Problems conceiving
Dear Dr Mitchell,
I am 24 years old and I live in Fort Lauderdale, Florida. I am having some problems conceiving. The doctors in Florida had tried to give me birth control, but I refused it due to the fact that all my friends on birth control are overweight, so I do not want to risk getting bigger than I am. Is there a natural remedy to help me conceive?
Approximately 90 per cent of women will conceive after having regular, unprotected sexual activity two to three times per week for one year.
The fact that you have not become pregnant may be due to several factors. Inability to ovulate may be a significant underlying cause. Women who ovulate tend to have regular, predictable cycles on average every 28 days and get breast tenderness, bloating, and lower abdominal cramps at around the middle of the cycle which is usually day 14. There is also an associated change in the cervical mucus in women who ovulate when the cervical mucus becomes almost like egg white. On the other hand, women who do not ovulate have painless periods without the mid-cycle cramping and all the other symptoms. The cycle tends to be irregular and unpredictable.
Failure to ovulate may be a result of excessive weight gain or even severe weight loss. Any drastic change in weight or exercise pattern can cause problems with ovulation. You should try to achieve the ideal weight for your height if you are overweight. A reduced caloric diet with three meals and one to two small snacks will definitely help. You should also exercise regularly to burn some calories and lose some body fat. It helps to get some assistance from a dietitian who can recommend the right choice of foods and their proportions. It is always a good practice to walk as often as possible. This will help to burn some calories and improve your fertility.
Polycystic ovarian syndrome is a condition that is associated with increased weight gain, inability to conceive, increased risk of developing diabetes mellitus, and excessive male hormone production. The excess testosterone causes excessive hair growth on the face, chest and abdomen, hair loss around the temples in a male pattern type, acne, deepening of the voice, and sometimes in severe cases, an enlarged clitoris. The treatment is usually to lose the excess weight initially and then fertility drugs, such as clomiphene citrate (clomid), are used to induce ovulation. Metformin is used in addition to clomid to help restore normal metabolism and improve fertility.
If pregnancy is not immediately desired, then the use of a low-dose oral contraceptive pill containing an antiandrogen cyproterone acetate is usually used to help reverse some of the effects of the increased circulating testosterone; reduce the bulky size of the ovaries; establish regular cycles; and then eventually — on discontinuation — helps to improve your chance of becoming pregnant. Once on the birth control pills, you will not conceive. Some contraceptive pills do cause weight gain but there are appropriate ones you can choose where weight gain is not a significant factor.
Other causes of inability to ovulate and become pregnant include thyroid problems and overproduction of prolactin by the pituitary gland. These can be assessed by doing a simple blood test. It is important to establish whether the Fallopian tubes are blocked by doing an X-ray of the tubes (hysterosalpingogram).
Your partner also needs to be evaluated and have a semen analysis done. Males contribute to infertility in as many as 40 per cent of the cases involving infertile couples. Try to lose weight and establish a healthy habit of eating properly. Take folic acid supplementation daily since this helps to prevent birth defects. Your can track your ovulation by checking on your urine at home using the ovulation kit sold in several pharmacies. A blood test done on day 21 counting from the first day of the last menstrual period will determine if you do ovulate, and measures can be taken if this is a problem.
Consult your gynaecologist who will advise you further.
Best wishes.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 968-2025. Dr Mitchell cannot provide personal responses.
DISCLAIMER
The contents of this article are for informational purposes only and must not be relied upon as an alternative to medical advice or treatment from your own doctor.
