It should be a simple as making love, but there are many factors that can threaten conception. And it's not just about falling pregnant - there's the multiple pregnancies issue, choosing the baby's sex, or worrying about carrying to full term? Here are some questions that the Fertility Expert gets asked most often.
Q: Choosing the sex of your baby
I want to know if there are doctors that can help you choose the sex of your baby when your'e trying to conceive?
A: There are procedures available to choose the sex of your baby and this is done via in-vitro fertilization and in addition a procedure called pre-genetic diagnosis (PGD).
However this is a relatively expensive procedure and there are potential technical errors that may be encountered through this procedure. In addition to technical errors there are ethical issues that need to be fully discussed before embarking on a procedure for sexing of your baby.
Q: Will fibroid removal aid conception?
I had a myomectomy (surgical removal of fibroids) in June 2010 and have been trying to fall pregnant before this for almost 2 years. I want to know how successful will the operation be in helping me to get pregnant. My gynae told me to wait till end November 2010 before he can start me on any treatment. I'm now aged 32 and so worried I may never fall pregnant. I'd love to have 2 kids, but feel like time is running out.
A: The presence of a fibroid or fibroids is not usually an indication of infertility. However the presence of a fibroid may result in miscarriages. The fact that you haven’t conceived for two years may indicate other possible causes that may be present in making it difficult for you to conceive.
Firstly you would need to check you hormonal levels and see if ovulation is taking place and all your other hormones are normal. Next you will have to see if your fallopian tubes are opened and that they haven’t been damaged. Lastly your husband will need to go for a semen analysis to assess if there are no male factors present that may be contributing to you taking longer to conceive. You and your doctor will then be in a better position to ascertain if you will be able to fall pregnant soon or require some assistance.
Q: Sperm retrieval
I have had a vasectomy done in 2000, and I am considering the option of sperm retrieval along with my new partner – how does this work?
A: If you need to find out how sperm is retrieved after a vasectomy then 2 methods can be used:
firstly sperm may be retrieved form either a testicular or epididymal aspiration, or alternatively can also be retrieved more effectively with a testis biopsy. This testicular tissue is then frozen and used in an in-vitro fertilisation [IVF] combined with an intracytoplasmic sperm injection [ICSI] cycle.
Q: Endometriosis removal
3 weeks ago I had a Laparoscopy, removed Endometriosis, cyst on left ovary and HPV virus on mouth of womb. We are trying for another baby, but after sex there is still bleeding. When will that end, and when can I expect to fall pregnant?
A: Usually slight bleeding is to be expected especially if some form of specialised treatment was done to the cervix [mouth of the womb]. This bleeding should subside totally after 4-6 weeks and should all other factors be normal conception may be expected within the first 9 months. However this does depend on the grade of the endometriosis as well as other factors such as age, hormonal status, semen parameters and cervical canal and mucus factors as well.
Q: Trying for a baby
My husband and I have been trying for more than a year to fall pregnant with no luck. I am 28 years old, weight 52kg, height 1.7m. I've been off the pill for 5 years now and we've been trying without any form of contraception for more than a year. We've recently started using an ovulation calender.
How much longer before we resort to testing and medical intervention? I'm a bit concerned about not conceiving. There is no history of infertility in our family and besides bladder infections when I was younger, I've had no serious complications with my reproductive system. Please advise, as I need some direction.
A: By definition, the inability to conceive within a year would categorise you as having a problem of infertility. You may not necessarily have a problem but at this stage it is important to find out if a problem exists or not. Problems are generally divided into either male factor problems, female factor problems or if you are lucky, no problems at all. So it is advisable for you to see a gynaecologist or a fertility clinic so as to ascertain if there is a problem, and how it can be sorted out.
Q: Multiple pregnancies through fertility treatment
I am currently pregnant and it is a multiple pregnancy. My concerns are over the babies' health. Are the risks for foetal abnormalities less or higher with pregnancies through IVF, as compared to naturally conceived babies? I am terrified right now. I will only be seeing a foetal specialist in the next month, but this wait is excruciating for me. I just don't know what to expect and as much as I am trying to function as I normally do, with a sound mind, it is proving impossible right now as I am so anxious.
A: The risks of foetal abnormalities are not higher in pregnancies through IVF as compared to naturally conceived babies. However, there are potential problems associated with multiple pregnancies, the most common being an increased risk of miscarriages, as well as a high chance of premature labour and premature deliveries. However, please be rest assured that the risk of congenital abnormalities is the same whether you have conceived through IVF or through natural conception.
Q: Pregnyl use for men
Doc, my hubby has a low sperm count and abnormal sperms. My ovulation and levels have been tested and all is fine. The problem is with him. Can he use these pregnyl injections to increase the sperm count, and make the abnormal sperms normal? How long should he use it for and when? Should I also get clomid or pregnyl to stimulate my ovaries? I am scared to use the medications as I do want to prevent a miscarriage, twins or ectopic pregnancy. I had reversal done of sterilisation and believe all went well. The only problem now is for my hubby to be sorted out.
A: If you had a reversal of sterilisation done and believe all has gone well, may not necessarily mean that it is functioning. It is important for you to have either a laparoscopy or a HSG to ascertain if the fallopian tubes are patent after a reversal. I have no experience in the use of Pregnyl for low sperm count in men, and I would suggest that he sees an urologist to ascertain if there is any identifiable cause for his sperm count and quality.
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(Joanne Hart, Health24, September 2010)