Unable to conceive after a miscarriage
Dear Dr Mitchell,
In 2014 I got pregnant but had a miscarriage. I was treated at hospital (with a ‘wash out’) and now my boyfriend wants a baby but I can’t conceive. I’m afraid that something is wrong with my body. What could be wrong?
The problem that you are experiencing with the inability to conceive may be due to an underlying problem with either yourself or your partner. Once you have been sexually active two to three times per week for a year you should conceive, all being well.
The fact that you were pregnant in 2014 and had a dilation and curettage is of significance. In some cases the lining of the uterus can become damaged from excessive scraping at the time of dilation and curettage and this can result in a subsequent inability to conceive.
It is important to get an X-ray of the Fallopian tubes done (Hysterosalpingogram HSG) to determine if the tubes are blocked as a consequence of an infection. The HSG will also help to determine if the lining of the uterus is normal.
A pelvic ultrasound should be done to check the ovaries for cysts and to rule out uterine fibroids and endometriosis. A blood test done to check your progesterone level on day 21, counting from the first day of the menstrual cycle, will help to determine if you are actually ovulating. If it is confirmed that you do not ovulate regularly, then medication can be given to help improve your chances.
Your partner needs to have a semen analysis done to check on the sperm count and motility. This is important because males contribute to infertility in a significant number of couples. If he is the problem then he can also be helped with specific treatment depending on the underlying problem. If he smokes, drinks alcohol excessively, or wears tight underpants, you should encourage him to discontinue.
Consult your family doctor or gynaecologist who will do the baseline investigation and make the appropriate referral.
Best regards.
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.
