What you should do if childless after 2 years in marriage —Expert

Mr and Mrs K.O. are a lovely couple I had the privilege of attending to a few years ago. Mrs K.O. was a 32 year old researcher with a government parastatal who had been diagnosed with having tubal blockage. She gave a history of a pregnancy shortly after their wedding which unfortunately ended in a miscarriage. She had an evacuation of the womb done at a private facility but she started bleeding again a week later and a scan confirmed some retained tissue. She had to have a repeat evacuation done.  She was convinced (and rightly so) that this was responsible for the tubal blockage that was later diagnosed!

There was no fertility concern before that miscarriage, she assured me. Her husband was a soft spoken Engineer who just wanted the best for his wife.  Mrs K.O. has had several flushing of the tubes and was eventually advised to have a tubal surgery. Three years after the tubal surgery they were still waiting for the fruit of the womb.

After evaluation, I counseled them that neither tubal flushing nor tubal surgery was likely to benefit them. I therefore advised them to give serious consideration to in vitro fertilization. IVF! Mrs K.O. exclaimed, saying “I am just 32-years-old for crying out loud. Isn’t IVF a last resort kind of treatment for old couples?” I carefully tried to explain to them that as long as the tubes are blocked, the sperms will have a difficult time getting to the eggs and conception will be difficult. IVF technology helps to bypass the function of the fallopian tubes. The sperm and eggs are made to fertilize outside the body and the resulting embryos are returned into the womb for implantation. “It is also very expensive” she added. “How expensive” I asked her? But she had no idea. She just knew it was EXPENSIVE. “If you can afford a car, you can afford IVF,” I told them. They had to plan for it financially but it was worth it. Though their first attempt at IVF was unfortunately unsuccessful, I encouraged them to give it another shot and we were rewarded with a big fat positive line: they were blessed with two sons nine months later. I can never forget their names – Joshua and Caleb.

In this episode we will be discussing the causes of female infertility which will be highlighted below:

Fallopian tube blockage

This is the commonest cause of female infertility in this part of the world. The fallopian tubes are the tubes along which an egg travels from the ovary to the womb. The egg is fertilized by the sperm as it travels down the fallopian tubes. When it reaches the womb, it is implanted into the womb’s lining, where it continues to grow. If the womb or the fallopian tubes are damaged, or stop working, it may be difficult to conceive naturally. Tubal blockage can be due to factors like infections of the reproductive system. This occurs most commonly from sexually transmitted infections, also after pregnancy termination or delivery.

Operations such as fibroid removal can sometimes cause damage and scarring to the fallopian tubes. This accounts for the misconception that after a fibroid surgery, a woman may not be able to conceive. However, this is not so. If a fibroid surgery is complicated by infection, it could cause extensive scarring which may eventually lead to tubal blockage.

Ovulation disorders

Infertility is commonly caused by problems with ovulation (the monthly release of an egg). Some problems entirely halt the release of egg by women while some others; cause an egg to be released during some cycles, but not others.

Ovulation problems can occur as a result of many conditions, such as:

• Polycystic ovary syndrome (PCOS) – a condition that makes it more difficult for your ovaries to produce an egg
• Thyroid problems – both an overactive thyroid gland (hyperthyroidism) and an underactive thyroid gland (hypothyroidism) can prevent ovulation
• Premature ovarian failure – where a woman’s ovaries stop working before she is 40.

Endometriosis

Another cause includes gynaecological conditions such as endometriosis. Endometriosis is a condition where small pieces of the womb lining, known as the endometrium, start growing in other places, such as the ovaries.

This can cause infertility because the new growths form adhesions (sticky areas of tissue) or cysts (fluid-filled sacs) that can block or distort the pelvis. These make it difficult for an egg to be released and become implanted into the womb.

It can disturb the way that a follicle (fluid-filled space in which an egg develops) matures and releases.

Age related infertility

Infertility in women is closely linked to age.  This is because the quality of the female egg starts to reduce after the age of thirty. The biggest decrease in fertility begins during the mid-thirties. Among women who are 38 years and above, chances of natural conception are less than 15 per cent and after 40 years, it is less than 10 per cent. This is why the simplest thing to do to avoid infertility is to start raising a family early. The next best thing is to see a specialist after two years of trying on your own without success. Feel free to give us a call or visit us at our centre if you need any of our services. Vine Branch Fertility Centre has a tradition of excellence and affordability. We would be delighted to initiate the investigation and formulate a treatment plan that is both cost effective and time efficient.

Our team of fertility specialists, experienced nurses, and skilled laboratory professionals will do their best to put a smile on your faces.

Pregnancy tips

Ready to be pregnant now? Follow these tips to help you conceive more quickly.

• Go off your birth control —ahead of time

After you’ve been using birth control for awhile, it may take your body a few cycles to start ovulating regularly and be primed for pregnancy. Getting off birth control way ahead of time gives you time to track your cycle to figure out exactly when you ovulate which is key for timing your babymaking.

• Figure out your fertile days

No matter how often you and your partner have sex, if you skip the key days out of the month when your egg is raring to go, you won’t get pregnant. The biggest mistake women trying to conceive make is not knowing exactly when they ovulate.

• Have sex before you ovulate

Those hardy sperm can stick around in your uterus and fallopian tubes for two to three days, but your egg only lasts for 12 to 24 hours after it’s released. So having sex before you ovulate boosts the chances that there will be sperm around to greet your egg as soon as it debuts.