Desperate for a baby
Dear Dr Mitchell,
My husband just turned 50 and I am 30. We have been having unprotected sex for years now, with no results. I was diagnosed with mild PCOS a year ago, and was placed on Metformin and another medication, but I could not afford to continue the treatment. My doctors see no issue with me, and my husband refuses to be examined. I am desperate for a child.
The fact that you have tried for several years to conceive without success is significant. Approximately 90 per cent of couples will conceive after one year of regular sexual activity two to three times per week.
Polycystic ovarian disease is a relatively common condition that is associated with weight gain, irregular menstrual periods, excessive production of male hormones, an increased tendency to develop diabetes mellitus, and difficulty with becoming pregnant. The mainstay with the management of women with polycystic ovarian disease is to lose weight by embarking on a weight loss programme with diet and exercise.
With the use of drugs such as Metformin and Clomiphene Citrate to induce ovulation, the outcome is usually very good, with most women achieving regular cycles. With loss of weight to achieve the ideal weight for height, this also reduces the risks of developing diabetes mellitus and hypertension in pregnancy once conception occurs.
The fact that your husband is 20 years older is significant. If he is 50 years old and has not had any children, this could suggest that he might not have any sperm, or that he has a significantly low sperm count and possible abnormalities in the movement of the sperm. If he has had children before then he could have had a vasectomy that he has not declared to you. The fact that he has refused to be examined is significant. The process of having a baby requires the commitment of both partners and he has to be committed to this effort.
He needs a physical examination and a semen analysis done. If he refuses you could encourage him to go for counselling or ask a close friend whom he respects to talk to him.
If this is not forthcoming, then you could use donor sperm from a younger person. This can be obtained from the Fertility Management Unit at the University of the West Indies. Sperm can be obtained locally or brought in from other sperm banks through the fertility unit. Artificial insemination can be done successfully with a good outcome. If that is unsuccessful, then in-vitro fertilisation may be used where the egg is removed from your ovary under ultrasound guidance and then fertilised with the donor sperm and replaced in the uterus. This is all with the presumption that your husband does not come on board. Consult your gynecologist who will advise you further.
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. All responses are published. 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.
