Q: Good evening ma’am! Please, I had two kids through CS and the second child will be 3yrs in July and I used withdrawal method all through. Since last year July, I started trying for conception all to no avail. I went for scan and I was told there was no problem. But up till now, there’s no baby to show for it. I am worried and I am 36yrs! Please, Doc help me.
A: Withdrawal method involves pulling the male organ out of the vagina just before ejaculation. This method can protect against pregnancy if used well but does not protect against STIs. It has been argued in some quarters that the pre-ejaculate (a lubricating fluid) may contain some sperm cells and so even if your partner is able to withdraw before ejaculation, the harm would have been done. However, the sperm in the pre-ejaculate is not there at the time the fluid is produced, but is sperm from previous ejaculations that was probably left in the urethra. It is believed that urinating and cleaning the tip of the penis before sexual intercourse helps to clear the urethra of the sperm left from previous ejaculations. Congratulations on having been able to prevent pregnancy using this method! 😀
Secondary infertility is very common, but not often talked about. Even when women present themselves to the hospital, they don’t come out straight to let the doctor know what actually brought them to hospital, and rather list a series of symptoms most often, unconnected to their primary (main) concerns. Secondary infertility is the inability to become pregnant, or carry a pregnancy to term following the birth of one or more children. There however has to be frequent (at least three times a week), unprotected intercourse for a period of at least one year (six months for women older than 35), for this definition to be complete.
The causes include impaired sperm production (quantity and/or quality), erectile dysfunction, or new disease conditions in males. In females the causes include tubal damage (that is damage to the tubes from infections or adhesions in which case certain body surfaces stick together following surgery), ovulation problems (menstrual abnormalities), uterine conditions (infections from complications during a prior delivery, retained placenta, or a miscarriage which wasn’t properly cared for), complications from previous pregnancy(excessive bleeding following delivery) and changes in you or your partners’ risk factors; like changes in age (increasing age), weight, smoking and use of certain medications or disease conditions.
Oftentimes, no reason can be found for the infertility and this is even more nerve wracking, because nobody has an idea how long it’s going to last or what treatments are going to work best. Joining support groups and/or counseling sessions may be helpful during this period of waiting.
Prevention of infertility is targeted at the risk factors. Quit smoking, reduce alcohol consumption, exercise moderately and keep your weight within normal limits.
Find a hospital with a good Obstetrics and Gynaecology specialist. The closest teaching hospital to you may be a good place to start your search. He will examine you properly and advice on the best course of treatment for you.
All the best! J