around the testes).
The best thing to do is to try having regular intercourse two to three times per week for a year and if nothing happens then both you and your partner can get tests done to determine the underlying problem. Your fertile period is usually day 14 to day 21 in a 28-day cycle. You count the first day of the period as day one. The time from ovulation to the onset of the menses is usually fixed but the time from the first day of the period to ovulation is the part of the cycle that varies especially in women who do not have regular cycles.
You are still young at 25 years so make sure you are in a stable relationship and in a position to undertake the long-term responsibilities that are associated with caring for a child.
Best wishes.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@ jamaicaobserver.com; mail c/o Jamaica Observer, 40-421/2 Beechwood Ave, Kingston 5; or fax to 968-2025.
