The other side of infertility

Peju and Dapo had been trying to have a baby for six years when they finally thought of seeking professional help through Assisted Reproduction Technique (ART). Initially, they were convinced that the problem was with Peju. Usually, couples think most problems with infertility are due to the woman. The doctor they met suggested Dapo’s sperm is checked too, simply because it makes it a lot easier to narrow the problem that way. It was a great shock when they discovered that he was Azoospermic, that is, he had zero sperm count!

Azoospermia is not a very common condition quite right, but it happens. Often it could be caused by a blockage and the only definite way to find out what was responsible in this case was to have a testicle biopsy. They did a hormone check and the result came back a little odd. So they had the biopsy and the conclusion was that he lacked any sperm producing cells. All the investigations done on Peju including Laparoscopy came back normal.

The couple was devastated, but at the same time happy that they finally knew what was wrong. They were then persuaded to try out the procedure of Intra- uterine insemination (IUI) using donor sperm. At first, Dapo was unsure about his ability to raise a child that was not biologically his, but later decided it was probably their only hope because the couple could not even begin to think of adoption.

Peju had a really hard time trying to pinpoint her ovulation and after two failed attempts was put on the fertility drug clomid that made it much easier to tell when she was ovulating. After two failed attempts of Intra-uterine insemination , the couple decided to do another cycle and this time luck shone on them. Four weeks later she tested positive and was pregnant. It was really great for Dapo as well. He felt so much involved and he was with Peju throughout. He was there through all the IUI’s and through the pregnancy. After nine months, Peju gave birth to a beautiful and healthy baby girl, Damilola. Now, Dami as she is fondly called is two and a half years old and her parents have never had regrets because she looks so much like both of them. They never even mentioned to each other about the donor but are both very thankful to him.

Six months after the birth of her daughter, Peju herself became a donor. She wanted to help others achieve parenthood as well. The lesson here is that you should not give up. It is all worth it over again if it works. By the time most couples have reached a point of asking for reproductive assistance, they’ve usually learned that the infertility experience is far more than just a physical challenge. The truth is that trying to conceive without success places an emotional strain on partnerships and on each individual’s sense of well-being.

For this reason, fertility experts have long recognised the importance of offering psychological services to their patients. In some practices and for some patients situations, involvement with a counsellor maybe mandatory in helping people experiencing infertility. There are independent consultants who offer their experience in assisting women and couples with issues surrounding infertility, pregnancy loss, and postpartum adjustment. At these consultations, things like personal and family history of psychiatric treatments, alcoholism or drug abuse, emotional instability, individual and family medical history are discussed. Others like learning disorders and /or cognitive impairment and sexual and gynaecological history also come up.

There are usually a number of other important considerations, such as the couple’s beliefs. It’s important to look at the grieving response of both partners. It is better to explore the couple’s relationship in regards to whether they are fully in agreement, or if some level of appeasement is going on.

Timing intercourse to achieve pregnacy and pregnancy testing
It has been demonstrated that pregnancy only occurs if intercourse occurs within six days before and on the ovulation day. From studies, it is known that intercourse after the ovulation day does not result into pregnancy. The probability of conception ranges from 10 per cent when intercourse occurs on the day of ovulation itself.

Data suggests the best timing of intercourse in order to achieve conception is on days 10, 12, 14, and 16 (in case of late ovulation) of a 28 day cycle or days -4.-2, 0, +2 in relation to expected ovulation in the case of cycles different than 28 days.

PREGNANCY TESTING
The general rule of thumb can be used to test for pregnancy a day after late menses or about 15 days after ovulation. The test can be positive anywhere from about two to three days prior to a missed menstrual cycle to four to five days after.

Modern pregnancy tests available over the counter are as accurate as those done at the chemist or in the hospital. The tests are very sensitive to HCG (human chorionic gonadotrophin) also called the pregnancy hormone. The test can be positive a few days before the missed period. An early morning urine is usually most concentrated with this hormone and is best used to achieve accuracy.

Sometimes, women find that they have test positive pregnancy test but later they start their period or it becomes negative. The earlier pregnancy is detected ,the more likely to find miscarriages. Testing with extremely sensitive pregnancy kits show that one in two or three pregnancies are not carried to term. These biochemical pregnancies as they are called, are not clinically diagnosed.

Conversely, women have a negative test after a missed period and then it goes on to be positive and the period never comes. This may be related to delayed ovulation or because the pregnancy test was not sensitive enough. It is advisable to wait at least a week after a missed period for a reliable answer to that question. But often, the suspense is just too much to bear!

Testing really does depend upon how regular your menses are or in other words how regular ovulation occurs. If you tend to be late (longer than 28 days) with your periods or the timing of menses varies by several days of each cycle, then it is better not to waste pregnancy tests by testing at day 28-29 after the last period starts.