Q: Greetings Dr. Ketch, I am 31 years old – in the journey of trying to get pregnant. I had a miscarriage in March 2017; before then, earlier in 2016, I was diagnosed with fibroids. I had a myomectomy to take out the fibroids and eventually the following year that’s 2017 I conceived but had a miscarriage. Since then, over 6months now I have been unable to conceive again. Please doctor advise me on tips and what am supposed to do
A: Not being able to have a child at the time that we expect it can be a harrowing experience…especially in Africa where a couple of months into your marriage, family members and even outsiders are beginning to look at you in suggestive ways. Some actually ask outright, ‘when are you guys planning to start having babies?’
However, in the medical world, we can only agree that perhaps there might be an issue after one full year of trying to have babies with no luck. This, however, implies that there is frequent and unprotected sexual intercourse. Frequency in this respect means that sexual intercourse should be at least 3 times in a week. Unprotected means that there should be no barrier protection like a condom. Don’t laugh…this has been known to happen. People use a condom and then expect to get pregnant J The ejaculate (semen) should also be of significant volume.
Therefore, if this has been established to have been happening for one year, the next thing is to run tests. The less ‘invasive’ tests are usually done first. This usually involves the husband who provides his semen for analysis. Other tests will now be run on the wife, which presumably has already happened in the case above.
Some causes of infertility in men include problems with the production of sperm, problems with the delivery of sperm, being exposed to environmental toxins (like sitting in hot tubs) and cancer.
Some causes of infertility in women include problems with ovulation, problems with the uterus and cervix, blockage or damage of the fallopian tube, thyroid problems, cancer etc. Fibroids may or may not cause inability to have a pregnancy. It depends on size and position. Big fibroids in the area of the womb where a baby is meant to implant may cause a miscarriage or indeed, failure of the fertilized embryo to implant. Your doctor will take a decision on what to do with the fibroids based on size, symptoms etc., if this is still a problem.
Other risk factors for both sexes include use of alcohol and tobacco, being overweight or even underweight and age (the older people get, the more difficult it is to get pregnant).
Where a problem is identified, this is taken care of through various options like the use of drugs or surgery.
Oftentimes, no reason can be found for infertility. In these instances, the couple may want to consider assisted reproduction. Your doctor will discuss the different options available in your area and if you can afford it, he will suggest other centers where better facilities exist.
Prevention of infertility is targeted at the risk factors. Quit smoking, reduce alcohol consumption, exercise moderately and keep your weight within normal limits.
Infertility is really 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, patiently and prayerfully J
On your miscarriage….condolences on the loss of your baby. It is never an easy experience for anyone to go through.
Unfortunately, often times, the cause of a miscarriage is not identified. You need to understand this so that you don’t blame yourself unduly. Having said that though, first trimester miscarriages are mainly due to problems with the baby/fetus. These problems could be due to problems with the placenta. This is how the baby receives its nutrients in the womb and so, if this organ cannot deliver, a miscarriage might occur. There may also be a problem with the baby’s chromosomes, such that a baby may receive too many or too few genetic materials or there may be a damaged egg/sperm. Other associated risk factors include smoking and drinking alcohol, being overweight, malnutrition, increased maternal age, trauma and drug abuse. By the way, trimester is 3 months of pregnancy. Therefore, first trimester refers to the 1st three months, 2nd trimester, the 2nd three months and 3rd trimester, the last three months
To try for a pregnancy again, remember to ensure there is unprotected sexual intercourse at least three times a week with ejaculation of sufficient amounts of semen. You should start on folic acid supplements as soon as you can, to prepare you and baby for the journey ahead.
To prevent a recurrence, focus on ensuring that you stay healthy and do not indulge in harmful habits like smoking and excessive alcohol drinking. Other helpful tips include eating healthy, keeping weight within normal parameters, avoiding trauma and not abusing drugs.
In addition, as soon as you get pregnant again, you should register for antenatal as soon as possible and keep to your appointments religiously.
For more on this topic, please click on the link below:
All the best!